无宫颈病变的高危人乳头瘤病毒感染妇女的2年随访研究

目的 探讨无宫颈病变而有高危人乳头瘤病毒感染(HR-HPV)妇女的病毒自然清除时间及两年内转归情况.方法 选取2012年1月至2017年2月来南通市如东县第二人民医院检查有单一HR-HPV感染但并无宫颈病变的妇女67例,平均年龄(41.58±4.94)岁,定期对受试对象进行随访,检查妇女不同亚型病毒的病毒清除时间,观察两年内转归情况.结果 不同年龄段妇女的不同亚型病毒感染均不同,其中16亚型占38.81％,其次是18、39及42亚型;不同年龄段妇女不同亚型的清除时间也均有差异,16亚型病毒在20～29岁组的清除时间低于其他年龄段组,其中20～29岁组清除时间与40～49岁及≥50岁比较,差异均具有统计学意义(P<0.05),其他单一亚型病毒亦呈现相同的趋势;20～29岁组妇女所有亚型的平均清除时间为(7.26±1.07)个月,30～39岁、40～49岁及≥50岁年龄段组的清除时间分别为(8.56±2.21)个月、(10.44±2.21)个月及(14.56±3.98)个月;两年内随访中,高危人乳头瘤病毒转阴性者为60例,转阴率为89.56％,有7例妇女仍保持阳性.结论 本组所有妇女在两年内高危人乳头瘤病毒大部分可以自然清除,其中年龄与清除时间有一定相关性,因此建议对单一感染高危人乳头瘤病毒且无宫颈病变的女性采用姑息处置,以减少药物的使用.

Two years follow-up analysis of women with high-risk human papillomavirus infection without cervical lesions

Objective To investigate the natural clearance time of virus in women without cervical lesions and high-risk human papillomavirus (HR-HPV) and the outcome within two years. Methods A total of 67 women with sin-gle HR-HPV infection but no cervical lesions were enrolled in our hospital from January 2012 to February 2017. The av-erage age was (41.58 ± 4.94) years. The clearance time of different subtypes of virus in women was examined regularly, and the prognosis in two years was observed. Results The virus subtypes in the different age groups were different, among which 16 subtype accounted for 38.81％, followed by 18, 39 and 42 subtypes. The clearance times of different subtypes of virus in different age groups were also different (P<0.05). The clearance times of 16 subtype viruses in the 20-29 age group was significantly lower than that of other age groups (P<0.05), and other single subtype viruses also showed the same trend. The average clearance time for all virus subtypes in women aged 20-29 years, 30-39 years, 40-49 years and ≥50 age were (7.26 ± 1.07) months, (8.56 ± 2.21) months, (10.44 ± 2.21) months and (14.56 ± 3.98) months, respectively. During the follow-up period in two years, 60 cases were negative at high risk human papillomavi-rus and 89.56％, and 7 cases of women remained positive. Conclusion Most of the high-risk human papillomavirus were removed in the women in two years. The age of the patients is closely related to the time of eradication. Therefore, it is suggested that palliative treatment should be taken to reduce the use of drugs in women with single-infection high-risk human papillomavirus and no cervical lesions.