Critchlow C W, Wölner-Hanssen P, Eschenbach D A, Kiviat N B, Koutsky L A, Stevens C E, Holmes K K
Department of Epidemiology, University of Washington, Seattle, USA.
Am J Obstet Gynecol. 1995 Aug;173(2):534-43. doi: 10.1016/0002-9378(95)90279-1.
Our purpose was to assess determinants of cervical ectopia and cervicitis, specifically after adjustment for cervical infection.
A cross-sectional study was conducted with colposcopic, cytologic, and microbiologic examination of 764 randomly selected women attending a sexually transmitted disease clinic and 819 consecutive college students undergoing routine annual examination.
After we controlled for potential confounders, cervical ectopia was positively associated with oral contraception and Chlamydia trachomatis infection and negatively associated with aging in both populations, with recent vaginal douching in patients with sexually transmitted diseases, and with current smoking in college students. Oral contraception wa also associated with the radius of ectopia, and among users of oral contraception ectopia was associated with duration of oral contraception. Cervicitis (evaluated by Gram stain, Papanicoloau smear, and colposcopy) was associated with cervical infection by C. trachomatis and cytomegalovirus (both populations) and with gonorrhea and cervical herpes simplex virus infection (patients with sexually transmitted diseases). Cervicitis was independently associated with ectopia but not with oral contraception after we adjusted for these four cervical infections. However, oral contraception was associated with edema and erythema of the zone of ectopia among women without cervical infection.
Oral contraception, aging, cervical infection, smoking, and douching have effects on cervical ectopia that may influence the acquisition, transmission, or effects of sexually transmitted agents. Ectopia is associated with young age, oral contraception, and cervical infection; cervicitis is associated with ectopia and cervical infection by C. trachomatis, Neisseria gonorrhoeae, herpes simplex virus, and cytomegalovirus. In women without cervical infection, edema and erythema of the zone of ectopia are associated with oral contraception.
我们的目的是评估宫颈外翻和宫颈炎的决定因素，特别是在对宫颈感染进行校正之后。
对764名随机选取的就诊于性传播疾病诊所的女性以及819名接受常规年度检查的连续大学生进行了阴道镜、细胞学和微生物学检查，开展了一项横断面研究。
在我们对潜在混杂因素进行控制之后，宫颈外翻在这两个人群中均与口服避孕药和沙眼衣原体感染呈正相关，与年龄增长呈负相关，在性传播疾病患者中与近期阴道灌洗有关，在大学生中与当前吸烟有关。口服避孕药还与外翻半径有关，在口服避孕药使用者中，外翻与口服避孕药的使用时长有关。宫颈炎（通过革兰氏染色、巴氏涂片和阴道镜检查评估）在两个人群中均与沙眼衣原体和巨细胞病毒宫颈感染有关，在性传播疾病患者中与淋病和宫颈单纯疱疹病毒感染有关。在我们对这四种宫颈感染进行校正之后，宫颈炎与宫颈外翻独立相关，但与口服避孕药无关。然而，在无宫颈感染的女性中，口服避孕药与外翻区域的水肿和红斑有关。
口服避孕药、年龄、宫颈感染、吸烟和阴道灌洗对宫颈外翻有影响，可能会影响性传播病原体的获得、传播或影响。外翻与年轻、口服避孕药和宫颈感染有关；宫颈炎与外翻以及沙眼衣原体、淋病奈瑟菌、单纯疱疹病毒和巨细胞病毒的宫颈感染有关。在无宫颈感染的女性中，外翻区域的水肿和红斑与口服避孕药有关。
