Relationship Between Cervical Squamous Intraepithelial Lesions And Vaginal Microecology In Postmenopausal Women With Human Papillomavirus Infection

Objective:To investigate the correlation between cervical squamous intraepithelial lesions of postmenopausal human papillomavirus-infected women and vaginal microecological changes,and to restore the vaginal microecological balance and block cervical squamous intraepithelial lesions of postmenopausal human papillomavirus provide the basis for the occurrence and development.Methods:Collect post-menopausal women who visited the gynecological clinic of Baoding First Central Hospital from April 2018 to April 2019.High-risk human papillomavirus infection with or without thin-layer liquid-based cytology tests（thinprep cytologic test,TCT）was abnormal,and 122 patients with cervical squamous intraepithelial lesions were further diagnosed by colposcopy as pathological group,and 129 patients with cervical squamous intraepithelial lesions were diagnosed as normal group.Compare the results of vaginal micro-ecological examination of the diseased group and the normal group,and observe the detection rate of bacterial vaginosis and vulvovaginal candidiasis,vaginal cleanliness,lactobacillus content,whether hydrogen peroxide is lacking,and whether metabolites of microorganisms in the vagina.Logistic regression analysis was used to analyze the risk factors of cervical squamous intraepithelial lesions in postmenopausal women with human papillomavirus infection.Results:1.Among the vaginal micro-ecological morphological indicators,the detection rates of bacterial vaginosis（BV）in the diseased group and normal group were 32.79% and 12.40%（P<0.001）,the detection rates of vulvovaginal candidiasis（VVC）were 14.75% and 10.85%（P>0.05）,vaginal cleanliness III to IV were 68.03% and 46.51%（P<0.05）,lactobacilli were13.93% and 20.16%,（P>0.05）,white blood cell（WBC）counts>10/highest possible frequency（HPF）were 62.30% and 40.31%（P<0.001）.The detection rate of vulvovaginal candidiasis and the content of lactobacillus in the two groups of patients were not statistically significant.2.Among the vaginal micro-ecological functional indicators,the lesion group and the normal group had hydrogen peroxide（H₂O₂）deficiency of15.57% and 22.48%（P>0.05）,the leukocyte esterase（LE）positive were36.07% and 17.83%（P<0.05）,sialidase（SNA）positive were 19.67% and6.20%（P<0.05）.The lack of hydrogen peroxide in the two groups of patients was not statistically significant.3.Logistic regression analysis showed that infection with bacterial vaginosis,poor cleanliness,white blood cell>10/（HPF）,leukocyte esterase positive and sialidase positive were significantly associated with cervical squamous intraepithelial lesions.Conclusion:Infection with BV,poor vaginal cleanliness,multiple leukocytes,and positive leukocyte esterase and sialidase may be closely related to the occurrence and development of cervical squamous intraepithelial lesions in postmenopausal women with human papillomavirus infection.