性病门诊男性人乳头瘤病毒基因型与临床诊断相关性分析  

Correlation between the genotypes and clinical symptoms of human papilloma virus in male outpatients at STD clinics

作　　者：宛传丹 赵一琳 蒋廷旺 崔燕红 WAN Chuan-dan;ZHAO Yi-lin;JIANG Ting-wang;CUI Yan-hong(Changshu Medical Laboratory Center,Changshu,Jiangsu 215500,China)

机构地区：[1]常熟市医学检验所,江苏常熟215500

出　　处：《中华男科学杂志》2018年第8期719-723,共5页National Journal of Andrology

摘　　要：目的:调查性病门诊男性感染人乳头瘤病毒(HPV)及其基因亚型分布并分析与临床主要症状之间的关联,为防治男性HPV感染提供参考。方法:回顾性分析2016年2月至2018年2月就诊于常熟地区性病门诊患者602例,采集外生殖器脱落细胞标本,提取核酸进行扩增,以基因芯片法检测HPV基因亚型。统计分析患者临床诊断症状类型与基因型分布之间的关系等。结果:性病门诊男性HPV阳性率48.2%(290/602),其中低危型占47.2%(137/290)。多重感染占30.0%(87/290)。主要流行的基因型依次为6、11、39、52等。临床症状主要表现为病毒性疣占43.1%(125/290),皮疹占41.0%(119/290)。病毒性疣患者中主要为低危型的6、11占60.0%(75/125),显著高于高危型的15.0%(15/125)(P<0.05);皮疹患者低危型占38.7%(46/119),与高危型38.7%比例相同;包皮/阴茎头炎患者中低危型感染显著高于高危型(56.0%vs 32.0%,P<0.05);无症状/体检中高危型占84.6%(11/13),显著高于高低危混合型15.4%(2/13)和低危型0(0/13)(P<0.05)。结论:常熟市性病门诊男性HPV感染阳性率48.2%,以低危型单一感染为主。低危型感染症状表现为病毒性疣与包皮/阴茎头炎等;无症状健康体检中以高危型居多。Objective ： To investigate the distribution of the human papilloma virus （HPV） and its genotypes in the male outpa- tients at the clinics of sexually transmitted diseases （STD） in Changshu and analyze its association with the primary clinical symptoms so as to provide some evidence for the prevention and treatment of HPV infection in men. Methods ： We collected exfoliated cell sam- ples from the external genitals of 602 male outpatients at the STD clinics in Changshu from February 2016 to February 2018, extracted and amplified nucleic acids from the samples, and detected the HPV genotypes using the gene chip technique. We performed statistical analyses on the types of symptoms in clinical diagnosis and their correlation with the genotypes of HPV using the chi-square test. Re- sults ： The HPV positive rate in the male STD clinics was 48.2%, of which 47.2 % fell into the low-risk type, 30.0% with multiple infections. The main genotypes included HPV types 6, 11, 39, and 52, and the main HPV-related clinical symptoms were verruca （43.1%） and erythra （41.0%）. Low-risk types 6 and 11 accounted for a significantly higher percentage than the high-risk types in the verruca patients （60.0% vs 15.0% , , P 〈 0.05） , but showed no statistically significant difference from the latter in the erythra patients （ 38.7% vs 38.7% , P 〉 0.05 ）. The incidence of low-risk infection was remarkably higher than that of high-risk infection in the acrobystitis and balanitis patients （P 〈 0.05）, while the high-risk types constituted a markedly higher percentage than the low- risk and high- and low-risk mixed types in the asymptomatic men at physical examination （ 84.6% vs 0.0% and 15.4% , P 〈 0.05 ）. Conclusion ： The HPV positive rate was as high as 48.2% in the males at the STD clinics in Changshu, and the main infection type was low-risk genotype single infection. The clinical symptoms of low-risk infection were mainly verruca and prepuce balanitis, and the high-risk type was mostly asymptoma

关 键 词：人乳头瘤病毒 男性 基因型 临床诊断 

分 类 号：R697.16[医药卫生—泌尿科学]