HPV分型检测在CIN患者LEEP术后随访的临床研究.docVIP

HPV分型检测在CIN患者LEEP术后随访的临床研究 　　摘要：目的 检测宫颈上皮内瘤变患者Ⅰ-Ⅲ（CINⅠ-Ⅲ）高频电刀锥切术（LEEP）治疗后高危型乳头瘤病毒（HPV）及其亚型清除的情况，评价手术疗效及其随访价值。方法 200例因CINⅠ-Ⅲ接受LEEP手术治疗的患者，随机分为三组，术前HPVDNA检测证实高危型HPV感染。治疗后6个月再次检测HPVDNA，如为高危型HPV持续感染再次行活检病理学检查。比较各组HPV及其亚型术后清除率。结果 各年龄组LEEP治疗后HPV清除率分别为93.7%、71.4%、64.2%，各年龄组两两比较有统计学意义（P0.05）；随CIN级别增加，术后HPV16、18亚型清除率下降，其它亚型清除率下降， 不同级别间各亚型清除率比较无统计学意义（P0.05）。结论 LEEP可在切除病变的同时清除HPV，是一种简单安全的手术；术后6个月HPV分型检测是一种较好的随访方法；对年龄较大，病变程度高，尤其是术后HPV16、18亚型持续感染人群应密切加强随访。 　　关键词：宫颈上皮内瘤变；人乳头瘤病毒；高频电刀锥切术 　　中图分类号：R711.74 文献标识码： A 　　Detection of HPV Types in CIN LEEP Postoperative Follow-up of Patients with Clinical Studies 　　HU Yan-mei 　　（Panzhihua Maternal and Child Health Hospital， Panzhihua 617071，Sichuan，China） 　　Abstract：Objective Detection in patients with cervical intraepithelial neoplasia Ⅰ - Ⅲ （CIN Ⅰ - Ⅲ） high frequency electric knife cut method （LEEP） after treatment of high-risk type cone papilloma virus （HPV） and its subtypes removal， evaluating the effect of surgery and follow-up value. Methods 200 cases for CIN Ⅰ-ⅢLEEP surgery treatment of the patients， randomly divided into 3 groups， preoperative HPVDNA tests identified high-risk type HPV infection. 6 months after treatment HPVDNA again detection， such as high risk type HPV persistent infection， biopsy pathology examination again. Comparison between groups of HPV and its subtypes postoperative clearance. Results HPV clearance after LEEP treatment among all age groups are 93.7%， 71.4% and 93.7% respectively， two comparison among all age groups was statistically significant （P0.05）； With the increase of level of CIN， HPV16， 18 subtype clearance decreased postoperatively， other subtypes clearance decreased，each subtype of clearance between different levels is no statistical significance （P0.05）. Conclusion ①LEEP in the diseased clear HPV at the same time， is a kind of simple and safe operation；②after 6 months of HPV types detection method is a kind of good follow-up；③To older， high degree of pathological changes， especially po