不同亚型人乳头状瘤病毒感染与复发率的研究分析

Correlation between different subtypes of HPV infections and recurrence rate of condyloma acuminatum

目的探讨不同尖锐湿疣(CA)患者皮损中人乳头状瘤病毒(HPV)亚临床感染与CA复发率的关系,以降低感染率及复发率。方法选取2010年3月-2011年1月在门诊就诊并确诊为尖锐湿疣的48例初发病例为研究对象,用基因芯片检测病毒亚型分组,按常规激光祛除疣体方法治疗后,分组进行临床复发观察,时段在1、3、6、12月份进行复发率的统计分析。结果尖锐湿疣患者低危组28例,占58.4%,其中以HPV6/11为主,占47.9%,高危组有16例占33.3%,以HPV16/18为主占16.7%,混合型组4例,占8.3%,低危组患者治疗总有效率为90.0%,对照组为77.8%(P<0.05);复发率低危组为33.3%、高危组为72.2%(P<0.05),治疗后两组患者免疫球蛋白IgA、IgM和IgG与补体C3、C4的水平无差异。结论 HPV6/11型复发率低,HPV16/18型复发率高,与病毒可能整合到宿主细胞内有关,HPV16/18型为易复发型,并且潜伏周期长,随时间推移,复发率有所增加,值得临床注意。

OBJECTIVE To explore the correlation between the different subtypes of human papilloma virus（HPV） infections in skin lesion of condyloma acuminatum（CA）patients and the recurrence rate of CA so as to reduce the infection rate as well as the reoccurrence rate.METHODS A total of 48patients who were diagnosed as the initial onset of CA in the outpatient department from Mar 2010to Jan 2011were enrolled in the study,and the subtypes of the virus were detected by gene chip,and the patients were grouped after the treatment by using the conventional laser dispel wart body,then the clinical reoccurrence was observed,and the reoccurrence rate in February,March,April,May,June,August,October or December was statistically analyzed.RESULTS Of the patients with CA in this area,the HPV6/11infection（30cases）was predominant in the low risk group,with the mixed infections existing,and HPV16/18infection（18cases）was predominant in the high risk group,with the mixed infections existing,the difference in the reoccurrence rate after the treatment between the two groups was significant（P0.05）.The total effective rate of the low-risk group was 90.0%,the high-risk group 77.8%（P 0.05）;the reoccurrence rate of the low-risk group was 33.3%,the high-risk group 72.2%（P0.05）;however,the difference in the level of IgA,IgM,IgG,C3,or C4after the treatment between the two groups was not significant.CONCLUSIONThe recurrence rate of CA in the patients with HPV6/11infections is low,the patients with HPV16/18infections high,which may be related to the virus integrated into the host cells,the HPV16/18is the type easy relapse,and the latent period is long,the reoccurrence rate is increasing along with time,which is worthy to be attached great importance to.