城市和农村妇女高危型人乳头瘤病毒感染的危险因素分析

Risk factors of high-risk human papillomavirus infection in urban and rural area of China

目的:探讨影响我国城市和农村地区高危型人乳头瘤病毒(HR-HPV)感染的危险因素,为HR-HPV感染和子宫颈癌的防治工作提供依据。方法:采用横断面调查方法对城市地区(北京和上海)1 569人、农村地区(山西和河南)1 763人进行流行病学调查和妇科检查及高危型人乳头瘤病毒检测(HC-Ⅱ)。利用χ2检验和非条件Logistic回归模型分析HR-HPV感染的危险因素。结果:多因素分析结果显示,影响城市地区HR-HPV感染的危险因素为丈夫婚外性行为、生殖器感染史(STD)、流产次数和吸烟,而细胞学检查史是保护因素。影响农村地区HR-HPV感染的危险因素为初次性交年龄、近5年性伴侣数、丈夫婚外性行为、性生活年限和饮酒。结论:影响城市与农村地区妇女感染HR-HPV的危险因素存在着较大差异。提示,在制定预防和控制宫颈癌以及HR-HPV感染的措施时要因地制宜。

OBJECTIVE：To provide the evidence on the prevention of HR-HPV infection and cervical cancer in china by comparing the risk factors which affect HR-HPV infection among urban and rural population.METHODS： The study was embedded in a cross-sectional epidemiological survey.Totally 1 569 people from city（Beijing and Shanghai）,1 763 people from rural（Shanxi and Henan） were recruited for an epidemiologic survey,gynecologic examination and high-risk HPV testing by HC-Ⅱ.The association between risk factors and HR-HPV infection was explored by using chi-square tests and unconditional logistic regression model.RESULTS： Multivariate logistic regression analysis showed that the risk factors of HR-HPV infection in urban included husband＇s extramarital sexual activity,STD,number of abortions and smoking.History of cytology tests was a protective factor.While risk factors were found associated with HR-HPV infection in rural areas including sexual debut age,number of sexual partners in the past 5 years,husband＇s extramarital sexual activity,number of years having sex activity and alcohol.CONCLUSIONS： Differences exist on the risk factors affecting HR-HPV infection among urban and rural women.This suggests cervical cancer prevention and control measures should be adjusted according to the local conditions.