高危型人乳头瘤病毒感染患者病毒清除及持续感染的随访性研究

发布时间：2018-03-15 09:23

本文选题：高危型人乳头瘤　切入点：持续感染　出处：《首都医科大学学报》2015年02期 　论文类型：期刊论文

【摘要】：目的探讨医院机会性筛查人群初次高危型人乳头瘤(high risk human papillomavirus,HR-HPV)感染后病毒自然清除或持续感染的相关因素。方法随访2013年1月1日到2013年12月31日首都医科大学附属北京朝阳医院妇产科初次HRHPV阳性患者969例。观察HR-HPV感染患者病毒自然清除特征及相关因素,分析年龄、病毒基因分型、多重感染以及初次感染病毒负荷量与病毒自然消除及持续性感染的关系。SPSS 18.0统计软件进行统计学处理,Kaplan-Meier生存分析用于计算病毒清除时间。COX比例风险回归用于病毒清除相关因素分析。结果 969例HR-HPV感染患者平均病毒清除时间为9.52(95%CI:9.09~9.95)个月,中位消退时间8(95%CI:7.65~8.36)个月。不同年龄组HR-HPV自然清除的时间不同(χ2=7.93,P=0.047)。不同亚型HPV自然清除时间不同,清除时间最长的前5位分别是HPV56型、HPV33型、HPV58型、HPV52型、HPV18型。病毒清除时间最短的是依次HPV45型、HPV51型、HPV68型。多病毒联合感染同病毒持续感染相关,联合感染者病毒清除时间明显延长,持续感染时间延长(χ2=18.67,P=0.000)。初次感染的病毒负荷量不同,病毒自然清除时间不同,差异有统计学意义(χ2=18.68,P=0.000)。COX比例风险回归分析显示:年龄(回归系数为-0.082,P=0.046)及多病毒联合感染(回归系数为-0.231,P=0.037)同病毒清除呈负相关,初次感染病毒负荷量分级(回归系数为-0.185,P=0.108)与病毒自然清除时间无相关。结论 HR-HPV基因型为HPV56型、HPV35型、HPV58型、HPV51型、HPV35型,≥50岁女性、多重感染以及初次高病毒负荷量患者,病毒自然清除时间长,更易发生持续性感染。
[Abstract]:Objective to investigate the factors related to the natural clearance or persistent infection of high risk human papillomavirusHR-HPV-infected human papillomavirus.Methods from January 1st 2013 to December 31st 2013, a follow-up study was carried out in Capital University of Medical Sciences. A total of 969 patients with HRHPV positive in gynecology and obstetrics department of Beijing Chaoyang Hospital were studied. The characteristics and related factors of virus clearance in patients with HR-HPV infection were observed. Age analysis, virus genotyping, Relationship between multiple infection and initial infection virus load and virus natural elimination and persistent infection. Statistical software SPSS 18.0 for statistical analysis of Kaplan-Meier survival analysis used to calculate virus clearance time. Cox proportional risk regression for viruses. Results the average virus clearance time of 969 patients with HR-HPV infection was 9.52% 9.09% 9.95 months. The median extinction time was 8 / 95 CI: 7.65 / 8.36) months. The time of natural clearance of HR-HPV was different in different age groups (蠂 ~ 2 / 7.93). The time of natural clearance of HPV was different among different subtypes of HPV. The first five places with the longest clearance time were HPV56, HPV33, HPV58, HPV52, and HPV18, respectively. The shortest clearance time of the virus was HPV45, HPV51 and HPV68. The co-infection of polyvirus was associated with the persistent infection of the virus, and the clearance time of the co-infected patients was significantly prolonged. The duration of persistent infection was prolonged (蠂 2 + 18.67). The virus load was different and the time of virus clearance was different in the first infection. The difference was statistically significant (蠂 ~ 2 / 18.68 / P 0.000). Cox proportional regression analysis showed that age (regression coefficient = -0.082) and polyvirus co-infection (regression coefficient = -0.231) were negatively correlated with virus clearance, and the correlation between age (regression coefficient = -0.082) and polyvirus co-infection (regression coefficient = -0.231) was negatively correlated with virus clearance. There was no correlation between the initial viral load classification (regression coefficient = -0.185) and the time of natural virus clearance. Conclusion the genotype of HR-HPV is HPV56 / HPV35 / HPV58 / HPV51 / HPV35, which is more than 50 years old in women with multiple infection and initial high viral load. Virus natural clearance time is long, more prone to persistent infection.
【作者单位】：首都医科大学附属北京朝阳医院妇产科;首都医科大学附属北京通州潞河教学医院妇产科;首都医科大学附属北京朝阳医院病理科;首都医科大学附属北京朝阳医院检验科;
【基金】：北京市自然科学基金(7122069) 北京市科学技术委员会科技计划(Z131100004013018) 北京市金桥工程种子资金项目(2014-2016)~~
【分类号】：R737.33

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