ASCUS患者发生宫颈高级别病变高危因素分析

探讨不能明确意义的非典型鳞状细胞患者发生CINⅡ 及其以上宫颈病变的影响因素。方法 通过完善设计的调查量表对我院门诊就诊行宫颈液基细胞学检查（TCT）为ASCUS的236例患者进行回顾性资料收集,同时行人乳头瘤状病毒（HPV）基因型检测,和阴道镜检查+宫颈活检,对相关危险因素进行单因素和多因素分析。结果 236例ASCUS病变中,病理证实CIN共68例（28.81%）,其中CINⅡ及以上检出36例,占总病例数的15.25%。236例ASCUS病例中,高危型HPV阳性率为55.51%,高危型HPV阳性及高危型HPV阴性组CINⅡ及以上病变检出率分别为25.19%、2.86%,差异有统计学意义（P＜0.05）。高危型HPV检测CINⅡ及其以上的敏感性达91.67%,阴性预测值达97.14%。单因素分析中年龄、初次性生活年龄、流产次数、HR-HPV与CINⅡ及其以上密切相关。Logistic多因素回归分析的结果表明初次性生活年龄、流产次数、HR-HPV是宫颈CINⅡ及其以上的高危因素。结论 高危型HPV检测是ASCUS患者分流的重要指标,尤其是年龄在30~50岁。初次性生活年龄≤20岁、流产次数＞2次、HR-HPV是ASCUS患者发生宫颈高度病变的独立的高危因素。     

成都市1490例妇女HPV感染现状及危险因素分析

目的 探讨成都市妇女人乳头瘤病毒(human papilloma virus,HPV)感染现状及危险因素.方法 选择成都市体检的妇女1490例作为研究对象,展开HPV筛查,得出HPV的阳性感染率,分析HPV感染与宫颈炎、宫颈上皮内瘤样变以及宫颈癌等妇科疾病之间的关系,同时对HPV感染的危险因素进行调查分析.结果 1490例妇女中192名妇女为HPV阳性,HPV的阳性感染率为12.86％.HPV阳性妇女宫颈炎、宫颈上皮内瘤样变以及宫颈癌的发生率分别为41.67％、20.31％和8.69％,显著高于非HPV阳性妇女宫颈炎、宫颈上皮内瘤样变以及宫颈癌的发生率7.01％、1.93％和0.15％,差异具有统计学意义(P＜0.01).经常被动吸烟与熬夜、初次性行为年龄小以及首次妊娠年龄早以及有宫颈癌家族史是HPV感染的危险因素.结论 成都市妇女HPV阳性感染率较高,应当引起卫生部门的高度重视,并应该针对HPV感染的危险因素展开宣传和教育,以便降低妇女HPV的感染、保护妇女的身心健康.     

体检者胃溃疡检出率及其影响因素分析

目的 调查体检者胃溃疡的检出情况及其发生的影响因素。方法 收集2018年1月~12月我院健康管理中心9125名体检者的体检资料,根据胃镜检查及/或病理检查结果将体检者分为胃溃疡组519例和非溃疡组8606例,比较两组一般资料（年龄、性别、教育程度、BMI、吸烟、饮酒、Hp感染状况、饮食、每日睡眠时间、体检季节）,采用Logistic回归模型分析胃溃疡发生的影响因素。结果 共9125名体检者,胃溃疡检出率5.69%。单因素分析结果显示,两组年龄、性别、教育程度、吸烟、饮酒人数、Hp感染状况、饮食、每日睡眠时间、体检季节比较,差异有统计学意义（P＜0.05）;多因素Logistic回归分析结果显示,受教育程度是胃溃疡的保护因素,年龄、男性、吸烟、饮酒、饮食不规律、日睡眠时间＜8 h、Hp阳性、冬春季节是发生胃溃疡的风险因素（P＜0.05）。结论 9125名体检者胃溃疡检出率较低,受教育程度高是胃溃疡发生的保护因素,年龄增加、男性、吸烟/饮酒、Hp阳性,饮食不规律、日睡眠时间＜8 h、冬春季节均是增加胃溃疡发生风险的独立影响因素。     

