南宁市妇女人乳头状病毒感染状态及危险因素调查

Prevalence and risk factors of human papilloma virus among women attending cervical cancer screening in Nanning city

目的调查南宁市妇女高危型人乳头状病毒（HPV）感染状态及危险因素。方法2014年1～6月，在该院妇科门诊就诊自愿参加进行宫颈癌机会性筛查及问卷调查的妇女431名为研究对象，收集她们的人口学信息和相关危险因素信息，并行常规妇科检查、生殖道微生物检测、宫颈细胞第2代杂交捕获技术（HC2）检测、细胞学检查。对可疑宫颈上皮内瘤变或宫颈癌患者行阴道镜检查活检，并进行组织病理学诊断。结果431名调查对象中，高危型HPV感染54例，感染率12．53％。在宫颈病变组与宫颈正常组中，高危型HPV阳性率分别为87．50％和9．64％，两者比较差异有统计学意义（P〉0．05）。单因素及多因素研究分析，多个性伴侣（≥2个）和病原菌感染（尤其是细菌性阴道炎）是高危型HPV感染的高危因素。对阴道微生态环境的多因素分析显示，病原菌感染和细菌性阴道病是HPV病毒感染的高危因素。结论宫颈病变组中HPV感染率高于宫颈正常组，而初次性生活年龄早、多个性伴侣、病原菌感染、细菌性阴道病是HPV感染的危险因素。

Objective This study evaluates the prevalence and factors related to high-risk human papilloma virus （HR-HPV） infection in Nanning adult women. Methods A total of 431 women who presented cervical cancer screening in （gynecological clinic, maternal and child health hospital of the Guangxi Zhuang Autonomous）were selected as subjects, from January to June, 2014. A standardize questionnaire regarding demographic characteristics and possible risk factors of cervical cancer was filled by each participant. Routine gynecological examination, microbial detection of reproductive tract, cervical cell HC2 test, cervical cytological and HPV DNA testing were applied to all participantes. Individuals who were suspicious for cervical intraepithelial neoplasia or cervical cancer received colposcopy biopsy and histopathological diagnosis. The date were analyzed in SPSS 19.0. Results Out of the total number of 431 samples. 54 （12.53%） subjects were positive for HR-HPV. Among women with cervical abnormalities, 82.50% had HR-HPV infection compared to 9.64% of those women with healthy cervix （P〈0.01. Analysis for risk factors of HPV infection showed that extramarital sexnal behaviors and mahiple sexual partners would increase the risk of HPV positivity. For vaginal micro ecological environment of muhi-factor analysis showed that pathogen infection and bacterial vaginal disease are risk factors of HPV infection. Conclusion Among women with cervical abnormalities, HR-HPV positivity was significantly higher than that among women with normal cervix, extramarital sexnal behaviors,multiple parity, pathogen infection and bacterial vaginal disease increase the risk of HPV infection.