宫颈病变患者hr-HPV感染基因分型及其影响因素模型构建  

Genotyping of hr-HPV infection in patients with cervical lesions and construction of a model of influencing factors

作　　者：魏碧娜 彭臻菲[1] 过丹丹 叶丽颖 程武 WEI Bi-na;PENG Zhen-fei;GUO Dan-dan;YE Li-ying;CHENG Wu(Fujian Health Vocational and Technical College,Fuzhou,Fujian 350101,China;不详)

机构地区：[1]福建卫生职业技术学院医学技术系,福建福州350101 [2]福建中医药大学附属第三人民医院检验科,福建福州350108

出　　处：《中华医院感染学杂志》2023年第11期1700-1704,共5页Chinese Journal of Nosocomiology

基　　金：福建卫生职业技术学院科技计划基金资助项目(2018-2-7)。

摘　　要：目的探讨宫颈病变患者高危型人乳头瘤病毒(hr-HPV)感染基因分型检测结果及其影响因素,并构建预测模型。方法回顾性收集2019年1月-2021年12月福建中医药大学附属第三人民医院收治的宫颈病变患者1974例的临床资料,根据是否发生hr-HPV感染将患者分为高危感染组(313例),与非高危感染组(1661例)。统计宫颈病变患者感染hr-HPV基因分型,采用多因素Logistic回归分析宫颈病变患者hr-HPV感染的影响因素并构建宫颈病变患者hr-HPV感染预测模型,采用受试者工作特征(ROC)曲线分析预测模型对宫颈病变患者hr-HPV感染的预测价值。结果1974例宫颈病变患者中发生hr-HPV感染患者313例,主要基因分型为HPV 16型、HPV 18型,分别占53.35%与23.00%;多因素Logistic回归分析结果显示,初次性行为年龄<20岁、性伴侣数量2个及以上、生殖道炎症、阴道菌群有衣原体、阴道菌群有解脲脲原体、避孕方式为口服避孕药均为宫颈病变患者hr-HPV感染的危险因素(OR=2.672、3.494、3.304、2.939、3.165、2.630,P<0.05),阴道菌群有乳酸杆菌为宫颈病变患者hr-HPV感染的保护因素(OR=0.409,P=0.010)。根据多因素分析结果构建预测模型:logit(P)=-11.062+0.983×初次性行为年龄<20岁+1.251×性伴侣数量2个及以上+1.195×生殖道炎症-0.894×阴道菌群有乳酸杆菌+1.078×阴道菌群有衣原体+1.152×阴道菌群有解脲脲原体+0.967×避孕方式为口服避孕药;ROC曲线分析结果显示,当logit(P)>12.00时,曲线下面积(AUC)值为0.881,敏感度为76.04%,特异度为82.00%。结论宫颈病变患者感染hr-HPV基因分型主要为HPV 16型、HPV 18型,根据危险因素构建的预测模型对宫颈病变患者感染hr-HPV具有较好的预测价值,临床可采用此预测模型对宫颈病变患者感染hr-HPV进行预测,并进行针对性治疗,降低患者hr-HPV感染发生的风险。OBJECTIVE The investigate the results of genotyping tests for high-risk human papillomavirus(hr-HPV)infection in patients with cervical lesions and its influencing factors,and to construct a prediction model.METHODS Clinical data of 1974 patients with cervical lesions admitted to the Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from Jan.2019 to Dec.2021 were retrospectively collected,and the patients were divided into a high-risk infection group(313 cases)and a non-high-risk infection group(1661 cases)according to whether the hr-HPV infection occurred.The genotypes of hr-HPV infection in patients with cervical lesions were counted,and the factors influencing hr-HPV infection in patients with cervical lesions were analyzed by Multivariate Logistic regression and a prediction model of hr-HPV infection in patients with cervical lesions was constructed.The ROC curve was used to evaluate the predictive value of the prediction model for hr-HPV infection in patients with cervical lesions.RESULTS Among the 1974 patients with cervical lesions,313 patients were infected with hr-HPV,and the main genotypes were HPV 16 and 18,accounting for 53.35%and 23.00%,respectively.Multivariate Logistic regression analysis showed that age at first sexual intercourse 20 years old,number of sexual partners 2 or more,genital tract inflammation,vaginal flora with chlamydia,vaginal flora with ureaplasma urealyticum,and contraceptive method with oral contraceptive were independent risk factors for hr-HPV infection in patients with cervical lesions(OR=2.672,3.494,3.304,2.939,3.165,2.630,P<0.05),and the presence of Lactobacillus in the vaginal flora was a protective factor for hr-HPV infection in patients with cervical lesions(OR=0.409,P=0.010).The predictive model was constructed based on the result of a multi-factor analysis:logit(P)=-11.062+0.983×age of first sexual intercourse 20 years+1.251×number of sexual partners 2 or more+1.195×genital tract inflammation-0.894×vaginal flora with Lactobacill

关 键 词：宫颈病变 高危型 人乳头瘤病毒 感染 因素 模型构建 基因分型 

分 类 号：R711.32[医药卫生—妇产科学]