滨海新区脑梗塞发病情况及影响因素分析

目的 探讨滨海新区脑梗塞发病情况及影响因素,为各级预防提供依据。方法 选取2015年1月~2017年8月在海滨新区7家医院就诊的患者31735例,其中脑梗死塞患者22850例,非脑梗塞患者8885例,收集患者的性别、年龄、职业、民族、吸烟等一般人口学信息,通过单因素和多因素分析影响脑梗塞的因素。结果 两组年龄、性别、民族、职业及吸烟情况比较,差异具有统计学意义（P＜0.05）。多因素Logistics回归分析结果显示,性别、年龄和吸烟都是脑梗塞患者的危险因素,即男性、年龄大和吸烟者更易患脑梗塞;与无业待业者相比,除了文化工作者外（P＞0.05）,其余职业均是保护因素,差异具有统计学意义（P＜0.05）。结论 高龄、男性、吸烟以及无业、待业者是易发脑梗塞的高危人群,应予以重点关注,采取及时有效的干预措施,降低脑梗塞的发病几率。     

老年患者胰十二指肠切除术后并发症及其危险因素分析

目的 探讨老年患者胰十二指肠切除术（PD）后并发症及其危险因素。方法 回顾性分析2010年1月至2013年1月接受胰十二指肠切除术的老年患者的临床资料,对患者术后并发症的发生情况及其危险因素进行统计分析。结果 本组共65例,均顺利完成手术,术后并发腹腔感染13例、胰漏9例、腹腔出血4例、胆漏4例、胃排空障碍2例、切口感染2例、肺部感染2例、上消化道出血1例、胸腔积液1例,术后总并发症发生率41.5%（27/65）。患者PD术后1个月内死亡5例,病死率7.7%（5/65）。多变量logistic回归分析显示术后总并发症发生的独立危险因素为胰腺质软和胰管直径＜3 mm（P＜0.05）;腹腔感染的独立危险因素为术中出血≥400 ml和胰腺质软;胰漏的独立危险因素为手术时间＞360 min、胰腺质软和胰管直径＜3 mm（P＜0.05）。结论 老年并非是胰十二指肠切除术禁忌,胰腺质软和胰管直径＜3 mm是术后并发症发生的独立危险因素。     

妊娠合并甲状腺功能减退症发生情况及影响因素分析

目的妊娠合并甲状腺功能减退症(SCH)发生情况及影响因素分析。方法选取2017年6月至2018年12月我院收治的70例妊娠合并甲状腺功能减退症患者作为观察组,另选取正常健康的70例妊娠期妇女作为对照组。调查妊娠合并SCH发生情况及相关因素分析。结果经单因素分析结果显示,妊娠合并SCH的发生与年龄、文化程度、孕产史、长期吸烟相关(P0.05),与其他变量无关(P0.05);经Logistic多元回归模型分析显示,年龄≥30岁、吸烟、孕产史和孕前BMI18kg/m~2是妊娠合并SCH发生的独立危险因素(P0.05)。结论妊娠合并SCH的发生与年龄、文化程度、孕产史、长期吸烟有关,年龄≥30岁、吸烟、孕产史和孕前BMI18kg/m~2是妊娠合并SCH发生的独立危险因素,应及时对危险因素进行有效干预,可以有效降低妊娠合并SCH的发生机率。     

湖北襄阳地区女性宫颈高危型HPV感染分布情况及危险因素探讨

目的 分析高危型人乳头瘤病毒(human papillomaviruses,HPV)在湖北襄阳地区妇女中的感染率及感染年龄分布情况,以及危险因素.方法 以2012-2014年间在本院就诊的4689例患者为研究对象,采用cervista酶切信号放大法检测14种高危型的HPV.其中感染高危型HPV阳性病例则进一步分析HPV感染年龄分布情况以及其在子宫颈上皮非典型增生(CIN)、宫颈癌、宫颈炎患者中的感染情况,并结合病例资料分析HPV感染危险因素.结果 4689例患者中有950例感染高危型HPV,感染率为20.26％.HPV在宫颈癌患者中的感染率最高,其次为CIN,宫颈癌相较于其他两类患者感染率对比差异有统计学意义(P＜0.05).HPV以≥55岁者的感染率最高.初次性行为年龄过早、宫颈癌家族史、多产史、经常熬夜等均是HPV感染的影响因素.结论 湖北襄阳地区HPV感染率与LARC国际癌症研究协会公布的亚洲常见HPV感染率一致.在不同年龄段中,感染率最高的年龄组为55岁以上及25岁以下,宫颈癌、CIN患者HPV感染率较高,而经常熬夜、有宫颈癌家族史、初次性行为年龄过早等因素属于HPV感染危险因素.     

