男性包皮状态与女性配偶高危型人乳头瘤病毒感染的相关性探讨

目的:探讨男性包皮状态对配偶感染HR-HPV的影响。方法:调查800对常规体检的已婚夫妇。由泌尿外科医生询问已婚男性有无包皮环切手术史并检查男性的包皮状态。由妇科医生取其配偶宫颈脱落细胞进行HR-HPV检测。男性包皮检查结果与其配偶的宫颈组织HR-HPV检测结果进行匹配分析。结果:800例男性中,包皮正常235例,占29.4%,包皮过长516例,占64.5%,包茎26例,占3.3%,曾行包皮环切术男性23例,占2.8%。800例女性共检出HR-HPV阳性344例,占43.0%。包皮异常组(包括包皮过长和包茎)男性的配偶HR-HPV阳性率为53.5%(290/542),包皮正常组(包括包皮环切术后)男性的配偶HR-HPV阳性率为20.9%(54/258),差异有统计学意义(χ2=75.68,P=0.000)。女性HPV感染以16、52、18、33、58型为主,分别占33.2%(126/380)、26.8%(102/380)、13.2%(50/380)、11.6%(44/380)、10.3%(39/380)。两组间HR-HPV亚型分布无显著性差异(χ2=2.761,P=0.737)。结论:男性包皮过长或包茎是其配偶感染HR-HPV的因素之一,有必要推行包皮环切术以降低女性HPV感染。     

3014例人乳头瘤病毒分型检测结果分析

目的:了解常居广州地区的性病高发人群最近一年人乳头瘤病毒(HPV)的感染情况及其型别分布,为防治HPV感染提供最新的理论依据。方法:回顾性分析我院2018年1月至12月3 014例性病高发人群HPV的检测结果,并初步探讨HPV与性别、年龄及人类免疫缺陷病毒(HIV)的相关性。结果:3 014例样本中男730例(24.22%),女2 284例(75.78%),型别以HPV6、11、16、52、58为主,检出率依次为8.36%(252/3014)、7.83%(236/3014)、6.74%(203/3014)、5.97%(180/3014)、4.64%(140/3014)。男性任一型HPV、低危型HPV、高危型HPV、单纯低危型HPV感染检出率依次为67.81%(495/730)、53.29%(389/730)、45.75%(334/730)、22.05%(161/730),均明显高于女性(P值均0.001),但男性单纯高危型HPV感染检出率和女性比较则无统计学差异(P0.05)。HPV感染在15～24岁和65～74岁这两个年龄段检出率最高,大致成"U"形分布。3 014例中有345例为HIV感染者,HIV感染者任一型HPV、低危型HPV、高危型HPV、单纯低危型HPV感染检出率依次为84.06%(290/345)、64.35%(222/345)、66.96%(231/345)、17.10%(59/345),均明显高于总人群(P值均0.001),但HIV感染者单纯高危型HPV感染检出率和总人群比较则无明显差异(χ~2=2.00,P0.05)。结论:常居广州地区性病高发人群最近一年流行的HPV型别为HPV6、11、16、52、58,表现出与性别、年龄、HIV感染相关的特点,加强HIV感染者的防治工作对降低本地区HPV感染率有重要意义。     

性病门诊无症状男性就诊者高危型人乳头瘤病毒检测结果分析

目的:探讨性病门诊男性无症状就诊者高危型人乳头瘤病毒感染的临床意义。方法:从807例性病门诊男性无症状就诊者不同身体部位收集样本,应用聚合酶链反应(PCR)检测高危型HPV(16,18)和低危型HPV(6,11)。结果:高危型HPV检测的阳性率为6.7%,男性龟头、包皮、尿道部位的HPV感染率差异无统计学意义(P>0.05),41-50年龄组的HPV感染率最高。结论:高危型HPV男性患者要定期进行生殖道的检查,预防生殖器肿瘤的发生。     

