男性尖锐湿疣患者人乳头瘤病毒基因型分布特点及复发危险因素

Analysis of human papilloma virus genotypes distribution characteristics and risk factors of the recurrence in male patients with condyloma acuminatum

目的分析男性尖锐湿疣(condyloma acuminate,CA)患者人乳头瘤病毒(human papilloma virus,HPV)感染的基因型分布特点,探讨疾病复发的潜在危险因素,为该病的防治提供一些科学参考。方法选取初诊于民航总医院皮肤性病科的167例男性CA患者作为研究对象,运用DNA芯片技术对患者皮损组织进行HPV基因分型检测。设计编制患者调查表,收集患者社会人口学特征、性行为特征、疾病特征和生活习惯特征纳入研究,并采用单因素和多因素二元Logistic回归分析,探究影响男性CA复发的危险因素。结果167例男性CA患者HPV感染率居前5位的基因型分别为HPV 6(62.28%)、HPV 11(39.52%)、HPV 16(17.37%)、HPV 42(14.37%)、HPV 43(11.38%);其中单一型感染占42.51%,混合型感染占57.49%。单一型感染中,低危型HPV感染占97.18%;混合型感染中,高-低危混合型占93.75%。长病程(OR=6.447)、高危型HPV感染(OR=4.868)、5个及以上的皮损数目(OR=5.780)、熬夜(OR=4.149)和吸烟(OR=3.671)是男性CA复发的独立危险因素(P<0.05)。结论男性CA患者HPV感染以低危型HPV 6、HPV 11为主,混合型感染高于单一型感染,而在混合型感染中尤以高-低危混合型感染较为常见。HPV型别、病程、皮损数目及不良生活习惯与男性CA复发关系密切,临床中应据此做好相应的防治措施。

Objective To describe the genotype distribution characteristics of human papillomavirus(HPV)infection in male patients with condyloma acuminatum(CA).To explore the potential risk factors of the recurrence and provide scientific reference for the prevention and treatment of CA.Methods Total of 167 male CA patients who visited dermatology and venereology department of Civil Aviation General Hospital were selected as the research subjects.HPV genotypes were detected in skin tissue of the patients by DNA chip technology.A patient questionnaire was designed and compiled to collect the sociodemographic characteristics,sexual behavior characteristics,disease characteristics and lifestyle characteristics of the patients.The risk factors for male CA recurrence were analyzed using univariate and multivariate binary Logistic regression analysis in the study.Results Among the 167 male CA patients,the top 5 infection rates of HPV were HPV 6(62.28%),HPV 11(39.52%),HPV 16(17.37%),HPV 42(14.37%)and HPV 43(11.38%),respectively.Single infection accounted for 42.51%,mixed infection accounted for 57.49%;Low risk HPV infection accounted for 97.18%of single infection.In the mixed infection,the high-low-risk mixed type accounted for 93.75%.Long course of disease(OR=6.447),high-risk HPV infection(OR=4.868),number of 5 or more lesions(OR=5.780),staying up late(OR=4.149)and smoking(OR=3.671)were independent risk factors for male CA recurrence(P<0.05).Conclusion HPV infection in male CA patients is mainly low risk HPV 6 and 11,mixed infection is higher than single infection,and the high-low-risk mixed infection is more common.HPV type,course of disease,number of lesions and bad living habits are closely related to the recurrence of male CA,and corresponding prevention and treatment measures should be taken accordingly in clinic.