宫颈分泌物HPV16,18型的FQ-PCR检测对育龄夫妇生殖健康的意义

目的探讨人乳头瘤病毒（HPV）16,18亚型在河北省衡水市育龄妇女中的流行情况以及感染妇女的男性性伴侣的感染率。方法采用荧光定量PCR（FQ-PCR）技术对367名育龄妇女进行了HPV16,18检测。观察HPV16,18感染的年龄分布特点。随后,30名HPV16,18阳性妇女和30名阴性妇女的男性性伴侣被邀请进行了HPV16,18检测。结果本地区HPV16,18现患率为10.4%（38/367）。感染妇女其男性伴侣感染率为13.3%（4/30）,与对照组非感染妇女的男性伴侣的感染率0（0/30）相比,有显著性差异（P=0.019,单侧检验）。结论367例育龄妇女分泌物HPV16,18检测阳性率为10.4%,男性性伴侣的感染率为13.3%。     

高危型HPV阳性患者宫颈支原体和衣原体感染与宫颈组织学改变的关系

目的 探讨高危型HPV阳性不孕患者宫颈支原体和衣原体感染与宫颈组织病变的关系.方法 以HPV阴性不孕患者为对照,回顾分析不同高危型别HPV阳性不孕患者宫颈支原体和衣原体感染与宫颈组织病理分级、炎症分级之间的关系.结果 支原体阳性者HPV感染的发生率与支原体阴性者差异有统计学意义（P＜0.01）,衣原体阳性者HPV感染的发生率与衣原体阴性者差异无统计学意义（P＞0.05）.与HPV阴性组比较,HPV阳性者CIN和宫颈糜烂发生率以及CIN分级均较高（P＜0.01）,HPV阳性者宫颈糜烂程度无差异（P＞0.05）.与单纯HPV阳性组比较,HPV和支原体混合感染者CIN发生率及重度宫颈糜烂无差异（P＞0.05）.结论 支原体感染增加了高危型HPV的感染概率,高危型HPV感染增加了宫颈组织的病理损害程度,支原体感染可能是高危型HPV持续性感染的因素,宫颈组织病理程度是宫颈性不孕不可忽视的因素.     

HPV病毒16型感染的影响因素研究

目的 探讨人乳头瘤病毒(HPV) 16型感染的相关影响因素.方法 采用调查问卷的方式对1500例自愿进行宫颈脱落细胞HPV检测的筛查者进行调查,收集筛查者的基本信息、婚育史、月经情况、性行为情况、饮酒史、吸烟史、妇科手术史、卫生情况等,采用x2检验与多因素Logistic回归分析HPV病毒16型感染的相关影响因素.结果 1500例筛查者中,HPV阳性率为12.8％(192/1500),主要类型包含HPV16型40.1％(77/192),HPV58型16.7％(32/192),HPV18型10.4％(20/192).单因素分析结果显示,HPV16型感染的相关影响因素是吸烟史、很少进行妇科检查、首次性交年龄＜25、怀孕次数≥2、流产次数≥3、妇科手术史、性伴侣数目≥2.多因素Logistic回归分析结果显示,HPV16型感染的危险因素是吸烟史、首次性交年龄＜25、妇科手术史.结论 HPV16型感染的危险因素是吸烟史、首次性交年龄＜25、妇科手术史,应尽量避免.     

Epidemiologic risk profile of infection with different groups of human papillomaviruses

This study identified the age‐specific prevalence and epidemiologic risk profile for infection with different groups and species of human papillomaviruses (HPV). Structured interview and HPV testing were conducted for 2,604 Chinese women self‐referred for cervical screening. Independent risk factors for infection were identified by multiple logistic regressions. Overall, a major peak of HPV infection was observed at women aged 26–30 years, and a minor peak at 46–55 years. This pattern was observed for high‐risk, low‐risk, and alpha‐5/7/9 HPVs; but alpha‐3/6 HPVs showed peaks of similar magnitudes in young and older women. Independent risk factors for HPV infection (all types combined) included younger age (OR [95% CI] for >55 vs. ≤30 years = 0.22 [0.09–0.55]; 31‐45 vs. ≤ 30 years = 0.57 [0.33–0.99]), having ≥4 lifetime sexual partners (2.28 [1.06–4.88]), and smoking (2.24 [1.22–4.10]). Young age and smoking were the most consistent independent risk factors observed across different HPV groups. The risk profile for high‐risk HPV was similar to alpha‐5/7/9. Single‐type infection was associated with having more sexual partners, higher education level and oral contraception; whereas multiple‐type infection was associated with smoking. In conclusion, a U‐shaped age‐specific prevalence curve was observed for HPV infection overall, but with a different pattern for different HPV species. Different HPV groups showed variations in their risk profiles. These data are useful for formulating preventative strategy for HPV‐related diseases. Catch‐up vaccination program in Hong Kong should cover a wider age group as the first peak of infection occurred relatively late. J. Med. Virol. 81:1635–1644, 2009. © 2009 Wiley‐Liss, Inc.     