人乳头状瘤病毒感染与阴道微生态环境之间的关系研究

目的探讨人乳头状瘤病毒(human papilloma virus,HPV)感染与阴道微生态环境之间的关系。方法选择2016年1月至2016年12月在昆明市妇幼保健院妇科门诊进行健康体检宫颈癌筛查者3064例为研究对象,将宫颈HPV分型检测阳性者1614例设为观察组,将同期在妇科门诊进行健康体检和孕前常规宫颈HPV分型检测阴性者1450例设为对照组,对两组患者的临床资料进行分析比较。结果在3064例就诊者中,检出HPV感染者1614例(24. 00%),其中,高危型别HPV感染者占比67. 97%(1097/1614),低危型别HPV感染者占比15. 99%(258/1614),高低危混合型感染者占比16. 05%(259/1614);同时,单一型别感染者占比83. 02%(1340/1614),多重型别感染者占比16. 98%(274/1614)。高危型别感染前5位的型别分别为HPV52 (22. 00%)、HPV16 (14. 00%)、HPV58 (9. 98%)、HPV51 (8. 98%)、HPV18(8. 00%)。HPV感染者中,阴道微生态正常者占比18. 90%(305/1614),HPV检测阴性者1450例中,阴道微生态正常者占比36. 07%(523/1450),两组差异具有统计学意义(P 0. 05),HPV阳性者阴道微生态失调发生率较HPV阴性者增高。HPV检测阳性者细菌性阴道病(BV)感染者占比6. 57%(106/1614),需氧菌性阴道炎(AV)感染者占比18. 34%(296/1614),HPV检测阴性者BV感染者占比3. 45%(50/1450),AV感染者占比6. 69%(97/1450),两组差异具有统计学意义(P 0. 05),提示HPV感染增加了AV、BV的感染率。高危型HPV感染与低危型HPV感染人群中,阴道微生态各项指标比较差异均无统计学意义(均P 0. 05)。结论 HPV感染对阴道微生态环境具有一定的影响,HPV感染增加了BV和AV的感染率。阴道微生态状态与HPV高低型别感染无关。     

1619例尖锐湿疣患者人乳头瘤病毒基因型检测及分析

目的探讨深圳地区尖锐湿疣(condyloma acuminatum,CA)组织中人乳头瘤病毒(human papillomavirus,HPV)基因型分布情况。方法采用反向点杂交技术,检测1 619例CA患者疣体脱落细胞中的HPV基因型。结果 1 619例CA患者中低危型阳性率为68.6%,高危型阳性率为57.3%;主要HPV型别:6型(35.8%)、11型(25.1%)、43型(14.8%)、16型(14.5%)、52型(10.1%)、58型(8.3%)、18型(5.7%)。男性和女性高危型HPV感染阳性率比较差异有统计学意义(P0.01)。单一HPV感染占63.9%,多重感染占36.1%,高危型多重感染比例为89.7%(524/584)。男、女性多重感染的比例差异有统计学意义(P0.001)。结论深圳地区CA感染HPV型别主要为低危型,高危型比例明显上升,主要流行型别是HPV6、11、43、16、52、58、18。高危型多存在混合感染,女性多重感染比例最高。     

高危型人乳头瘤病毒检测在子宫颈癌筛查中的临床应用效果研究

目的:探讨人乳头瘤病毒及行为危险因素与子宫颈癌的临床关系。方法:通过分析2014年6月至2015年6月医院收治的203例HPV感染患者的临床资料,对患者临床资料进行整合,探讨HPV感染及相关行为危险因素及其同子宫颈癌的相关关系。结果:HPV感染并发宫颈癌患者中高危HPV患者占比显著高于低危HPV感染患者,比较差异有统计学意义(P0.05);两组患者行为危险因素中吸烟、首次性行为年龄、性伴侣个数、性卫生意识、孕次和避孕方式相关因素指标存在显著差异,有统计学意义(P0.05)。结论:高危型HPV感染是诱发子宫颈癌的高危因素,性行为及吸烟等行为危险因素同子宫颈癌发病有一定的相关性。     

