东营市HPV流行和致病情况研究指导预防性疫苗开发和引进  

Epidemiological and pathogenic research on human papillomavirus for the exploitation and introduction of preventive vaccines at Dongying

作　　者：朱新兴 吴红光 刘文圣 殷立奎 孙学青 

机构地区：[1]东营市人民医院,山东东营257091

出　　处：《现代预防医学》2015年第4期631-633,648,共4页Modern Preventive Medicine

摘　　要：目的通过检测和统计东营市HPV各亚型在健康人群和宫颈疾病患者中的流行情况,指导当地HPV预防性疫苗的开发和引进。方法留取健康体检妇女以及各级宫颈上皮不典型增生和宫颈癌患者的宫颈脱落细胞,采用基因导流杂交技术检测21种HPV亚型,统计HPV各亚型在健康人群和宫颈疾病患者中的流行情况,分析当地开发和引进预防性HPV疫苗时所应重点选择的亚型。结果在6 401例健康体检人群中,HPV总感染率为15.11%（967/6 401）,检出HPV 1 145株,各HPV亚型感染所占比例排名靠前依次为16型（23.23%）、52型（16.68%）、58型（10.22%）、53型（9.34%）、33型（6.29%）、18型（5.94%）;在166例HPV感染的CINⅠ~Ⅱ患者中检出HPV亚型198株,各HPV亚型感染所占比例排名靠前依次为16型（18.37%）、58型（14.29%）、31型（14.29%）、52（10.20%）、18型（9.18%）、68型（8.16%）;在31例HPV感染的≥CINⅢ患者中检出HPV亚型38株,各HPV亚型感染所占比例排名靠前依次为16型（36.84%）、31型（18.42%）、58型（15.79%）、18型（10.52%）、68型（7.89%）、33型（5.26%）。结论因HPV亚型的流行存在地域性,且各亚型的致病能力不同,所以各地区应综合考虑以上两方面因素,有针对性地开发和引进HPV疫苗。就东营市而言,如果以全面降低人群HPV感染为主要目的,应考虑开发和引进以16、52、58和53型为主的HPV四联预防性疫苗,可降低59.47%的HPV人群感染;如果以降低宫颈癌变为主要目的,应考虑开发和引进以16、31、58和18型为主的HPV四联预防性疫苗,可降低81.57%CINⅢ以上宫颈病变的发生。Objective The aim of this study was to guide the exploitation and introduction of HPV preventive vaccines through evaluating the epidemiological condition of human papillomavirus （HPV） subtypes in healthy female and female with cervical disease. Methods A total of 21 subtypes of HPV were detected by polymerase chain reaction and molecular hybridization in cervical exfoliated cells for healthy female and female with cervical disease. Proportion of every subtypes of HPV infection was calculated in all the groups. And the preventive vaccines against HPV subtypes were selected out. Results AmOng all 6401 normal cases, the total infection rate of HPV was 15.11% （967/6401）, and 1145 HPV strains were detected. The proportion of HPV subtypes were HPV-16 （23.23%）, HPV-52 （16.68%）, HPV-58 （10.22%）, HPV-53 （9.34%）, HPV-33 （6.29%）, and HPV-18 （5.94%）. Among all 166 ＂CIN Ⅰ-Ⅱ ＂ cervical disease cases, and the infection proportion were HPV-16 （18.37%）, HPV-58 （14.29%）, HPV-31 （14.29%）, HPV-52 （10.20%）, HPV-18 （9.18%）, and HPV-68 （8.16%）. Among all 31 ＂≥ CIN Ⅲ＂ cervical disease cases, there were 38 HPV strains were detected, and the infection proportion were HPV-16 （36.84%）, HPV-31 （18.42%）, HPV-58 05.79%）, HPV-18 （10.52%）, HPV-68 （7.89%）, and HPV-33 （5.26%）. Conclusion Officials from different regions should exploit and introduce H：PV vaccines according to the epidemiology and pathogenic ability of HPV subtypes. For Dongying, it is suggested to exploit and introduce preventive vaccines of subtypes 16, 52, 58 and 53 to lower the infection rate in normal group （59.47%）, and exploit and introduce preventive vaccines of subtypes 16, 31, 58 and 18 to reduce infection rate in cervical cancer cases （81.57%）.

关 键 词：人乳头状瘤病毒 预防性疫苗 流行病学 宫颈上皮不典型增生 宫颈癌 

分 类 号：R186[医药卫生—流行病学]