宜城人民医院门诊1200例体检妇女HPV感染情况及相关因素分析

目的：检测并分析宜城人民医院妇科门诊行妇科检查妇女宫颈人乳头瘤状病毒(human papilloma virus，HPV)的感染率及高危因素。方法：选取本院妇科门诊进行妇科检查的1200例妇女作为调查对象，采用实时荧光定量PCR法(FQ-PCR)测定1200例妇女宫颈脱落细胞HPV感染率及分型情况，并收集调查对象的一般资料、行为信息学指标，采用单因素和多因素分析HPV感染的高危因素。结果：1200例调查对象，收集到检测样本及调查资料符合要求的共有1184例，其中共计检出HPV阳性感染者104例，阳性感染率为8.78%；HPV16感染阳性率占总感染患者的38.46%，其次为HPV58达到29.81%；多因素结果显示，性伴侣数目>1个(OR=1.721)、性生活频次>4次/月(OR=1.583)、宫颈糜烂(OR=2.081)是中青年妇女发生HPV感染的主要高危因素。结论：中青年妇女HPV感染的主要型别为HPV16，主要危险因素为多性伴侣、性生活较频繁、宫颈糜烂。     

Predictors of human papilloma virus (HPV) infection in Italian women

HPV infection is a “necessary cause” of cervical cancer and it is sexually transmitted. Due to upcoming mass vaccination investigation on risk factors for infection is the basis to implement prophylactic strategy even in older women. The aim of the study was to evaluate predictors of high‐risk (HR) HPV infection in adult women. Between 2006 and 2008, 100 women aged >18 years, with no previous treatment for cervical lesions, were screened for HR HPV infection in Rome, Italy. Risk factors for HPV infection were investigated through a questionnaire including: ethnicity, religion, education, marital status, sexual behavior, gynecological and obstetrical history, smoking and alcohol intake. Multivariate analysis identified the “never married–separated/divorced” status (OR: 3.38; 95% CI: 1.14–10.12) as predictor of HPV infection, while having a higher age at the first sexual intercourse (FSI) shows a protective effect (OR: 0.84; 95% CI: 0.71–1.00). A trend for the association between the infection and having more than three lifetime partners was also observed (OR: 2.57; 95% CI: 0.86–7.71). No significant association was found for other demographic characteristics investigated. These findings provide a contribution in the knowledge of an adult population defining a “high‐risk” sexual behavioral profile and could be helpful to target prophylactic strategies in older woman. J. Med. Virol. 82:1921–1927, 2010. © 2010 Wiley‐Liss, Inc.     

Prevalence of low‐risk and high‐risk types of human papillomavirus and other risk factors for HPV infection in Germany within different age groups in women up to 30 years of age: An epidemiological observational study

Human papillomavirus (HPV) infection is frequent in young women and persistent infection may lead to cervical cancer. Therefore, vaccination against HPV is recommended for young women in the age group from 12–17 years in Germany. However, epidemiological data on the prevalence of HPV types and risk factors for infection for younger women in Germany is scarce. To address this, an observational study was performed in Germany including 1,692 women aged 10–30 years. After a routine Pap smear, cervical swabs were tested for high‐risk and low‐risk HPV, respectively, using the Hybrid Capture 2 (HC2) test, and genotyped using the PCR‐based tests SPF₁₀/LiPA₂₅ and PapilloCheck®. In addition, the women were interviewed regarding their medical history and lifestyle factors. Three hundred seventy‐seven (22.28%) women had positive HC2 results. The proportion of HPV positive women was highest in the 20–22 age group with 28.3%. Predominant HPV types were HPV 16, 42, 51 and HPV 16, 51, 31 as defined by PapilloCheck® and SPF₁₀/LiPA₂₅, respectively. 95.8% of women did not show signs of any cervical lesion. Adjusted analysis identified number of sexual partners (OR:1.105; 95% CI:[1.069–1.142]), smoking (OR:1.508; [1.155–1.968]), and vaccination against HPV (OR:0.589; [0.398–0.872]) rather than increasing age as risk associated with HPV infection. Comparison of the genotyping assays showed that they correspond well regarding the high‐risk HPV types but less well for low‐risk HPV types. This epidemiological study shows that high‐risk HPV infection is common in young women in Germany. According to our data, vaccination of young women could have a potential impact on the prevention of HPV infection and cervical disease. J. Med. Virol. 82:1928–1939, 2010. © 2010 Wiley‐Liss, Inc.     

