人乳头状病毒感染现状及其影响因素分析

Analysis of human papilloma virus infection status and its influencing factors

目的通过检测阴道微生态及人乳头状病毒(HPV)感染情况, 分析HPV感染现状及其影响因素。方法本研究为回顾性研究, 选取2020年1月至2021年3月上海市第六人民医院金山分院妇产科门诊就诊且同时完成宫颈脱落细胞HPV和阴道分泌物微生态检测的3 373例女性, 年龄(37.17±12.19)岁, 年龄范围为15~88岁, 孕妇1 141例, 非孕妇2 232例。检测阴道分泌物微生态、宫颈脱落细胞HPV基因型, 分析孕妇组与非孕妇组纳入者HPV基因亚型分布情况、高低危型HPV感染率, 分析年龄、阴道微生态变化与HPV感染的关系及影响, 分析妊娠、年龄、阴道微生态变化与高危型HPV感染的关系及影响。结果孕妇HPV常见亚型依次为52、16、68、58, 非孕妇HPV常见亚型依次为16、52、58、68, 均为高危型。孕妇组与非孕妇组均以单一高危型HPV感染为主, 孕妇HPV感染率[25.59%(292/1 141)]低于非孕妇组[33.33%(744/2 232)], 差异有统计学意义(P<0.05)。HPV阳性与阴性间年龄、pH、过氧化氢、唾液酸苷酶、滴虫情况比较, 差异均有统计学意义(P<0.05)。logistic回归分析发现, 年龄、过氧化氢和唾液酸苷酶三个因素对HPV有影响, HPV高危组白细胞酯酶[68.30%(599/877)]高于低危组[59.75%(95/159)], 差异有统计学意义(P<0.05)。logistic回归分析发现, 高危型HPV感染与妊娠、年龄及阴道微生态变化均无关, 差异无统计学意义(P>0.05)。结论 HPV感染患者中以高危型为主, 阴道微生态异常者(过氧化氢及唾液酸苷酶阳性)更容易感染HPV, 妊娠、年龄及阴道微生态变化不影响高危型HPV的感染。

Objective The status of human papilloma virus(HPV)infection and its influencing factors were analyzed by examining the vaginal microecology and HPV infection in women.Methods This study was a retrospective study,3373 women(1141 pregnant women and 2232 non pregnant women)were selected from the gynecology and obstetrics clinic of Jinshan Branch of Shanghai Sixth People′s Hospital from January 2020 to March 2021,aged(37.17±12.19)years old,ranging from 15 to 88 years old.All the recruited participants received HPV genotypes test of cervical exfoliated cells and vaginal microecology test of vaginal secretions at the same time.Tested the microecology of vaginal secretions and HPV genotypes of cervical exfoliated cells,analyze the distribution of HPV genotypes and the infection rate of high-risk HPV in pregnant women and non pregnant women,analyze the relationship and influence between age,vaginal microecological changes and HPV infection,and analyze the relationship and influence between pregnancy,age,vaginal microecological changes and high-risk HPV infection.Results The common subtypes of HPV in pregnant women were 52,16,68 and 58,and the common subtypes of HPV in non pregnant women were 16,52,58 and 68,all of which were high-risk types.Both pregnant women and non pregnant women were mainly infected with single high-risk HPV.The HPV infection rate of pregnant women[25.59%(292/1411)]was lower than that of non pregnant women[33.33%(744/2232)],and the difference was statistically significant(P<0.05).There were significant differences in age,pH,hydrogen peroxide,sialidase and Trichomonas between HPV positive and negative(P<0.05).Logistic regression analysis showed that age,hydrogen peroxide and sialidase had an effect on HPV infection,leukocyte esterase[68.30%(599/877)]in high-risk group was higher than that in low-risk group[59.75%(95/159)],and the difference was statistically significant(P<0.05).Logistic regression analysis showed that high-risk HPV infection was not related to pregnancy,age and vaginal microecological changes,and the differences were not statistically significant(P>0.05).Conclusions High-risk types were mainly found among the patients with HPV infection.Patients with abnormal vaginal microecology(positive for hydrogen peroxide and sialidase)were more likely to be infected with HPV.Pregnancy,age and vaginal microecology changes had no affect the infection of high-risk HPV.