潍坊市人民医院妇科就诊者高危型人乳头瘤病毒感染危险因素分析

Risk factors of high-risk human papilloma virus infection in gynecological patients from Weifang People＇s Hospital

目的 分析潍坊市人民医院就诊妇女人乳头瘤病毒（HPV）的感染情况及高危型HPV感染的危险因素.方法 对2010年1月至2012年12月来潍坊市人民医院妇科就诊妇女的宫颈分泌物进行HPV DNA分型检测,从符合纳入标准的391例HPV阳性妇女中选出高危型HPV感染妇女（356例）作为病例组,采用1∶1配对病例-对照的方法,选取HPV检测阴性妇女作为对照组.所有研究对象接受问卷调查,包括基本人口学信息、孕期情况、生活环境史、性行为特征和家族史等50个项目.采用逐步条件Logistic回归分析高危型HPV感染的危险因素.结果 391例HPV阳性妇女中,HPV单一高危亚型318例（81.3％）,单一低危亚型35例（9.0％）,多重感染38例（9.7％）.对356例高危型HPV感染妇女进行逐步条件Logistic回归分析发现,已婚、初次性行为＜20岁,多个性伴侣,有口交史,有商业性行为史和阴道冲洗≥1次/周是高危型HPV感染的危险因素（OR=4.053,1.861,1.587,2.420,5.125和1.943,P＜0.01）.结论 不安全性行为方式与高危型HPV感染有关.应提倡健康的性行为方式,并加强对妇女高危型HPV感染检测和预防控制.

Objective To investigate the prevalence of human papilloma virus （HPV） infections among gynecological patients and to identify the risk factors associated with high-risk HPV （HR-HPV）infection.Methods HPV DNA genotyping was performed in 391 HPV infected gynecological patients admitted in Weifang People＇s Hospital during January 2010 and December 2012.HPV negative patients （controls,n =356） were matched to HR-HPV positive patients （cases,n =356） with a 1 ∶ 1 ratio.All the participants took part in a questionnaire survey with 50 items,including demographic characteristics,pregnancy and reproductive history,living conditions,sexual behavior,family history,etc.Stepwise Logistic regression analysis was used to determine the risk factors of HR-HPV infection.Results Among 391 HPV positive patients,318 （81.3％） were infected with one type of HR-HPV,35 （9.0％） were infected with one type of low-risk HPV,and 38 （9.7％） were infected with mixed types.Logistic regression analysis showed that married women,age of sexual debut ＜ 20,multiple sexual partners,oral sex,commercial sexual activity,and vaginal douching more than once a week were risk factors of HR-HPV infection （OR =4.053,1.861,1.587,2.420,5.125 and 1.943,respectively,all P ＜ 0.01）.Conclusions Unprotected sex may be associated with HR-HPV infection.Healthy sexual behavior should be encouraged,and the detection,prevention and control of HR-HPV infection should be strengthened.