不孕患者中宫颈HPV高危型别感染率及病毒载量的调查

Investigation on EIPV viral load and high risk EIPV types infection among patients with infertility

目的调查高危型人乳头瘤病毒（HPV）在不孕患者宫颈细胞中的感染情况，探讨HPV病毒型别及其载量（viral load）对不孕发生的影响。方法对临床130份不孕患者的宫颈脱落细胞标本和在门诊体检的150份对照组的宫颈脱落细胞标本采用多通道实时荧光定量PCR仪进行八种高危HPvDNA分型及定量检测，该八种高危HPV型别为主要高危型：HPV16，18，45，31和次要高危型HPv33，52，58，67。结果不孕组阳性率为25．38％（33／130），对照组的阳性率为11．33％（17／150），两组间的阳性率差异有统计学意义。不孕组的33份阳性标本中病毒载量≥10^6为24例，病毒载量〈10^6为9例；对照组的17份阳性标本中，病毒载量≥10^6为4份，病毒载量〈10^6为13份，两组间的病毒载量有显著性差异。结论不孕组高危型HPV感染率比正常人群（对照组）高。对不孕组病毒载量的分析表明：不孕组人群中其病毒载量明显高于正常人群。此外，本研究还为分泌物核酸检测的定量设置了内标（β-球蛋白），提出可供临床使用的分泌物取样的核酸定量检测方法。

Objective High risk human papilomavirus （HPV） infection is often related to cervical cancer. This study investigated the infection of high risk HPV in cervical epithelia among infertile patients. Relative quantification and absolute quantification were applied for determination of ＂real＂ HPV viral load in the clinical setting.Methods Adopting multi-channels real time PCR to genotype and quantify eight high risk HPV （HPV16, 18, 45, 31; intermediate risk types： HPV33, 52, 58, 67） DNA in cervical epithelia of the 130 infertile patients and the 150 controls. This study applied housekeeping gene （β-globin） for the DNA quantification on secretions samples for clinical diagnosis. Results The infection rate of the infertility group was 25.38 % （33/ 130） and that of the control group was 11.33% （17/150）, the difference was statistically significant. Among the 33 positive cases in the infertility group, 24 cases showed a viral load no less than 106 ; in 9 of them, the viral load was less than 10^6 .Among the 17 positive cases in the control group, 4 cases had a viral load no less than 10^6 ; in 13 of them, the viral load was less than 10^6. There is a statistically significant difference in viral load between the infertility group and the control group. Conclusion The HPV infection rate of the infertility group was higher than that of the control group.