育龄期妇女HPV感染筛查、疫苗接种认知调查及干预建议

目的筛查育龄期妇女人乳头瘤病毒(HPV)感染情况,并调查育龄期妇女对HPV疫苗接种认知,给出高危型HPV感染及HPV疫苗接种认知不良的干预建议。方法选取2016年3月至2018年5月辽宁省健康产业集团阜新矿总医院妇科进行HPV筛查的450例育龄期妇女作为研究对象。采用聚合酶链反应(PCR)结合脱氧核糖核酸(DNA)探针杂交法进行HPV感染分型检测,统计高危型和低危型HPV感染情况。采用问卷调查法调查育龄期妇女对HPV疫苗接种的认识。采用Logistic回归分析法分析导致高危型HPV感染、导致不良HPV疫苗接种认识的危险因素。统计接受筛查咨询前后有接种意愿且接种HPV疫苗的情况。结果 450名研究对象中,HPV检出率为14.89%(67/450),其中高危型HPV感染者占比70.15%(43/67),以HPV16、HPV18、HPV52基因型为主;低危型HPV感染者占比29.85%(18/67),以HPV6、HPV11为主;高/低危型混合感染者占比8.96%(6/67),以HPV16/6为主;听说过HPV疫苗、清楚HPV疫苗可预防子宫宫颈癌、知晓疫苗接种机构、疫苗适宜接种人群的育龄期女性构成比均较低,450名研究对象中,认知良好者183名,占比40.67%,认知不良者267名,占比59.33%;经Logistic回归分析,初次性生活年龄≤20岁、性生活频率3次/周、多个性伴侣、服用避孕药均是导致高危型HPV感染的危险因素(OR=3.123、3.557、2.260、1.709;P0.05);经Logistic回归分析,受教育年限≤9年、居住地农村、家庭收入≤1000元/年均是导致不良HPV疫苗接种认识的危险因素(OR=2.880、3.526、1.925;P0.05);筛查咨询后HPV接种率71.80%高于筛查咨询前57.44%(P0.05)。结论育龄期妇女HPV感染以高危型为主,且对HPV疫苗接种认知程度较低,导致高危型HPV感染、HPV疫苗接种认识程度低的危险因素较多,开展针对性HPV疫苗接种知识宣教,提高育龄期妇女HPV疫苗接种率。     

尖锐湿疣皮损中高危型和低危型人乳头瘤病毒感染情况研究

目的:研究尖锐湿疣皮损中高危型和低危型人乳头瘤病毒(Human papillomavirus,HPV)感染情况。方法:研究纳入235例人乳头瘤病毒检查结果阳性的患者,对其型别、各型感染率及病毒拷贝数进行统计分析。结果:235例人乳头瘤病毒感染阳性患者,存在348人次人乳头瘤病毒感染,统计结果如下:HPV6和HPV11(36.7%,128/348)、HPV16(7.5%,26/348)、HPVl8(3.5%,12/348)、HPV31(1.7%,6/348)、HPV33(2.9%,10/348)、HPV35(2%,7/348)、HPV39(5.2%,18/348)、HPV45(1.1%,4/348)、HPV51(5.7%,20/348)、HPV52(11.5%,40/348)、HPV56(2.9%,10/348)、HPV58(10.1%,35/348)、HPV59(5.5%,,19/348)、HPV68(3.7%,13/348)。235例患者中128例为尖锐湿疣低危型HPV6及HPV11感染,高危型HPV中HPV52感染率最高,其次为HPV58,然后依次为HPV16,HPV51,HPV59,HPV39,HPV68,HPV18,HPV33,HPV56,HPV33,HPV31,感染率最低的是HPV45。感染低危型HPV6及HPV11患者为128例,只感染低危型HPV6及HPV11的患者为82例;感染高危型HPV患者为153例,只感染高危型HPV的患者为107例。低危型和高危型混合感染患者为46例。HPV感染拷贝数主要集中在107-103/104细胞。结论:尖锐湿疣中HPV6和11阳性率最高,高危型HPV可以和低位型HPV合并感染,也可以单独感染,发病率呈增高趋势,因此需要加强尖锐湿疣患者的治疗至关重要。     

