72例男性肛周尖锐湿疣的临床特征及流行病学调查

Clinical Features and Epidemiological Survey of Perianal Warts in 72 Males

目的：了解男性肛周尖锐湿疣的临床特征及流行病学资料.方法：观察并总结了2004年6月～2006年4月我院皮肤性病科门诊72例男性肛周尖锐湿疣临床特征及流行病学资料.结果：肛周尖锐湿疣主要见于18～45岁的中青年男性（61例,占84.72%）,有同性性行为占12.50%,有桑拿习惯的男性更容易患肛周尖锐湿疣.肛门直肠疾病如肛门瘙痒症、肛门湿疹、肛裂及痔疮等均可出现局部皮肤黏膜的破损而为人乳头瘤病毒（HPV）感染创造条件.经典尖锐湿疣61例（84.72%）,扁平型尖锐湿疣11例（15.28%）,前者多与6、11型HPV感染有关,后者与16、18型HPV感染有关.肛周扁平型尖锐湿疣适合冷冻术治疗.通过与健康对照组比较外周血T细胞亚群发现肛周尖锐湿疣患者细胞免疫功能下降.结论：肛周尖锐湿疣的传染途径中肛交不是主要因素,有桑拿习惯的男性更容易患肛周尖锐湿疣（χ^2=5.03,P＜0.05）.肛周尖锐湿疣以经典尖锐湿疣为主,扁平型其次.本研究对于了解我国男性肛周尖锐湿疣临床和流行病学特点和积极防治该病提供参考.

Objective： To investigate the clinical features and epidemiological data of 72 cases of male perianal warts. Methods： Seventy-two cases of perianal warts in our clinic dated from June, 2004 to April, 2006 were enrolled in the study, whose clinical information and epidemiological data were collected and analyzed. Results ： Perianal warts were most commonly seen in young and middleaged men aged from 18 to 45, only 12.5% of whom had homosexual behaviors. Sauna was another predisposing factor of perianal warts in males in China（ x^2 = 5.03 ,P 〈 0.05 ）. Primary eruptions of the anus and rectum, like perianal pruritus, eczema, anus fissure, and haemorrhoids, often impaired the local integrity of skin/mucosa. Classical condyloma acuminate was found in 61 （84.72%） of patients, who were susceptive to the infections of HPV 6/11, and were fiat condylomas related to HPV16/18. Cryotherapy was believed to be one of the most efficient therapeutic choices for fiat perianal warts. Suppression of cellular immune response was identified in the patients by comparison between the subgroups of peripheral T cells and the normal control. Conclusion ： Sauna is an essential predisposing factor of perianal warts in males, while anus sexual intercourse is not the main route of HPV infection. Classical condylomata a- cuminate constitute the majority of the eruptions, and flat condylomata come next. The study also provides some useful data for understanding the clinical and epidemiological features of perianal warts in Chinese males for the sake of prevention and treatment of the disease.