不同女性人群生殖道人乳头瘤病毒感染状况分析

发布时间：2018-04-23 02:16

  本文选题：人乳头瘤病毒 + 宫颈癌　； 参考：《实用妇产科杂志》2017年06期

【摘要】：目的:调查不同女性人群生殖道人乳头瘤病毒(HPV)感染状况,为制定不同人群宫颈癌筛查策略提供理论依据。方法:选择2010年1月至2015年12月在重庆市妇幼保健院妇产科门诊体检和就诊的3376例妇女,分为5组:普通人群组770例,妇科疾病患者组1069例,宫颈上皮内瘤变(CIN)患者组560例,不孕症患者组648例,产褥期妇女组329例。采用HPV基因分型技术进行HPV检查,分析HPV DNA亚型感染状况。结果:(1)共检出HPV 22个型别,最常见类型依次为6型(14.81%,500/3376),16型(14.16%,478/3376),52型(12.59%,425/3376),58型(11.91%,402/3376),43型(6.66%,225/3376),未检测出HPV 44型。(2)不同人群HPV总阳性率及高危型阳性率不同,由高到低依次为CIN患者组[89.46%(501/560),85.89%(481/560)],不孕症患者组[66.67%(432/648),58.80%(381/648)],妇科疾病患者组[62.77%(671/1069),55.57%(594/1069)],普通人群组[24.03%(185/770),19.22%(148/770)],产褥期妇女组[13.07%(43/329),10.03%(33/329)]。(3)不同人群中HPV DNA亚型分布有差异,CIN患者组及不孕症患者组以高危型HPV感染为主,感染HPV型别构成比相似,最常见类型均为HPV16、58、52型,且HPV多重感染百分率高于其他组(P0.01),但妇科疾病患者组总体高危型HPV感染率及多重感染率明显高于普通人群及产褥期妇女组。(4)CIN患者组中随CIN病变级别增高,HPV总阳性率及高危型HPV阳性率皆增高,差异有统计学意义(χ~2总=57.49,P0.01;χ~2高危型=58.40,P0.01)。三重及以上HPV感染在高级别病变(CINⅡ、Ⅲ)中更常见(χ~2=8.96,P0.05),在CINⅡ、CINⅢ组中HPV16型检出率高于CINⅠ组,差异有统计学意义(χ~2=33.24,P0.01)。结论:不孕症患者及妇科疾病患者是高危型HPV感染及CIN的高危人群,重视机会性筛查是提高CIN检出率的有效手段。不同女性人群HPV感染状态不同,应针对不同女性人群制定特异筛查模式。
[Abstract]:Objective: to investigate the human papillomavirus (HPV) infection in different female populations and to provide theoretical basis for the development of cervical cancer screening strategy. Methods: 3376 women were selected from January 2010 to December 2015 in Chongqing Maternal and Child Health Hospital. They were divided into 5 groups: general population group (770 cases), gynecological disease group (1069 cases) and cervical intraepithelial neoplasia (cin) group (560 cases). There were 648 cases of infertility and 329 cases of puerperal women. HPV genotyping technique was used to detect HPV DNA subtype infection by HPV. Results A total of 22 types of HPV were detected, the most common type being type 6 (14.81 / 3376 / 16). The total positive rate of HPV and the positive rate of high risk type were different among the different population groups. The positive rate of HPV was different among the different population groups, and the positive rate of HPV was different from that of the high risk type, and the positive rate of HPV was different among different population groups, including 4.92 / 33767.43 type 4.92 / 337643 type 6.25 / 337676%, and the positive rate of high risk type was different among different population groups. 鐢遍珮鍒颁綆渚濇�′负CIN鎮ｈ，

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