男男性行为者肛周及肛管尖锐湿疣复发的危险因素分析

发布时间：2018-05-08 19:14

本文选题：男男性行为者 + 尖锐湿疣　；参考：《中国艾滋病性病》2017年06期

【摘要】：目的探讨男男性行为者(MSM)肛周及肛管内尖锐湿疣复发的危险因素。方法通过问卷调查,采集132例患者的社会人口统计学、行为学资料,使用导流杂交基因芯片技术确定患者感染人类乳头瘤病毒(HPV)的基因分型。采用单因素和多因素Logistic回归分析方法,筛选尖锐湿疣复发的影响因素。单因素分析中P0.20的变量纳入多因素Logistic回归分析。结果 132例患者首次CO2激光治疗后,复发67例,复发率50.8%。HPV阳性的132例标本中,共检出13种HPV基因型。低危型感染82例(62.1%),高危型感染50例(37.9%)。多因素Logistic回归分析发现,感染HPV基因分型中含有高危型[比值比(OR)=3.501,95%可信区间(CI):1.147~10.682]、皮损的发生部位侵及肛管(OR=5.130,95%CI:1.548~17.006)、首诊时疣体数目10个或受累面积2cm~2(OR=7.291,95%CI:2.376~22.374)、患者合并肛门常见疾病(痔疮、肛瘘、肛裂)(OR=6.026,95%CI:1.414~25.686)、合并艾滋病病毒(HIV)感染(OR=15.224,95%CI:1.353~171.241),是尖锐湿疣复发的危险因素。结论高危型HPV感染要加大治疗力度,加强随访,定期复查,关注HIV感染,并采取良好有效的干预机制,以降低尖锐湿疣的复发率。
[Abstract]:Objective to investigate the risk factors of recurrence of condyloma acuminatum in perianal and anal canal of MSM. Methods the data of social demography and behavior of 132 patients were collected and the genotyping of HPVinfected patients with HPV was determined by using the gene chip technique of diversion hybridization. Univariate and multivariate Logistic regression analysis was used to screen the factors affecting recurrence of condyloma acuminatum. The variable of P0.20 in univariate analysis was included in multivariate Logistic regression analysis. Results after the first CO2 laser therapy, 67 cases recurred. 13 HPV genotypes were detected in 132 samples with positive 50.8%.HPV recurrence rate. There were 82 cases of low risk type infection and 50 cases of high risk type infection. Multivariate Logistic regression analysis showed that high risk type was found in the genotyping of infected HPV [the ratio was 3.50195% confidence interval (CI: 1.147U 10.682)], the site of skin lesion was involved in OR5.130 ~ 95CI: 1.548 ~ 17.006%, the number of warts was 10 or the affected area was 2cm ~ (2cm) at the first visit, the patient was 2.37622.3744.The patient was complicated with common anal diseases (hemorrhoids, haemorrhoids, etc.) Anal fistula, anal fissure, 6.026 ~ 95% CI: 1.4141425.686, combined with HIV infection) infection: 15.224c95 CI: 1.353C 171.241, which is a risk factor for the recurrence of condyloma acuminatum. Conclusion High risk HPV infection should be treated more intensively, follow up more regularly, pay attention to HIV infection, and take good and effective intervention mechanism in order to reduce the recurrence rate of condyloma acuminatum.
【作者单位】：上海市第一人民医院分院;上海交通大学附属第一人民医院;上海建工医院;上海市疾病预防控制中心;上海心生;
【基金】：上海市卫生和计划生育委员会委级科研项目(20134220)~~
【分类号】：R752.53

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