目的:了解南京市女性人乳头瘤病毒(HPV)感染状况与性伴侣包皮过长或包茎间的关系。方法:回顾性调查2011年5~12月在南京医科大学附属南京妇幼保健院宫颈科门诊就诊的女性,发放调查问卷,获取性生活等资料。由受调查者根据示意图对照判定其性伴侣是否存在包皮过长或包茎;取宫颈脱落细胞,运用凯普生物-HPV分型检测试剂盒,采用PCR和膜杂交的方法,检测不同型别HPV感染情况,其中检测出任何一种型别即为HPV阳性。组间率的比较采用χ2检验;运用非条件多因素Logistic回归分析独立危险因素。结果:共发放调查问卷2 040份,472例拒绝,1 568例接受问卷调查,去除不合格问卷458份,有效问卷1 110份,有效率为71%。1 110例女性研究对象中感染HPV的患者占50.9%(566/1 110),566例感染HPV的女性中,性伴侣包皮过长或包茎的占78.6%(445/566)。HPV感染类型以16、58、52、18型为主,分别占34.2%(152/445)、28.1%(125/445)、20.2%(90/445)、10.8%(48/445)。多因素非条件Logistic回归分析表明:性伴侣包皮过长或包茎是女性HPV感染的独立危险因素,OR值为3.387,95%CI(2.491~4.607)。结论:南京城区宫颈HPV感染者性伴侣多数存在包皮过长或包茎,且是女性宫颈HPV感染的独立危险因素,提示有必要在本地区推行包皮环切,以降低宫颈HPV感染。
Objective: To investigate the incidence of human papillomavirus(HPV) infection in women and its correlation with redundant prepuce or phimosis in the patients' sexual partners.Methods: We conducted a questionnaire investigation among the women outpatients at the cervical disease clinic of Nanjing Maternity and Child Health Hospital from May to December 2011.We obtained information on their sexual life and determined whether their sexual partners had redundant prepuce or phimosis according to the schematic illustratons we offered.We used biology-hybribio HPV-type test kit,PCR and hybrid membrane methods for detection of different HPV genotypes in cervical exfoliated cells,taking any type of HPV detected as positive.We made between-group comparisons by chi-square test and analyzed independent risk factors by non-conditional logistic regression analysis.Results: Of the 2 040 questionnaires,1 568 were collected and 1 110(71%) accepted as valid by inclusion criteria.Among the 1 110 subjects,566(50.9%) were infected with HPV,and 445(78.6%) of the infected women admitted that their sexual partners had redundant prepuce or phimosis.The most frequent infection type was HPV16(34.2%),followed by HPV58(28.1%),HPV52(20.2%) and HPV18(10.8%).Multivariate logistic regression analysis suggested that redundant prepuce or phimosis in the women's sexual partners was an independent risk factor for HPV infection(OR 3.387,95%CI [2.491-4.607]).Conclusion: In Nanjing urban area,the majority of the sexual partners of the HPV-infected women have redundant prepuce or phimosis,which is an independent risk factor for female cervical HPV infection.Male circumcision is necessitated in Nanjing to reduce the incidence of cervical HPV infection.