Screening for human papillomavirus infection in asymptomatic women in Hungary

BACKGROUND: A multicentre epidemiological survey was carried out in order to determine the prevalence of, and risk factors for, persistent cervical human papillomavirus (HPV) infection in women in Hungary. METHODS and RESULTS: A total of 728 women were examined for the prevalence of HPV. The estimated overall rate of HPV infection was 17%. In univariate analysis the strongest predictors were young age (< or =24 years), unmarried family status, smoking, a pathological Papanicolaou (Pap) smear, having a condyloma and previous gynaecological cancer in the family (age and marital status being the most important predictors). In multiple regression analysis, young age (< or =24 years)(odds ratio = 1.86, 95% confidence interval = 1.19-2.90, P < 0.01), smoking (1.78, 1.17-2.71, P < 0.05), an abnormal Pap smear (6.92, 2.68-17.84, P < 0.001), having a condyloma (4.22, 1.42-12.58, P < 0.01) and living in a region where the unemployment rate is relatively high (1.56, 1.24-2.82, P < 0.01) were associated risk factors for HPV infection. CONCLUSIONS: The prevalence of HPV infection in young women in Hungary is high. Screening for HPV is suggested only in women with an unfavourable gynaecological history who are < or =24 years old.     

Low rate of oral human papillomavirus (HPV) infection in women screened for cervical HPV infection in Southern Italy: A cross‐sectional study of 140 immunocompetent subjects

Even though the natural history of cervical and oral human papillomavirus (HPV) infection has been investigated intensely, the possibility that HPV may infect both sites in the same subject is not well documented. This study investigated the frequency of concurrent oral and cervical HPV infection in southern Italian women, in the light of some selected socio‐behavioral variables. One hundred forty women (mean age: 36 years), with known cervical HPV status, were analyzed for oral HPV. Age, smoking/drinking habits, clinical and socio‐behavioral history were assessed by personal interviews. Oral mucosal cells were collected by oral brushing and HPV DNA was sought by the use of nested PCR amplification followed by direct DNA sequencing and the commercial assay INNOLiPA HPV Genotyping (Innogenetics N.V., Ghent, Belgium). The data were analyzed by using the chi‐square test and a logistic regression (logit) model (P < 0.05 statistically significant). Oral HPV infection was detected in 2/140 (1.4%) cases, being present in 2/76 (2.6%) women with cervical HPV infection and 0/64 uninfected women (P = 0.19). A lack of type‐specific concordance in the two patients with concurrent infection was observed. In the sample of population examined, HPV cervical infection does not seem to predispose to oral transmission, even in the presence of oral–genital sexual habits, thus suggesting the independence of infection at the two mucosal sites. J. Med. Virol. 81:1438–1443, 2009. © 2009 Wiley‐Liss, Inc.     

Determinants of adolescent childbearing in Ethiopia,analysis of 2016 Ethiopian demographic and health survey: a case-control study

BackgroundPregnancy and birth complications experienced by adolescents are also problems of older women. But it is severe among the young due to physical immaturity and social condemnation from basic reproductive health services. The study was aimed to analyze determinants of adolescent childbearing in Ethiopia using the Ethiopian demographic and health survey.MethodThe data source for this study was the 2016 demographic and health survey. Records of 359 cases and 1436 randomly selected controls (1:4 ratio) were included in the analysis. Adolescent childbearing was the main outcome variable and the independent variables were sociodemographic and sexual & reproductive factors. Multivariable logistic regression analysis was used to identify factors associated with adolescent childbearing.ResultThe mean age of girls at first cohabitation was 15.28 ±1.64 and the mean age of first birth was 16.47±1.35. Adolescent childbearing was found to be higher in the Afar region (34.8%), and the lowest was in Addis Ababa city (4.1%). Finding from the multivariable analysis showed that place of residence, survey time age, and age at first sexual intercourse were the factors that have an association with adolescent childbearing. The odd of childbearing was higher among rural residents (AOR = 1.74; 95 % CI: 1.12, 2.72), early (<18 years) initiation of sexual intercourse (AOR =12.5; 95% CI: 5.97,25.18) and the risk is also higher among older teenagers (AOR =7.92; CI:3.92,15.90).ConclusionPlace of residents, age, and timing of first sexual intercourse was found to be the influencing factors of adolescent childbearing. Our finding indicates that the place of residence of the adolescent mothers must be considered in planning policies that attempt to disrupt successive cycles of socioeconomic deprivation. Public health interventions should focus their programs to be based on community and aim on prevention of early sexual intercourse and marriage.