某煤矿女职工HPV感染现状及其危险因素调查分析

Investigation and analysis of HPV infection and its risk factors among female workers in a coal mine

目的了解某煤矿女职工人乳头瘤病毒(HPV)感染现状,并分析其与阴道微环境的关系。方法以华北医疗健康集团峰峰总医院2020年9月至2021年11月接受宫颈癌(cervical cancer,CC)筛查的3079名煤矿女职工为研究对象,收集其宫颈脱落细胞检测HPV基因亚型,检查阴道分泌物中细菌、滴虫、乳酸杆菌、假丝酵母菌、霉菌。计算HPV感染率,描述HPV感染的基因亚型分布,根据病毒亚型所造成的损伤分成低危型和高危型两类。并了解HPV感染和阴道微环境相关指标(包括阴道清洁度、细菌、滴虫、假丝酵母菌、霉菌感染情况及乳酸杆菌含量)的关系。结果3079名煤矿女职工HPV感染率为21.01%,其中高危型HPV感染率为17.15%(528/3079),低危型HPV感染率为3.86%(119/3079);高危型HPV感染率居于前三位的基因亚型为HPV52、16与58,低危型HPV感染率居于前三位的基因亚型为HPV6、11与43;40~49岁为HPV及高危型HPV感染率最高的年龄段,其次为30~39岁年龄段,且不同年龄段煤矿女职工HPV及高危型HPV感染率比较,差异有统计学意义(χ^(2)=86.452、79.879,P<0.05);HPV及高危型HPV感染率随着煤矿女职工学历降低而逐渐增高(χ^(2)=18.967、21.246,P<0.05),井下作业高于井上作业的煤矿女职工(χ^(2)=49.279、21.583,P<0.05),阴道清洁度异常、滴虫感染、乳酸杆菌缺乏明显高于清洁度正常、非滴虫感染、乳酸杆菌未缺乏者(χ^(2)=5.410、4.634、4.108,χ^(2)=4.863、4.229、4.306,P<0.05);logistic回归分析显示,阴道滴虫感染(OR=2.016)、乳酸杆菌缺乏(OR=2.246)为高危型HPV感染的危险因素。结论煤矿女职工HPV感染率较高,尤其是年龄在30~49岁、学历低、井下作业的煤矿女职工,且HPV感染以高危型为主,常感染的基因亚型为HPV52、16与58。滴虫感染、乳酸杆菌缺乏可能增加HPV尤其是高危型HPV感染风险。

Objective To investigate the current status of human papillomavirus(HPV)infection among female coal mine workers,and to analyze its relationship with vaginal microenvironment.Methods A total of 3079 female coal mine workers who underwent cervical cancer(CC)screening in Fengfeng General Hospital of North China Medical Health Group from September 2020 to November 2021 were selected as the research objects.Cervical exudated cells were collected to detect HPV gene subtypes,and vaginal secretions were examined for bacteria,trichomonas,Lactobacillus,Candida and mold.The HPV infection rate was calculated,and the distribution of the gene subtypes of HPV infection was described.According to the damage caused by the virus subtypes,it was divided into low-risk and high-risk types.The relationship between HPV infection and vaginal microenvironment related indicators(including vaginal cleanliness,bacteria,trichomonas,Candida,mold infection and Lactobacillus content)was also investigated.Results The HPV infection rate of 3079 female coal mine workers was 21.01%,among which the high-risk HPV infection rate was 17.15%(528/3079),and the low-risk HPV infection rate was 3.86%(119/3079);the top three gene subtypes of high-risk HPV infection were HPV52,16 and 58,and the top three gene subtypes of low-risk HPV infection were HPV6,11 and 43;the age group with the highest infection rate of HPV and high-risk HPV was 40-49 years old,followed by 30-39 years old;there were significant differences in the infection rate of HPV and high-risk HPV among female coal mine workers of different ages(χ^(2)=86.452,79.879,P<0.05);HPV and high-risk type HPV infection rate increased gradually along with coal female worker degree lower(χ^(2)=18.967,21.246,P<0.05),the female worker in coal mine underground work above inoue homework(χ^(2)=49.279,21.583,P<0.05),abnormal vaginal cleanness,cleanness of trichomonas infection,lack of lactic acid bacteria are significantly higher than normal,non trichomonas infection,has not been a lack of lactic acid bacteria(χ^(2)=5.410,4.634,4.108,χ^(2)=4.863,4.229,4.306,P<0.05);logistic regression analysis showed that vaginal trichomonas infection(OR=2.016)and Lactobacillus deficiency(OR=2.246)were risk factors for high-risk HPV infection.Conclusion The HPV infection rate of female coal mine workers is relatively high,especially the female coal mine workers aged 30-49 years old,with low education,and working underground.The HPV infection is mainly high-risk types,and the frequently infected genotypes are HPV52,16 and 58.Trichomonas infection and Lactobacillus deficien⁃cy may increase the risk of HPV infection,especially high-risk HPV infection.