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目的了解浙江省台州市路桥区已婚妇女宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的流行病学特征,分析其相关危险因素,为采取防治措施提供科学依据。方法对台州市路桥区35~59岁已婚农村妇女共11 500人进行宫颈癌筛查,选取确诊为CIN的325例患者为病例组,选择同期在台州恩泽医疗中心路桥医院进行健康体检的CIN阴性者325人为对照组。对两组研究对象进行问卷调查。调查内容包括基本信息、文化程度、月经婚育情况、初次性生活年龄、经期每日清洗、初产年龄、性伴侣数、孕产次、宫颈糜烂、避孕措施、同房前清洗、丈夫包皮过长、宫颈上皮内瘤家族史、人乳头瘤病毒(HPV)感染情况。对调查结果进行单因素和多因素logistic回归分析。结果单因素logistic回归分析提示:病例组和对照组的初次性生活年龄、性伴侣数、孕产次、宫颈糜烂、避孕、初产年龄、丈夫包皮过长、宫颈癌家族史及HPV感染差异有统计学意义(P<0.05)。初次性生活年龄、婚外性伴侣数、丈夫性伴侣数、宫颈糜烂、宫颈癌家族史是CIN发生的危险因素。多因素logistic回归分析提示:初次性生活年龄≤20岁、婚外性伴侣数≥2、丈夫性伴侣数≥2、宫颈糜烂、药物避孕、丈夫包皮过长、宫颈癌家族史、HPV阳性是CIN发生的危险因素。结论台州市路桥区CIN防治重点人群应包括初次性生活年龄≤20岁、婚外性伴侣数超过2个以上、丈夫性伴侣数≥2、宫颈糜烂、药物避孕、丈夫包皮过长、宫颈癌家族史和HPV阳性者。
Objective To understand the epidemiological characteristics of cervical intraepithelial neoplasia (CIN) in Luqiao District of Taizhou City, Zhejiang Province, analyze the related risk factors and provide a scientific basis for prevention and control measures. Methods A total of 11 500 married rural women from 35 to 59 years old in Luqiao District of Taizhou city were screened for cervical cancer. A total of 325 patients diagnosed with CIN were selected as the case group. CIN was selected at the Luqiao Hospital of Taizhou Enze Medical Center during the same period. 325 negative for the control group. Questionnaire survey of two groups of subjects. The survey included basic information, educational level, menstrual marriage and childbirth, first sex life, daily menstruation, primiparous age, number of sexual partners, pregnancy, cervical erosion, contraception, cleaning in the same room, husband’s prepuce , Family history of cervical intraepithelial neoplasia, human papillomavirus (HPV) infection. The survey results were univariate and multivariate logistic regression analysis. Results The univariate logistic regression analysis showed that the difference of first sexual life, sexual partners, pregnancy, cervical erosion, contraception, first trimester age, husband’s prepuce, cervical cancer family history and HPV infection in case group and control group Statistical significance (P <0.05). Age of first sex, number of extra-marital sexual partners, number of husbands and partners, cervical erosion, family history of cervical cancer is a risk factor for CIN. Multivariate logistic regression analysis indicated that the age at first sexual life was less than 20 years, the number of extra-marital sexual partners was more than 2, the number of husband’s sexual partners was more than 2, cervical erosion, drug contraception, husband’s prepuce, family history of cervical cancer and HPV were CIN Risk factors that occur. Conclusion The key population of CIN prevention and treatment in Luqiao District of Taizhou City should include the first-time sexual life ≤20 years, the number of extra-marital sexual partners over two, the number of husband’s sexual partners ≥2, cervical erosion, drug contraception, husband’s prepuce, cervical cancer family History and HPV positive.