目的:了解宫颈疾病女性性功能障碍(female sexual aysfunction,FSD)患病率及危险因素。方法:采用回顾性调查方法,对在南京医科大学附属南京妇幼保健院宫颈科门诊就诊的18~55岁有正常性生活女性进行问卷调查。取宫颈脱落细胞,采用PCR和膜杂交方法,检测出21种常见人乳头瘤病毒(huma npapillomavirus,HPV)中任何一种HPv亚型即为HPV阳性。通过宫颈专科医生常规妇科检查获知女性所患宫颈疾病。应用女性性功能指数(femalesexual function index,FSFI)问卷对受访者近1个月的性生活状况进行调查,采用多因素非条件Logistic回归分析影响FSD的宫颈疾病。结果:发放调查问卷共2045份,472例拒绝,1573例接受问卷调查,去除不合格问卷458份,有效问卷1115份,有效率71%。1115例女性研究对象中宫颈疾病患者占43.6%(486/1115)。486例宫颈疾病患者中,性功能障碍者占52.3%(254/486)。在FSD组中,患有宫颈疾病者显著多于宫颈正常者,差异有统计学意义(P〈0.01)。宫颈疾病组的性欲、性唤起、阴道润滑、性高潮、性满意、性疼痛等各项性功能评分值均低于宫颈正常组(P〈0.05)。多因素非条件Logistic回归分析表明:宫颈息肉(OR=1.57,95%CI=1.01-2.45)、宫颈糜烂(OR=1.74,95%CI=1.23-2.45)、宫颈肥大(OR=2.26,95%CI=1.33-3.84)、宫颈上皮内瘤趸(cervical intraepithelial neoplasia,fiN)(OR=2.95.95%CI=2.13~4.08)是FSD的独立危险因素。危险度大小依次是:CIN〉宫颈肥大〉宫颈糜烂〉宫颈息肉。结论:南京城区FSD在宫颈疾病专科门诊中发病率颇高,有必要加强性保健宣传,促使有宫颈疾病者定期进行生殖系统健康体检.形成良好的性生活方式。从而降低FSD发病率。
Objective: To investigate the incidence and risk factors of female sexual dysfunction (FSD) in patients of cervical disease. Methods: A retrospective survey on women aged 18-55 years old with normal coitus in the cervical out-patients of Maternity and Child Health Hospital Affiliated to Nanjing Medical University was conducted. Different HPV genotypes were detected in cervical exfoliated cells by the method of PCR and membrane of the hybrid. Any type of HPV which had been detected can be seen as HPV positive. The cervical specialists through conventional gynecologial examination learned women who suffered from cervical disease. Female sexual function index (FSFI) questionnaire was applied to assess sex condition in nearly a month. Multiple Logistic regression analysis Was used to analyze independent risk factors. Results: In the 2 045 copies of the questionnaires, 472 cases were refused, and 458 cases were removed. Totally, 1 573 subjects completed the questionnaires and 1 115 (71%) valid questionnaires that met the ctiteria were finally included for analysis. There were 486 (43.6%) women with cervical disease in 1 115 patients. There were 254 (52.3%) cases who have sexual dyfunction in patients with cervical disease, The results had a significant difference between cervical disease group and normal group. The score of patients reduced in sexual desire, sexual arousal, vaginal lubrication, orgasm, sexual satisfaction and sexual pain (P〈0.05). Multivariate Logistic regression analysis showed that cervical polyp (OR=1.57, 95%CI= 1.01-2.45), cervical erosion (OR=1.74, 95%CI=1.23-2.45), cervical hypertrophy (OR= 2.26, 95%CI=1.33- 3.84), cervical intraepithelial neoplasia (OR= 2.95, 95%CI= 2.13-4.08) were independent risk factors of FSD. Risk factors in order were as follows: CIN 〉 cervical hypertrophy 〉 cervical erosion 〉 cervical polyp. Conclusion: In Nanjing city, the FSD incidence is high in out-patients of cervical disease. It is necessary to strengthen p