女性人乳头瘤病毒感染的相关因素分析

Analysis of human papilloma virus infection in female and related factors

目的 分析女性人乳头瘤病毒（human papilloma virus,HPV）感染率、HPV亚型分布及影响感染的相关因素,为女性宫颈癌的防治提供科学指导.方法 以2009年3-11月在哈尔滨医科大学附属肿瘤医院接受子宫颈HPV检测的605例女性为观察对象,取其宫颈脱落细胞标本,采用快速导流杂交技术HPV DNA检测法进行HPV的基因型分型,采用单因素和多因素非条件Logistic回归模型分析年龄、婚姻、受教育程度、收入、职业、初次性生活年龄、避孕方式、妊娠次数、分娩方式、吸烟等因素与HPV感染的关系.结果 女性HPV总感染率为21.49%（130/605）,其中高危亚型感染率为15.70%（95/605）,中国人常见亚型感染率为5.29%（32/605）.在单因素分析中,危险因素为初次性生活年龄,HPV感染率随初次性生活年龄增高而减低（X2=4.4618,P〈0.05）,而年龄、婚姻、受教育程度、收入、职业、避孕方式、妊娠次数、分娩方式、吸烟因素组内比较差异无统计学意义（χ^2值分别为0.0525、1.8510、1.0348、0.2592、1.1176、1.5664、2.8835、1.4597、2.6161,P均〉0.05）.在多因素非条件Logistic回归中,危险因素主要有初次性生活年龄、婚姻和妊娠次数（χ^2值分别为21.6637、8.0574、15.7573,P均〈0.05）.结论 初次性生活年龄、婚姻及妊娠次数与HPV感染高度相关,应尽量避免高危因素的发生,同时应重视HPV的筛查,尽可能做到早期发现及时进行规范性治疗.

Objective To discuss human papilloma virus（HPV）prevalence and HPV genotypes distribution and the infection factors,to provide scientific guidance for the prevention and treatment of cervical cancer.Methods From March to November in 2009,605 women received cervical HPV testing in the Tumor Hospital of Harbin Medical University,to obtain specimens of cervical cytology,rapid flow-through hybridization technique （namely Hybribio flow-through hybridization）was used to detect HPV genotypes simultaneously.Single-factor and multivariate factors non-conditional Logistic regression analytic method was used to discuss the relationship between HPV infection of females and age,marital condition,level of education,level of income,occupation,initial age for sex,contraception,number of pregnancies,delivery approach and smoking.Results HPV infection rate was 21.49%（130/605）,the positive rate of HPV infection in high-risk subtypes was 15.70%（95/605）,the most common type was 5.29%（32/605）in the samples.Single factor non-conditional logistic regression model analysis showed that initial age for sex was the risk factor（X2=4.4618,P〈0.05）,HPV prevalence increased with a lower initial age for.sex reduced.But there was no significant difference in age,marital condition,education,income,occupation,contraception,number of pregnancy,delivery approach and smoking teams（χ^2=0.0525,1.8510,1.0348,0.2592,1.1176,1.5664,2.8835,1.4597,2.6161,all P〉0.05）.The analysis of multivariate factors nonconditional Logistic regression showed that the age of initially having sex,marital status and number of pregnancies were the risk factors（χ^2=21.6637,8.0574,15.7573,all P〈0.05）.Conclusions The risk factors for HPV infection are mainly about having sex too young,marital status and number of pregnancies,attention should be paid to screening for HPV.