SOME ASPECTS OF THE COMPLEX TREATMENT OF WOMEN OF REPRODUCTIVE AGE WITH CERVICAL ECTOPY ASSOCIATED WITH HUMAN PAPILLOMAVIRUS

Abstract

The aim of the study – on the basis of the analysis of data from literary sources and materials of own observations, to compare the efficiency and safety of the use of Tirolon and Inosin Pranobex drugs in the complex treatment and prevention of relapse in women of reproductive age with ectopic cervix on the background of a papillomavirus infection of high-risk oncogenic (types 16, 18, 31, 33), as well as study immune and hormonal changes in the specified pathology.

Materials and Methods. During the five years (2012–2017) before and after the complex treatment, both 87 patients aged 18 to 35 years old were examined using both conventional and special diagnostic methods with an ectopic examination of the cervical epithelium of the cervix associated with high-risk papillomavirus infection oncogenic risk. Polymerase chain reaction studies were performed using test systems for the amplification of homologous DNA fragments of a human papillomavirus virus of high-oncogenic risk (types 16, 18, 31, 33). Extended colposcopy was performed by the colposcope MK – 200. A cytological and immunological study was conducted, blood concentrations of gonadotropic and steroid hormones were studied. To evaluate the biocenosis of the vagina, selective differential diagnostic nutrient media were used by determining the species and number of microorganisms of vaginal contents according to generally accepted methods.

Results and Discussion. The average age of women was (26.5±2.7) years, the average duration of the disease (3.8±2.1) years and probably did not differ between the established clinical groups. During the extended colposcopy, after the end of treatment, 20 (68.97 %) patients of the I (main), 19 (65.52 %) – ІІ (main) and 17 (58.62 %) – of ІІІ (control) groups were noted, the absence of the ectopic of the neck uterus. Laboratory data after treatment demonstrated a normalization of estradiol and progesterone levels in 29 (100 %) patients in the I (main) group. In II (main) group normalization of gonadotropic hormones was observed in all 29 (100 %) patients; Normal parameters of estradiol were recorded in 9 (31.03 %) patients, and progesterone in 7 (24.14 %). After the performed immunotherapy, it was possible to achieve elimination of human papillomavirus in 24 (82.76 %) patients of the I (main) and 23 (79.31 %) of women of the II (main) group.

Conclusion. The results of the study were obtained (in 82.76 % of patients in group I and 79.31 % of the II clinical groups, the elimination of the human papillomavirus was confirmed by polymerase chain reaction tests, good tolerance and no side effects), and the literature data indicate a high clinical efficacy of active reagent drugs which are tiloron and inosin in the scheme of integrated treatment of women of fertile age with ectopic cervix associated with papillomavirus infection.