妇科门诊女性生殖道人乳头状瘤病毒及病原体感染情况调查

Investigation and analysis of the prevalence of human papillomavirus infection and other microbial patho gens in Gynecology

目的探讨妇女人乳头状瘤病毒（HPV）及其他常见病原微生物感染现状。方法收集2009年1月～2011年12月在鄂州市中心医院妇科门诊就诊的2021例妇女的宫颈和阴道拭子标本，PCR检查HPVDNA及其基因分型，同时检测病原体感染情况。结果2021例病例HPV阳性625例，阳性率为30．93％。在625例HPV阳性病例中，除52例为混合基因型，其余573例共检测出35种HPV的不同亚型，检出率较高的亚型分别是HPV16（14．83％）、HPV58（9．08％）、HPV53（7．50％）、HPV42（6．28％）、HPV31和HPV6（各5．41％）；HPV高危型和可能高危型占52．53％，HPV低危型占22．86％，HPV未知危险型占24．61％。在HPV阳性625例妇女中，感染沙眼衣原体占12．80％，解脲支原体占33．92％，无乳链球菌占8．96％，阴道毛滴虫占1．12％，细菌性阴道病占9．44％，假丝酵母菌占12．64％。结论鄂州地区妇女高危型HPV感染率较高，早期筛查、控制HPV感染是降低宫颈癌发病率的有效途径．

Objective To investigate the prevalence of infections due to human papillomavirus and other microbial pathogens in Gynecology. Methods Cervical samples were collected to test for HPV and bacterial infections in Gynecology outpatients. HPV typing and sequencing was done by performing PCR on cervical swabs, and the other microorganisms were detected using conventional methods. Results Of 2 021 outpatients studied, 625 tested positive for HPV DNA, with a rate of infection of 30. 93%. HPV genotyping identified 35 different types of HPV. The most prevalent was HPV16 （14.83%）, followed byHPV58 （9.082%）, HPV53 （7.50%）, and HPV42 （6.28%）. Of the different types of HPV, 52.53% were a high-risk or possible high-risk type, 22.86%/oo were a low-risk type, and 24.61% were a type with an unknown risk. Among HPV-positive women, 12.80% were infected with Chlamydia trachomatis, 33.92% were in fected with Ureaplasma urealyticum, 8. 96% were infected with Streptococcus agalactiae, 1. 12% were infected with Trichomonas vaginalis, 9.44% had bacterial vaginosis, and 12. 64% were infected with Candida g labrata. Conclusion A high rate of infection with HPV was noted. Although having bacterial vaginosis was not significantly associated with HPV, it was more common among HPV-positive women. HPV infection must be detected early and controlled in order to prevent and treat cervical cancer.