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目的探讨召陵地区女性高危型人乳头瘤病毒(HPV)持续感染的影响因素及防控措施。方法前瞻性招募召陵地区20~65岁女性1 700例进行高危型HPV检测,每3个月对其进行一次门诊随访,随访时间为12个月,共检测4次。根据4次筛查结果,将全阴性的受试者纳入未感染组;仅1次阳性的纳入一过性感染组;连续2次及以上阳性的纳入持续感染组。采用问卷调查方式收集受试者人口学资料和日常膳食摄入情况。结果 1 700例受试者中有1 442例完成为期12个月的随访,其中未感染组800例、一过性感染组360例、持续感染组282例。是否饮酒、初潮年龄、初次性生活年龄、性伴侣个数在不同组别之间差异均无统计学意义(P>0.05)。年龄、是否吸烟、是否采取避孕措施、活产数、绝经情况在不同感染组之间差异均有统计学意义(P<0.05);其中随着年龄的增加高危型HPV持续感染率明显增加,吸烟、未采取避孕措施、活产数>2个和已绝经女性高危型HPV持续感染率明显增加。持续感染组和一过性感染组受试者每周谷类摄入次数明显高于未感染组,蔬菜类、蛋类、豆制品类摄入次数明显低于未感染组,差异有统计学意义(均P<0.05);持续感染组与一过性感染组之间以上指标比较差异无统计学意义(P>0.05)。多因素Logistic回归模型进分析显示,年龄≥40岁、吸烟、未采取避孕措施、已绝经、谷类摄入≥8次/w是本地区女性高危型HPV持续感染的独立危险因素。结论年龄、生活方式和膳食因素为召陵地区女性高危型HPV持续感染的主要影响因素,应采取针对性的防控措施,降低高危型HPV持续感染的发生率。
Objective To explore the influencing factors and prevention and control measures of persistent infection of female high risk human papillomavirus (HPV) in Zhaoling area. Methods A total of 1700 women aged 20-65 years in Zhaoling district were prospectively enrolled for high-risk HPV testing. Outpatients were followed up every 12 months for 12 months with a total of 4 tests. According to the 4 screening results, all negative subjects were included in the uninfected group; only 1 positive was included in the transient infection group; and 2 consecutive positives were included in the persistent infection group. A questionnaire was used to collect demographic data and daily dietary intake. Results A total of 1 442 out of 1,700 subjects were followed up for 12 months, of whom 800 were uninfected, 360 were transient, and 282 were persistent. Whether drinking, age of menarche, first sex life, number of sexual partners in different groups were no significant difference (P> 0.05). Age, whether smoking, whether to take contraceptive measures, live birth number, menopausal situation in different infection groups were statistically significant (P <0.05); among them, the infection rate of high-risk HPV was significantly increased with age, , No contraceptive measures were taken, the number of live births> 2 and the persistently infected women with high-risk HPV had significantly increased persistent infection rate. The number of cereal intake per week in patients with persistent infection and transient infection was significantly higher than that of non-infected patients, and the intake of vegetables, eggs and soy products was significantly lower than that of non-infected patients (the difference was statistically significant ( All P <0.05). There was no significant difference between the persistent infection group and the transient infection group (P> 0.05). Multivariate logistic regression model analysis showed that age ≥ 40 years old, smoking, no contraceptive measures, menopause, cereal intake ≥ 8 times / w is an independent risk factor for persistent high-risk HPV infection in women in this area. Conclusions Age, lifestyle and dietary factors are the main influencing factors of persistent high-risk HPV infection in women in Zhaoling area. Specific prevention and control measures should be taken to reduce the incidence of persistent high-risk HPV infection.