尖锐湿疣患者皮损中HPV基因芯片型别分析

目的探讨本地区尖锐湿疣患者皮损中人乳头瘤病毒(HPV)感染型别及其临床意义。方法采用PCR-反向点杂交法检测172例尖锐湿疣患者皮损中23种HPV基因型别感染率。结果尖锐湿疣患者皮损中HPV检出率为97.67%(168/172),所有检出的阳性患者中单一型别感染率为38.10%(64/168),以HPV6/1l为主(70.31%,25.00%);多重HPV混合感染率为61.90%(104/168),以高低危HPV混合感染为主(P0.05),18~35岁组较35岁组高危HPV感染率偏多,差异有统计学意义(P0.05),女性的多重感染率及高危型感染率均高于男性,差异有统计学意义(P0.05)。结论本地区尖锐湿疣皮损以HPV6/1l型感染为主,并多伴有其他HPV型别感染;年龄、性别和感染重数与HPV型别分布相关。     

尖锐湿疣组织HPV基因芯片分型及型别分析

目的研究尖锐湿疣(CA)组织中人乳头瘤病毒(HPV)感染的病毒亚型分布,CA患者中高危型HPV感染的情况。方法采用基因芯片检测和分型方法,对武汉市302例CA患者的皮损组织进行HPV检测及分型。结果302份CA组织标本中HPV阳性286例,检出率为94.7%,单一型别阳性率为73.8%,多重型别阳性率为20.7%,低危型别(HPV6,11,42,43,44)阳性率为80.5%,高危型别(HPV16,18,31,33,35,39,45,51,52,53,56,58,59,66,68,73,83,MM4)阳性率为14.2%,对照组阳性率为16.7%。结论本地区尖锐湿疣以单一型别及低危型别HPV感染为主,高危型HPV感染阳性率为14.2%。     

包皮龟头炎120例临床分析

目的:分析包皮龟头炎患者的临床及相关因素,为包皮龟头炎的诊断、治疗提供依据。方法:对我院诊治的120例包皮龟头炎患者进行详细病史询问,记录临床症状、体征,并做病原学检查,对其临床资料进行回顾性分析。结果:病原菌检查阳性82例(68.33%),其中念珠菌感染48例(40%),BV(bacterial vaginosis)阳性21例(17.5%),二者混合感染13例(10.83%);包皮过长、包茎占42.5%,2型糖尿病占15%,配偶患阴道炎占31.7%。结论:念珠菌感染是包皮龟头炎发病的重要因素,包皮过长、包茎、性伴阴道炎、2型糖尿病是易感因素。     

Human papillomavirus infection in men who have sex with men participating in a Dutch gay-cohort study

BACKGROUND: To develop strategies for prevention and early treatment of human papillomavirus (HPV) anal and penile cancer, a better understanding of related sexual behavior risk factors is needed. GOAL: The goal of this study was to establish the prevalence of anal and coronal sulcus HPV in a group of men who have sex with men participating in a Dutch gay-cohort study, to identify risk factors associated with HPV infection in this group, and to investigate the presence of identical HPV types in couples with stable relationships. STUDY DESIGN: A cross-sectional study of 241 HIV-negative and 17 HIV-positive men who have sex with men visiting the sexually transmitted disease clinic of the Erasmus MC for a regular and scheduled examination. Participants underwent a routine venereological examination including HIV serologic analysis, and swabs were taken from the coronal sulcus and anus for HPV DNA testing. All subjects were asked to complete a questionnaire on sexual risk behavior. RESULTS: HPV DNA was detected at the coronal sulcus in 23.5% of the HIV-positive men and in 15.8% of the HIV-negative men (P=0.492). In anal specimens, HPV DNA was detected in 64.7% of the HIV-positive men and 32.8% of the HIV-negative men (P=0.015). High-risk HPV types (P=0.007) and 2 or more different HPV genotypes (P=0.006) were seen more often in anal specimens of HIV-positive persons than in specimens of HIV-negative persons. A factor possibly associated with the presence of anal HPV infection was a concomitant anal infection with Chlamydia trachomatis, gonococci, or herpes simplex virus (P=0.059). In only 16.7% of HPV-positive steady couples, both companions showed the presence of one or more identical HPV genotypes. CONCLUSION: In this study, anal HPV DNA was detected more often than HPV DNA at the coronal sulcus. HIV positivity was associated with a higher prevalence of high-risk, but not with low-risk HPV types, at the anus. No association was found between HIV positivity and presence of high-risk HPV at the coronal sulcus. No sexual behavioral determinants for the presence of HPV could be identified. Concomitant anal infection with C trachomatis, gonococci, or herpes simplex virus may be associated with HPV infection. In the majority of steady couples, partners were infected with different HPV types.     

