人乳头状瘤病毒母婴传播的研究

A study on mother-to-child transmmission of HPV

目的 调查人乳头状瘤病毒母婴感染及母婴传播情况.方法 运用聚合酶链式反应结合DNA探针杂交检测方法 对不同孕期的1 660例孕妇进行宫颈脱落细胞HPV-DNA分型（23种型别）检测;对检测为阳性孕妇的新生儿在出生洗净后进行口咽部和生殖器粘膜细胞HPV-DNA分型检测,综合分析人乳头状瘤病毒母婴传播情况.结果 孕妇人乳头状瘤病毒感染率为15.18%（252/1 660）,新生儿人乳头状瘤病毒感染率为27.62%（29/105）.人乳头状瘤病毒母婴垂直传播率为27.62%（29/105）,母婴传播一致率为51.72%（15/29）;不同性别新生儿的母婴HPV感染型别一致性比较差异无统计学意义（Fisher精确概率法P〉0.05）,新生儿口腔和外生殖器部位的母婴HPV感染型别一致性比较差异无统计学意义（Fisher精确概率法均P〉0.05）,高危型别组HPV感染孕妇与低危型别组的母婴HPV感染型别一致性比较差异无统计学意义（Fisher精确概率法P〉0.05）,剖宫产新生儿的母婴HPV感染一致性高于顺产者,经比较差异有统计学意义（Fisher精确概率法P〈0.05）.结论 人乳头状瘤病毒存在垂直传播,母婴感染人乳头状瘤病毒型别的一致率提示新生儿感染不仅可由母婴传播,还可能由多种不同途径传播.

Objective To investigate situation of mother-to-child transmmission of human papillomavirus （HPV）. Methods 1 660 pregnant women in different trimesters of gestation were investigated for HPV-DNA typing of cervical exfoliated cells by using DNA hybridization technique and polymerase chain reaction（PCR）. Those newborns born by HPV-positive mothers were investigated for HPV-DNA typing of mucosal cells in pars oralis pharyngis and external genital organs taken at birth after cleaning. Results The rate of HPV infection among pregnant women and the newborns were 15.18% （252/1 660） and 27.62% （29/105）, respectively. The positive rate of vertical motherto-child transmission of HPV was 27.62% （29/105）. The rate of concordance of HPV type between mothers and the newborns was 51.72% （15/29）. In concordance of HPV type of different genders of newborns with thire mothers, there was significant difference （by Fisher＇ s exact test： P 〉 0. 05 ）. In concordances of HPV type in pars oralis pharyngis and external genital organs of the neonorns with their mothers, there were also no significant differences （ by Fisher＇ s exact test： both P 〉 0.05 ）. Between the high-risk HPV type group and the low-risk HPV type group, in concordance of HPV type between the mothers and the neonates, there was no significant difference （by Fisher＇ s exact test： P 〉 0.05）. The rates of concordance of HPV types of the newborns born by cesarean section with their mothers was higher than that of those neoborns born vaginally （ by Fisher＇ s exact test： P 〈 0.05 ）. Conclusion HPV could be transmitted vertically during pregnancy. The concordance of HPV types between the mothers and the newborns suggests that HPV infection in the newborns may be acquired from not only their mothers but also some other routes.