Singh V, Gupta M M, Satyanarayana L, Parashari A, Sehgal A, Chattopadhya D, Sodhani P
Institute of Cytology and Preventive Oncology, Maulana Azad Medical College Campus, New Delhi, India.
Sex Transm Dis. 1995 Jan-Feb;22(1):25-30. doi: 10.1097/00007435-199501000-00005.
To determine the association, if any, between different reproductive tract infections and cervical inflammatory epithelial changes.
Clinical, colposcopic, cytologic, and microbiologic screening for reproductive tract infections was conducted. Subjects were screened for Chlamydia trachomatis, Neisseria. gonorrhoeae, Trichomonas vaginalis, bacterial vaginosis, yeast vaginitis, human papillomavirus, and serology for herpes simplex viruses, syphilis, and human immunodeficiency virus-1 and -2. The subjects were 257 women who visited a maternal and child health center between January 1992 and December 1993.
Cervical cytology revealed inflammatory epithelial changes in 207 women (80.5%), the highest proportion in the published series. Inflammatory epithelial changes were significantly associated with the number of reproductive tract infections. Risk increased up to 72.6 fold when women were infected with two or more agents. The positive predictive value of inflammatory epithelial changes for any infection was 88.4%, whereas the negative predictive value for any infection was 63.4%. In univariate analysis, the cervical inflammatory epithelial changes were significantly associated with infections such as chlamydia (28.0%), human papillomavirus (56.5%), Trichomonas vaginalis (18.3%), bacterial vaginosis (38.2%), and herpes simplex virus as evidenced by the presence of immunoglobulin M antibodies (28%). Multivariate analysis, however, revealed an independent association of inflammatory epithelial changes with chlamydia (odds ratio, 21.3; 95% confidence interval, 2.6, 181.3), human papillomavirus (odds ratio, 13.5; 95% confidence interval, 4.5, 39.6), and bacterial vaginosis (odds ratio, 22.6; 95% confidence interval, 2.9, 181) only.
Cervical inflammatory epithelial changes are significantly associated with reproductive tract infection. Cervical inflammatory epithelial changes predict correctly to an extent of 81% infections with chlamydia, bacterial vaginosis, and human papillomavirus infection. A negative smear, on the other hand, rules out these infections to an extent of 83%.
确定不同生殖道感染与宫颈炎性上皮改变之间是否存在关联（若存在关联）。
对生殖道感染进行临床、阴道镜、细胞学及微生物学筛查。对受试者进行沙眼衣原体、淋病奈瑟菌、阴道毛滴虫、细菌性阴道病、念珠菌性阴道炎、人乳头瘤病毒检测，以及单纯疱疹病毒、梅毒和人类免疫缺陷病毒1型及2型的血清学检测。研究对象为1992年1月至1993年12月间到一家妇幼保健中心就诊的257名女性。
宫颈细胞学检查显示207名女性（80.5%）存在炎性上皮改变，这一比例在已发表的系列研究中最高。炎性上皮改变与生殖道感染的数量显著相关。当女性感染两种或更多病原体时，风险增加高达72.6倍。炎性上皮改变对任何感染的阳性预测值为88.4%，而对任何感染的阴性预测值为63.4%。单因素分析显示，宫颈炎性上皮改变与衣原体感染（28.0%）、人乳头瘤病毒感染（56.5%）、阴道毛滴虫感染（18.3%）、细菌性阴道病（38.2%）以及单纯疱疹病毒感染（通过免疫球蛋白M抗体的存在证明，28%）等感染显著相关。然而，多因素分析显示，炎性上皮改变仅与衣原体感染（比值比，21.3；95%置信区间，2.6，181.3）、人乳头瘤病毒感染（比值比，13.5；95%置信区间，4.5，39.6）和细菌性阴道病（比值比，22.6；95%置信区间，2.9，181）存在独立关联。
宫颈炎性上皮改变与生殖道感染显著相关。宫颈炎性上皮改变能在一定程度上正确预测衣原体、细菌性阴道病和人乳头瘤病毒感染，感染率为81%。另一方面，涂片阴性可在83%的程度上排除这些感染。