尖锐湿疣复发的相关因素及防治策略

尖锐湿疣是由人乳头瘤病毒引起,以发生在生殖器、肛周部位为主的良性增生性疾病,是一种常见的性传播疾病.临床上治疗尖锐湿疣的方法很多,但都不能避免其复发,而且复发率较高.导致尖锐湿疣复发的因素可能包括:人乳头瘤病毒的亚临床感染和潜伏感染、机体免疫力低下、不良的性行为、伴发其他性传播疾病、人乳头瘤病毒的载量、包皮过长等.因此,对尖锐湿疣复发的因素进行更深入的研究,采取相应措施,将有助于减少其复发.     

Violence against wives, sexual risk and sexually transmitted infection among Bangladeshi men

OBJECTIVE: To assess the relationship between men's reported violence against wives and their sexual risk behaviours and sexual health. Design, SETTING AND PARTICIPANTS: Cross-sectional analyses of a survey of a nationally representative household-based sample of married men in Bangladesh (n = 3096). Main outcome measure(s): Physical and sexual violence against wives during the previous 12 months was assessed and examined for relations to men's extramarital sexual behaviours and sexually transmitted infection (STI) symptoms or diagnosis during this same period, as well as to men's disclosure of such infection to wives and condom use while infected. RESULTS: More than 1 in 3 (36.84%) married Bangladeshi men reported physically and/or sexually abusing their wives in the past year. Men perpetrating such violence were more likely to report both premarital and extramarital sex partners (OR(adj)s 1.80-3.45; 95% CI 1.20 to 8.23); those reporting physical violence were more likely to report STI symptoms or diagnosis in the past year (OR(adj)s 1.68-2.52; 95% CI 1.24 to 3.73). Men perpetrating physical violence and contracting an STI were somewhat more likely to fail to disclose infection status to wives (OR(adj) 1.58; 95% CI 0.93 to 2.70) than infected men not reporting such abuse. CONCLUSIONS: Violence against wives is common among Bangladeshi men. Men who perpetrate such abuse represent increased risk regarding their wives' sexual health because they are more likely to both participate in extramarital sexual behaviour and contract an STI compared with non-abusive husbands. Given the growing epidemic of HIV infection among monogamous South Asian women based on intercourse with infected non-monogamous husbands, research and intervention regarding men's violence in marriage and implications of such behaviour for women's sexual health should be prioritised.     

抗HPV生物蛋白敷料治疗HPV高危感染合并宫颈CINⅠ的临床观察

目的:探讨抗HPV生物蛋白敷料治疗HPV高危感染合并宫颈CINⅠ的疗效。方法:选取2012年2月至2015年11月期间在我院门诊就诊患者,选取146例HPV高危感染合并宫颈CINⅠ患者,随机分为研究组和对照组,研究组84例,采用抗HPV生物蛋白敷料阴道上药,每次1支,隔日1次,10次为1个疗程,连用3个疗程。对照组62例,未使用药物,仅做观察。结果:在第4个月复查宫颈脱落细胞学检查和HPV检测,研究组总有效率为80.95%,对照组总有效率为46.67%,两组比较,差异有统计学意义(P0.05)。研究组宫颈脱落细胞学检查转阴率为80.77%,对照组转阴率为31.58%,两组比较,差异有统计学意义(P0.05)。结论:抗HPV生物蛋白敷料治疗HPV高危感染合并宫颈CINⅠ可能有效,未发现不良反应。     

