妇科疾病患者人乳头瘤病毒感染及其影响因素分析

Analysis of human papillomavirus infection and its influencing factors in patients with gynecological diseases

目的探讨妇科疾病患者人乳头瘤病毒(HPV)感染及不同亚型分布情况,分析HPV感染的影响因素。方法选择2017年6月至2020年6月在新乡医学院第三附属医院妇产科就诊的856例疑似HPV感染的妇女为研究对象。患者均行23种HPV基因分型检查,计算HPV感染率及其分型占比,并分析影响HPV感染的危险因素。结果856例患者中,360例(42.06%)HPV基因检测阳性,其中低危型HPV阳性52例(6.08%),高危型HPV阳性308例(35.98%)。高危型HPV感染中HPV16、HPV58、HPV52占比较高(分别为8.88%、7.48%、6.19%),低危型HPV感染中HPV6、HPV42、HPV43占比较高(分别为1.75%、1.40%、1.17%)。单因素分析结果显示,受试者年龄、生活方式、首次性生活年龄、首次妊娠年龄、是否绝经、宫颈癌家族史及流产次数与HPV感染有关(P<0.05),妇科疾病史和患者就诊季节分布与HPV感染无关(P>0.05)。多因素logistic回归分析结果显示,首次性生活年龄<23岁、有宫颈癌家族史及流产次数>2次是HPV感染的危险因素(P<0.05)。结论妇科疾病患者中HPV感染率较高,主要为高危型HPV感染,高危型HPV感染中以HPV16、HPV58、HPV52为主。过早开始性生活、流产次数较多及宫颈癌家族史是HPV感染的危险因素。

Objective To investigate the infection of human papilloma virus(HPV)and distribution of different subtypes in 856 patients with gynecological diseases,and analyze the influencing factors of HPV infection.Methods A total of 856 women with suspected HPV infection who were admitted to the Department of Obstetrics and Gynecology of the Third Affiliated Hospital of Xinxiang Medical University from June 2017 to June 2020 were selected as research objects.All patients underwent 23 HPV genotyping test,the infection rate and the ratio of HPV subtypes were calculated;the risk factors of HPV infection were analyzed.Results Among the 856 patients,360(42.06%)cases were HPV positive,52 cases(6.08%)were low-risk HPV positive,and 308 cases(35.98%)were high-risk HPV positive.The top three high-risk HPV subtypes were HPV16(8.88%),HPV58(7.48%),HPV52(6.19%),respectively;and the top three low-risk HPV subtypes were HPV6(1.75%),HPV42(1.40%),HPV43(1.17%),respectively.Univariate analysis showed that the age,lifestyle,age of the first sexual intercourse,age of the first pregnancy,menopause,family history of cervical cancer and abortion times were associated with HPV infection(P<0.05);the history of gynecological diseases and the seasonal distribution of patients were not related to HPV infection(P>0.05).Multivariate logistic regression analysis showed that the age of the first sexual intercourse<23 years old,family history of cervical cancer and abortion times>2 were the risk factors for HPV infection(P<0.05).Conclusion HPV infection rate is higher in patients with gynecological diseases.HPV infections are mainly high-risk HPV subtypes infections.The high-risk HPV subtypes infections are mainly HPV16,HPV58 and HPV52.Early sexual intercourse,more abortions and family history of cervical cancer are the risk factors of HPV infection.