高危型人乳头瘤病毒感染的危险因素分析及列线图预测模型构建

Analysis of risk factors of high-risk human papilloma virus infection and construction of nomograph prediction model

目的探讨女性感染高危型人乳头瘤病毒(HR-HPV)的危险因素及构建列线图预测模型的价值。方法选取2021年1-12月该院收治的接受HR-HPV感染筛查的146例HR-HPV阳性患者作为观察组和146例HR-HPV阴性者作为对照组。收集并比较两组的一般资料及HR-HPV感染问卷调查结果。采用Logistic回归分析HR-HPV感染的危险因素,并在此基础上构建列线图预测模型。结果与对照组比较,观察组使用洗剂进行外阴清洁、有清洗阴道习惯、初次性生活的年龄较小、性生活频繁、已育、阴道分泌物数量和性状异常的患者比例更高,差异均有统计学意义(P<0.05)。Logistic回归分析发现,HR-HPV感染与多种因素相关,有生育史、洗剂清洁外阴、过早进行性生活、阴道分泌物量和性状异常是感染HR-HPV的独立危险因素(P<0.05)。内部验证结果显示,列线图模型预测感染HR-HPV的C-index为0.753(95%CI:0.741~0.832),有较好的预测性能。列线图模型预测风险阈值>0.16,列线图模型提供临床净收益且均高于单个独立危险因素。结论HR-HPV感染与多种因素相关,构建预测模型能够有效地对感染HR-HPV患者进行风险评估。

Objective To explore the risk factors of high-risk human papilloma virus(HR-HPV)infection in women and the value of construction of nomograph prediction model.Methods A total of 146 HR-HPV positive patients who underwent HR-HPV infection screening in this hospital from January to December 2021 were selected as the observation group,and 146 HR-HPV negative women were selected as the control group.The general data and the results of HR-HPV infection questionnaire were collected and compared between the two groups.Logistic regression analysis was used to analyze the risk factors of HR-HPV infection,and a nomogram prediction model was constructed on this basis.Results Compared with the control group,the observation group had a higher proportion of patients who used lotion for vulvar cleaning,had the habit of cleaning vagina,had a younger age of first sexual life,had frequent sexual life,had children,had abnormal quantity and character of vaginal secretions,and the differences were statistically significant(P<0.05).Logistic regression found that HR-HPV infection was related to a variety of factors,and the independent risk factors for HR-HPV infection included childbearing history,improper cleaning vaginal,premature sexual life,and abnormal vaginal secretion volume and character(P<0.05).Internal validation results showed that the C-index of the nomograph model for predicting HR-HPV infection was 0.753(95%CI:0.741-0.832),which had good predictive performance.The nomograph model predicted a risk threshold>0.16,and the nomograph model provided a net clinical benefit and was higher than individual independent risk factor.Conclusion HR-HPV infection is related to variety of factors,and constrcution of prediction model can effectively evaluate the risk of HR-HPV infection in patients.