2368例女性健康体检者HPV感染相关因素分析

目的:探讨顺义区女性HPV感染情况和相关影响因素。方法:选取2016年3月至2016年6月在我院体检中心健康检查的2368例女性为研究对象,进行HPV检测和初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数、职业、学历等情况问卷调查。结果:HPV感染的危险因素分析显示,初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数方面,各组间相比较,差异有统计学意义(P0.01)。不同职业人群的HPV感染情况相比较,差异有统计学意义(χ2=103.8108,P=0.0000)。不同学历水平组HPV感染情况相比较,差异有统计学意义(χ2=60.5733,P=0.0000)。结论:妇女的HPV感染发生与初次性生活年龄、初次妊娠年龄、性生活频率、性生活前后是否洗澡、流产次数、职业、学历等方面密切相关。针对高危人群,加强HPV病毒上述易感因素的预防宣教,从而有效降低HPV感染,进而降低子宫颈疾病的发生。     

儿童包皮自动切除环的临床效果观察

目的:总结儿童包皮自动切除环在儿童包茎及包皮过长手术治疗中的经验。方法:对2007年1月至2015年1月640例患儿使用包皮自动切除环手术切除包皮,并与前期640例传统包皮切除术患儿比较。结果:包皮自动切除环组手术时间(3.4±1.6)min;术中出血约(0.5±0.1)m L;无术后出血发生;感染1例(0.1%);患者家属对瘢痕不满意1例(0.1%)。传统包皮环切术组,手术时间(15.4±3.1)min;术中出血(5±2)m L;术后出血需再次止血16例(2.5%);感染7例(1.1%);术中出现患者家属对瘢痕不满意28例(4.4%),差异有统计学意义。结论:儿童包皮自动切除环治疗儿童包皮过长及包茎具有操作简单,手术时间短,术中出血少,无术后出血、线结残留等并发症,发生术后感染几率小,手术切口美观等优点。     

Anal cytological abnormalities and anal HPV infection in men with Centers for Disease Control group IV HIV disease.

OBJECTIVE: To characterise risk factors for abnormal and cytology and anal human papilloma virus (HPV) infection in homosexual/bisexual men with advanced HIV related immunosuppression. DESIGN: Cross sectional study of men with Centers for Disease Control group IV HIV disease. SETTING: The University of California San Francisco, AIDS Clinic. PATIENTS: 129 homosexual or bisexual men with group IV HIV disease. METHODS: A questionnaire was administered detailing tobacco, alcohol and recreational drug use, medical history, and sexual practices. Anal swabs for cytology and HPV studies were obtained, as was blood for CD4 levels. MAIN OUTCOME MEASURES: Abnormal anal cytology and anal HPV infection. RESULTS: Abnormal anal cytology was detected in 39% of subjects and anal HPV infection in 93% as measured by polymerase chain reaction (PCR). Risk factors for abnormal cytology in multivariate analysis included HPV 16/18 infection (measured by PCR, RR = 2.1, 95% CI = 1.2-3.5) and intravenous drug use (RR = 1.8, 95% CI = 1.2-2.7). Infection with HPV 6/11 also had significantly elevated RRs in a separate model. Cigarette smoking, alcohol use, recreational drug use, and low CD4 level were associated with abnormal anal cytology in univariate analysis, as was infection with multiple HPV types and high levels of hybrid capture group B viral DNA. CONCLUSIONS: Anal cytological abnormalities and HPV infection are common among homosexual/bisexual men with group IV HIV disease. In this study population, the main risk factors for abnormal cytology were HPV infection and intravenous drug use.