目的:探讨人乳头瘤病毒（HPV）单一、多重感染在不同子宫颈病变中发生情况，分析单一感染时HPV型别分布及HPV感染患者治疗前后病毒载量的变化。方法:回顾性分析2017年5月至2019年3月山西省人民医院经子宫颈脱落细胞HPV-DNA检测HPV阳性者4 783例，其中3 728例符合标准纳入本研究。采用荧光定量聚合酶链反应（PCR）测定HPV基因型及病毒载量，并进行液基薄层细胞学（TCT）检查和阴道镜下组织病理学诊断。依据组织病理结果，将患者分为慢性子宫颈炎+子宫颈上皮内瘤变（CIN）Ⅰ组、CINⅡ+CINⅢ组及子宫颈癌组。结果:HPV单一感染共有3 364例，其中慢性子宫颈炎+CINⅠ占比为78.27%（2 633/3 364），CINⅡ+CINⅢ占比为18.73%（630/3 364），子宫颈癌占比为3.00%（101/3 364）；HPV多重感染共有364例，其中慢性子宫颈炎+CINⅠ占比为51.65%（188/364），CINⅡ+CINⅢ占比为42.58%（155/364），子宫颈癌占比为5.77%（21/364）；HPV单一感染和多重感染中不同病理级别子宫颈病变占比差异有统计学意义（n χ2＝127.21，n P<0.01）。慢性子宫颈炎+CINⅠ组、CINⅡ+CINⅢ组中前四位HPV单一感染基因型依次均为16、52、58、53型，其在慢性子宫颈炎+CINⅠ组中占比分别为17.05%（449/2 633）、12.91%（340/2 633）、9.08%（239/2 633）、8.89%（234/2 633），在CINⅡ+CINⅢ组中占比分别为32.22%（203/630）、10.32%（65/630）、8.41%（53/630）、5.87%（37/630）。子宫颈癌组中前二位HPV单一感染基因型依次为16、18型，其占比分别为81.19%（82/101）、6.93%（7/101）。120例HPV感染者治疗前病毒载量为4.89±1.14，治疗后为2.86±1.63，差异有统计学意义（n t＝13.260，n P<0.01）。n 结论:HPV多重感染较单一感染更易加重子宫颈病变程度。不同子宫颈病变中常见HPV感染亚型包括16、52、58、53、18型。“,”Objective:To investigate the occurrence of human papillomavirus (HPV) single and multiple infections in different cervical lesions, and to analyze the distribution of HPV types in patients with single infection and the change of viral load before and after treatment.Methods:A total of 4 783 HPV-DNA-positive cases who were detected by cervical exfoliated cells HPV-DNA testing from May 2017 to March 2019 in Shanxi Provincial People's Hospital were retrospectively analyzed, of which 3 728 cases met the criteria and were included in this study. Fluorescence quantitative polymerase chain reaction (PCR) was used to determine HPV genotype and viral load, and liquid-based thin-layer cytology (TCT) test and colposcopic histopathological diagnosis were performed. According to the histopathological results, the patients were divided into chronic cervicitis+cervical intraepithelial neoplasia (CIN) Ⅰ group, CIN Ⅱ+CIN Ⅲ group and cervical cancer group.Results:A total of 3 364 cases had HPV single infection, of which chronic cervicitis+CIN Ⅰ accounted for 78.27% (2 633/3 364), CIN Ⅱ+CIN Ⅲ accounted for 18.73% (630/3 364), and cervical cancer accounted for 3.00% (101/3 364); 364 cases had HPV multiple infections, of which chronic cervicitis+CIN Ⅰ accounted for 51.65% (188/364), CIN Ⅱ+CIN Ⅲ accounted for 42.58% (155/364), and cervical cancer accounted for 5.77% (21/364). The difference in the proportion of cervical lesions with different pathological grades in HPV single infection and multiple infections was statistically significant (n χ2 = 127.21, n P < 0.01). The top four HPV single infection genotypes in chronic cervicitis+CINⅠ group and CINⅡ+CINⅢ group were type 16, 52, 58 and 53, and their proportions were 17.05% (449/2 633), 12.91% (340/2 633), 9.08% (239/2 633) and 8.89% (234/2 633) in chronic cervicitis+CINⅠ group, and 32.22% (203/630), 10.32% (65/630), 8.41% (53/630) and 5.87% (37/630) in CINⅡ+CINⅢ group. In the cervical cancer group, the top two HPV single infection genotypes were type 16 and 18, and their proportions were 81.19% (82/101) and 6.93% (7/101). The viral load of 120 patients with HPV infection was 4.89±1.14 before treatment and 2.86±1.63 after treatment, and the difference was statistically significant ( n t = 13.260, n P < 0.01).n Conclusions:HPV multiple infections are more likely to aggravate the degree of cervical lesions than single infection. Common HPV infection subtypes in different cervical lesions include type 16, 52, 58, 53 and 18.