女性高危人群HPV感染情况和相关因素分析

目的 了解女性高危人群人乳头瘤病毒（HPV）感染情况和亚型分布特点,并分析HPV感染的相关风险因素.方法 采用PCR方法 对2008年6月至2009年8月妇科门诊的470例疑似HPV感染患者进行HPV亚型检测和相关情况的问卷调查.结果 470例患者中324例（68.9%）检测为HPV阳性,其中低危型以6、11和43型为主 高危型以16和58型为主.细胞学检查无异常者300例,异常者170例,包括宫颈上皮内瘤变（CIN）75例、湿疣54例和鳞状上皮内病变（SIL）41例.异常者中HPV阳性率为77.0%,正常患者中为64.3%（P＜0.05）.CINⅠ和Ⅱ级患者阳性率较低,但随CIN严重程度增加,HPV阳性率明显增加.HPV感染患者配偶HPV感染率为68.96%.HPV感染与患者初次性生活年龄和是否采用恰当的避孕措施密切相关,配偶间的相互传播感染也是相关因素之一.结论 高危人群HPV感染以6、11、43、16和58型为主.开展积极的健康教育尤其是正确的性观念和方式对预防HPV感染具有重要意义.

Human papillomavirus (HPV)infection in high-risk women and related risk factors

Objective To investigate the prevalence and subtypes distribution of human papillomavirus （HPV） infection in high-risk women, and to analyze the related risk factors. Methods Questionnaire survey was conducted in 470 outpatients suspected of HPV infection from June 2008 to August 2009 in our gynecological clinic. HPV subtypes of were examined using polymerase chain reaction technique. Results Of 470 outpatients, 324 patients were positive for HPV （68.9%）. The main genotypes for low risk HPV type were HPV 6, 11, and 43, while the main genotypes for high risk type were HPV16 and 58. The cytological examination revealed normal cytology in 300 patients, abnormal cytology in 170 patients,including cervical intraepithelial neoplasia （CIN） in 75 patients, condyloma in 54 patients and squamous intraepithelial neoplasia （SIL） in 41 patients. HPV positive ratio was 77.0% in patients with abnormal cytology and 64.3% in those with normal cytology （P〈 0.05）. HPV positive rate was lower in patients with CIN grade I and II, and increased with the severity of CIN. In addition, HPV positive rate were significantly correlated with the age of first sexual activity and contraceptive measures. HPV positive rate of both spouses was 68.96% indicating infection between spouses was also the risk factor. Conclusion The main subtypes detected in this study are HPV 6, 11, 43, 16 and 58.