北京通州地区妇女HPV亚型分布及感染状况及危险因素分析

Investigation on the subtype distribution, infection status and risk factors of HPV in women in Tongzhou, Beijing

目的调查北京市通州地区妇女HPV亚型分布、感染状况及危险因素。方法于2018年1~12月对北京市通州区妇幼保健院妇科门诊就诊且自愿接受检测的12 431例妇女进行HPV基因分型检测及危险因素问卷调查。描述研究对象HPV感染率,HPV亚型、感染年龄分布,比较不同年龄组的感染率及影响HPV感染的多因素指标。结果研究共检测阳性2 694例,总感染率21.67%;单一感染1 957例(72.64%),多重感染737例(27.56%)。HPV感染年龄分布比较,差异有统计学意义(χ^2=19.199,P=0.002)。性伴侣人数多[3.146(2.053~4.788)]、妊娠次数多[1.713(1.205~2.189)],是HPV感染的危险因素;文化程度高[0.428(0.301~0.675)]、初次性行为年龄晚[0.561(0.329~0.814)]、使用安全套[0.390(0.225~0.714)]是HPV感染的保护因素。结论通州地区妇女HPV感染率较高,高危型以HPV16、HPV51、HPV52、HPV53及HPV58为主,年龄以<21岁组、51~60岁组感染率最高。与HPV感染相关的因素有:文化程度、初次性行为年龄、性伴侣人数、是否使用安全套、妊娠次数。

Objective To investigate the distribution of HPV subtypes and infection status, and to analyze its risk factors in women in Tongzhou District, Beijing. Methods HPV genotyping and risk factors questionnaire survey were conducted in 12 431 volunteers undergoing routine physical examination in our hospital from January to December 2018. The HPV infection rate, HPV subtypes and infection age distribution of the subjects were described. The infection rate of different age groups and the multi-factor indicators affecting HPV infection were compared. Results A total of 2 694 positive samples were detected in this study, with a total infection rate of 21.67%. 1 957 cases were single infection(72.64%) and 737 cases were multiple infection(27.56%). HPV16(14.15%), HPV51(6.44%), HPV52(17.97%), HPV53(8.35%) and HPV58(10.43%) were the main high-risk types, while HPV42(22.90%) and HPV81(22.40%) were the main low-risk types. The age distribution of HPV infection showed significant statistical difference(χ~2=19.199,P=0.002). The high number of sexual partners [3.146(2.053, 4.788)] and high number of pregnancies [1.713(1.205, 2.189)] were risk factors for HPV infection. The high level of education [0.428(0.301, 0.675)], later age at first sexual intercourse [0.561(0.329, 0.814)], and the use of condoms [0.390(0.225, 0.714)] were protective factors for HPV infection. The age distribution of HPV infection was statistically significant(χ~2=7123.425, P=0.000). The positive proportions in the <21 years old group(28.26%) and the 51-60 years old group(25.05%) were the highest. The infection rate of 31-40 years old group was significantly lower than that of 41-50 years old group and 51-60 years old group(χ~2=10.761,P=0.001;χ~2=9.592,P=0.002). Conclusion The infection rate of HPV was higher in women in Tongzhou, Beijing. The high-risk types were HPV16, HPV51, HPV52, HPV53, and HPV58. The infection rate was the highest in the groups of less than 21 years old and 51-60 years old. The influencing factors included education level, age of first sexual behavior, number of sexual partners, use of condoms and number of pregnancies. It is suggested to strengthen health education, take good contraceptive measures, and maintain healthy sexual behavior to reduce HPV infection.