生殖医学杂志

目的 探讨重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术对宫颈癌前病变患者T淋巴细胞的影响。方法 选取2019年2月至2023年2月如皋市人民医院接收的70例高级别鳞状上皮内病变(HSIL)患者为研究对象，通过随机数字表法分为对照组(n=35)与观察组(n=35),对照组予以高频电刀宫颈环切术治疗，观察组予以重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术治疗。比较两组患者人乳头瘤病毒(HPV)转阴率、治疗前后的HPV病毒载量、T淋巴细胞水平[CD3阳性细胞(CD3⁺)、CD4阳性细胞(CD4⁺)、 CD8阳性细胞(CD8⁺)、CD4⁺/CD8⁺]、肿瘤标志物[癌胚抗原199(CA199)、细胞角蛋白19(CK19)、鳞状细胞癌抗原(SCCA)]、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]水平差异，并对比两组术后并发症发生情况。结果 治疗前，观察组与对照组在HPV病毒载量、T淋巴细胞水平、肿瘤标志物、炎症因子水平方面的差异均无统计学意义(P>0.05)。治疗后，两组的HPV病毒载量均显著低于治疗前水平(P<0.05),且观察组治疗后的病毒载量显著低于对照组(P<0.05),观察组患者的HPV转阴率显著高于对照组(P<0.05);两组CD3⁺和CD4⁺水平及CD4⁺/CD8⁺比治疗前均上升，且观察组显著高于对照组(P<0.05),两组CD8⁺水平均有下降，且观察组显著低于对照组(P<0.05);两组CA199、CK19、SCCA水平以及TNF-α、IL-6水平较治疗前均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。观察组中阴道出血、感染及宫颈粘连的总发生率显著低于对照组(2.86%vs. 17.14%,P<0.05)。结论 重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术可以显著提高HSIL患者的HPV转阴率，降低HPV病毒载量，调整T淋巴细胞水平，降低肿瘤标志物和炎症因子水平，减少术后并发症，是一种有效的治疗方法。

Objective:To explore the effects of recombinant human interferon α-2b gel assisted high-frequency loop electrosurgical excision procedure(LEEP) on T lymphocytes in patients with cervical precancerous lesions.Methods:From February 2019 to February 2023,70 high-grade squamous intraepithelial lesions(HSIL) patients treated at Rugao People's Hospital were randomly divided into a control group(n=35) and an observation group(n=35). The control group was treated with LEEP,and the observation group was treated with recombinant human interferon α-2b gel assisted LEEP. The HPV clearance rate, HPV viral load before and after treatment, T lymphocyte levels including CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺,tumor markers including carbohydrate antigen 199(CA199),cytokeratin 19(CK19) and squamous cell carcinoma antigen(SCCA),and levels of inflammatory factors including tumor necrosis factor(TNF)-α and interleukin(IL)-6 were compared between the two groups, as well as postoperative complications.Results:Before treatment, there were no significant differences in HPV viral load, T lymphocyte levels, tumor markers, and inflammatory factor levels between the observation and control groups(P>0.05). After treatment, the HPV viral load significantly decreased in both groups(P<0.05),with the observation group showing a significantly lower viral load than the control group(P<0.05). The HPV clearance rate was significantly higher in the observation group(P<0.05). Both groups showed an increase in levels of CD3⁺,CD4⁺,CD4⁺/CD8⁺,with the observation group being significantly higher than the control group(P<0.05). Both groups showed a decrease in CD8⁺,with the observation group being significantly lower than the control group(P<0.05). Levels of CA199,CK19,SCCA,TNF-α and IL-6 decreased in both groups(P<0.05),with the observation group being significantly lower than the control group(P<0.05). Furthermore, the incidence of vaginal bleeding, infection, and cervical adhesion in the observation group was 2.86%,lower than that in the control group(17.14%),with all comparative differences being significant(P<0.05).Conclusions:Recombinant human interferon α-2b gel assisted LEEP can significantly improve the HPV clearance rate, reduce HPV viral load, adjust T lymphocyte levels, decrease tumor markers and inflammatory factor levels, and reduce postoperative complications, proving to be an effective treatment method.