皮肤性病患者人乳头瘤病毒基因分型检测的临床分析

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目的:了解皮肤性病患者不同病变类型中的HPV感染型别。方法:选择2014年6月~2015年6月我科门诊就诊者368例,分为4个组别:尖锐湿疣患者组242例,鲍温样丘疹病患者18例,男性冠状沟珍珠疹和女性假性湿疣70例,未见任何皮疹且醋酸白试验阴性的体检者38例。采用PCR-反向点杂交法检测皮损或外阴局部HPV-DNA亚型,并用SPSS11.0软件进行统计学分析。结果:(1)HPV-DNA的总检出率为72.9%,其中单一型别感染率57.1%,多重感染率15.8%;(2)268例HPV阳性标本中,高危型感染占51.9%,低危型和混合型的阳性率分别为33.2%、14.9%;(3)尖锐湿疣组和鲍温样丘疹病患者组HPV-DNA的阳性率分别为97.9%、88.9%,而男性珍珠疹和女性假性湿疣组以及要求体检人群的阳性率分别为14.3%和13.2%;从感染型别分析,尖锐湿疣主要是6、11、16、18、31、33、35、43和66亚型,鲍温样丘疹病患者主要是16亚型,男性珍珠疹和女性假性湿疣以及要求体检人群的感染型别主要是低危型感染,分别是6、42、43、81和6、42、83;(4)在被检测的18个高危HPV亚型中,最常见类型依次为HPVl6、18、58、56、33、52、68、31、39,未检测出HPV35、45、51、53、59、66、73和82亚型;在被检测的5个低危HPV-DNA亚型中依次为HPV6、11、42和43,未检测出81亚型。结论:HPV感染以单一型别感染为主,且以高危型为主,应该重视临床HPV感染亚型的检测,尤其是高危型HPV感染者的随访管理。 Objective: To understand the type of HPV infection in different pathological types of skin venereal disease patients. Methods: From June 2014 to June 2015, 368 outpatients in our department were selected and divided into 4 groups: 242 patients with condyloma acuminatum, 18 patients with Bowenoid papulosis, male coronal ditch pearls and females 70 cases of pseudo-condyloma, no skin rash and acetic acid white test negative in 38 cases. HPV-DNA subtypes of lesions or vulva were detected by PCR-reverse dot blotting method and analyzed by SPSS11.0 software. Results: (1) The total detection rate of HPV-DNA was 72.9%, of which 57.1% were single type and 15.8% were multiple infection. (2) Among 268 HPV-positive specimens, 51.9% (3) The HPV-DNA positive rates of genital warts and Bowenoid papulosis patients were 97.9% and 88.9% respectively, while those of male pearl rashes and females The positive rates of pseudo-condyloma acuminatum group and those who required medical examination were 14.3% and 13.2% respectively. According to the analysis of infection types, genital warts were mainly 6,11,16,18,31,33,35,43 and 66 subtypes, Papillomaviruses are mainly 16 subtype, male pearl rash and female pseudo-genital warts, as well as the type of infection in the physical examination population is mainly low-risk infection, respectively 6,42,43,81 and 6,42,83; (4) Of the 18 high-risk HPV subtypes tested, the most common types were HPV16, HPV58, HPV46, HPV32, HPV58, HPV43, , 66, 73 and 82 subtypes. Among the five low-risk HPV-DNA subtypes tested, they were HPV6, 11, 42 and 43, and no 81 subtype was detected. Conclusion: HPV infection is predominately single type, and high-risk type is the main factor. HPV subtype detection should be emphasized, especially follow-up management of high-risk type HPV infection.
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