高危型人乳头瘤病毒感染的影响因素分析

Analysis of Influencing Factors for High-risk Human Papillomavirus Infection

  • 摘要:
      目的  分析高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染的相关危险因素。
      方法  选取2020年10月—2021年1月就诊于首都医科大学附属北京妇产医院妇科门诊的HR-HPV感染者作为感染组,同期于妇科门诊行子宫颈癌筛查且结果为HR-HPV阴性的患者作为对照组。两组均填写自行设计的《HR-HPV感染相关危险因素调查表》,统计分析HR-HPV感染相关危险因素。
      结果  共纳入感染组患者125例,对照组患者53例。对两组进行单因素组间比较显示,感染组无业或职业社会经济地位较低、用洗剂清洁外阴、冲洗阴道频率高、性取向为同性、生育次数多、既往阴道炎病史、阴道分泌物量多、阴道分泌物性状异常和沙眼衣原体感染率均高于对照组(P均<0.05)。多因素Logistic回归分析显示,生育史(OR=5.106,95% CI:1.521~17.145, P=0.008)、既往阴道炎病史(OR=3.910,95% CI:1.167~13.099, P=0.027)、阴道分泌物异常(OR=758.313,95% CI:58.151~9888.714, P<0.001)是HR-HPV感染的危险因素。此外,用洗剂清洗外阴或冲洗阴道的清洁习惯(OR=2.004)、性取向为同性(OR=13.972)、沙眼衣原体阳性(OR=15.058)均显示出与HR-HPV感染具有较强的关联性,但由于对照组样本量较少,并未得出有统计学意义的结果。
      结论  HR-HPV感染与多种因素相关,生育次数多、既往阴道炎病史、阴道分泌物性状异常是HR-HPV感染的危险因素,建议重视阴道分泌物变化,如有异常,及时就诊。在有条件的情况下,行宫颈HR-HPV筛查时加入阴道微生态的相关检查,如患有生殖道炎性疾病,应及时治疗,从多方面预防HR-HPV感染及降低HR-HPV持续感染的风险。

     

    Abstract:
      Objective  To investigate the relevant risk factors of high-risk human papillomavirus(HR-HPV) infection.
      Methods  From October 2020 to January 2021, the cases of positive HR-HPV test were selected as the infection group, and the cases of negative HR-HPV test were selected as the control group. Both groups of patients filled in self-designed "survey of HR-HPV infection-related factors" in order to explore the relevant risk factors.
      Results  A total of 125 patients in the infection group and 53 patients in the control group were included. Univariate analysis showed that there were statistically significant differences between the two groups in the following factors: unemployed or low socioeconomic status, vulva cleaning with lotion, high frequency of vaginal irrigation, homosexual orientation, production number, history of vaginitis, large amount of vaginal secretions, abnormal characteristics of vaginal secretion and chlamydia trachomatis infection(all P < 0.05). Logistic regression analysis showed that production number(OR=5.106, 95% CI: 1.521-17.145, P=0.008), previous history of vaginitis (OR=3.910, 95% CI: 1.167~13.099, P=0.027) and abnormal vaginal secretion (OR=758.313, 95% CI: 58.151~9888.714, P < 0.001) were risk factors for HR-HPV infection. In addition, the habit of using lotion to clean the vulva or vagina(OR=2.004), homosexual orientation (OR=13.972), and chlamydia trachomatis infection (OR=15.058) all showed a strong association with HR-HPV, but due to the small number of samples in the control group, no conclusions with statistical significance were drawn.
      Conclusions  HR-HPV papillomavirus infection is associated with a variety of factors. Production number, history of vaginitis and abnormal characteristics of vaginal secretion are risk factors for HR-HPV infection. It is therefore recommended to pay attention to the characteristics of vaginal secretions, and timely seek medical treatment if there is any abnormality. If possible, cervical HR-HPV screening should be added to the vaginal microecological examination. If there are reproductive tract inflammatory diseases, it should be treated in time, so as to prevent HR-HPV infection from many aspects and reduce the risk of continuing infection of HR-HPV.

     

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