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目的探讨河南新密农村地区妇女生活方式、膳食因素与高危型人乳头瘤病毒(HR-HPV)持续感染的关系。方法于2010年在河南新密进行前瞻性的研究,使用不同HR-HPV DNA检测方法对2500名妇女进行宫颈癌筛查;2012年和2014年对其中的部分妇女进行随访,并再次进行HR-HPV DNA检测。2014年,收集随访对象的一般人口学信息、妇科信息和过去12个月的膳食摄入情况。结合三次HR-HPV检测结果,判断持续感染情况,将最终纳入研究的721名研究对象分为持续感染组、一过性感染组和全阴性组。用卡方检验比较各因素在各组间的分布差异,以持续感染组为参考水平,用有序logistic回归模型进行危险因素的分析。结果 721名研究对象平均年龄50岁。持续感染组141人(19.56%),一过性感染组180人(24.96%),全阴性组400人(55.48%)。与HR-HPV持续感染相关的因素有:年龄(χ2=58.449,P<0.001,Ptrend<0.001)、吸烟(χ2=6.981,P=0.021)、采取避孕措施(χ2=8.448,P=0.015)、绝经(χ2=35.712,P<0.001)、活产数(χ2=16.340,P<0.001,Ptrend=0.001)及谷类(χ2=17.937,P=0.001)和其他类食物(χ2=12.107,P=0.017)的摄入。将可能的影响因素进行有序logistic回归分析后发现,以最大年龄组(≥59岁)为参考水平,其他三组(年龄由大到小)的OR分别为0.39(95%CI 0.26~0.59)、0.40(95%CI 0.23~0.69)和0.28(95%CI0.12~0.68)。结论年龄是HR-HPV持续感染的最主要的危险因素,控制年龄因素后,生活方式和膳食因素对HR-HPV持续感染的影响不具有显著性。
Objective To investigate the relationship between women’s lifestyle, dietary factors and persistent infection of high-risk human papillomavirus (HR-HPV) in rural Xinmi, Henan Province. Methods In 2010, a prospective study was conducted in Xinmi, Henan Province. 2,500 women were screened for cervical cancer by using different HR-HPV DNA detection methods. Some of them were followed up in 2012 and 2014 and HR- HPV DNA testing. In 2014, demographic information, gynecological information and dietary intake of the past 12 months were collected. Combined with three HR-HPV test results to determine the status of persistent infection, the 721 subjects finally included in the study were divided into persistent infection group, transient infection group and all-negative group. The chi-square test was used to compare the distribution differences of various factors in each group. The continuous infection group was taken as the reference level, and the logistic regression model was used to analyze the risk factors. Results The average age of 721 subjects was 50 years. In persistent infection group, 141 (19.56%) had infection, 180 (24.96%) had infection and 400 (55.48%) had infection. The factors associated with persistent HR-HPV infection were age (χ2 = 58.449, P <0.001, Ptrend <0.001), smoking (χ2 = 6.981, P = 0.021) and contraceptive measures (χ2 = 8.448, P = 0.015) (Χ2 = 12.107, P = 0.017) and other types of food (χ2 = 35.712, P <0.001) and live birth number (χ2 = 16.340, P <0.001, Ptrend = ) Intake. According to the possible logistic regression analysis of possible influencing factors, the OR of the other three groups (from the oldest to the younger age) were 0.39 (95% CI 0.26-0.59) , 0.40 (95% CI 0.23-0.69) and 0.28 (95% CI 0.12-0.68). Conclusion Age is the most important risk factor for persistent HR-HPV infection. After controlling for age, life style and dietary factors have no significant effect on persistent HR-HPV infection.