宫颈病变患者感染高危型HPV分型及其影响因素与模型构建  

Classification of high-risk HPV infection,its influencing factors and model construction in patients with cervical lesions

作　　者：罗春艳[1] 刘洁[1] 刘丽珍 王小兵 黄朝群 LUO Chun-yan;LIU Jie;LIU Li-zhen;WANG Xiao-bing;HUANG Chao-qun(Ji'an Central People's Hospital,Ji'an,Jiangri 343000,China;不详)

机构地区：[1]吉安市中心人民医院妇产科,江西吉安343000 [2]吉安县妇幼保健院妇产科,江西吉安343100

出　　处：《中华医院感染学杂志》2023年第23期3630-3634,共5页Chinese Journal of Nosocomiology

基　　金：江西省教育厅科学技术研究基金资助项目(190010)。

摘　　要：目的探究宫颈病变患者感染高危型人类乳头状瘤病毒(HPV)分型情况及其影响因素,并构建危险因素Logistic回归方程模型。方法回顾性选取吉安市中心人民医院2021年12月-2022年12月收治的104例宫颈病变患者,根据是否发生高危型HPV感染,将其分为感染组(63例)和非感染组(41例)。统计感染组的宫颈病变与高危型HPV分型的分布情况;通过单因素及多因素分析法分析宫颈病变患者感染高危型HPV的危险因素,建立危险因素模型,并绘制受试者工作特征(ROC)曲线分析危险因素模型对宫颈病变患者感染高危型HPV的预测价值。结果104例宫颈病变患者感染高危型HPV 63例,感染高危型HPV发生率为60.58%,其中63例宫颈病变感染高危型HPV患者中以宫颈上皮内瘤变(CIN)I级、CINⅡ级、CINⅢ级为主,检出较多的亚型分别是HPV16、HPV18和HPV58,占比分别为33.33%、28.57%、19.05%;多因素Logistic分析结果显示,初次性行为年龄小、产次次数多、流产次数多、≥2个性伴侣数量、有生殖道炎症是宫颈病变患者感染高危型HPV的危险因素(P<0.05);据此构建危险因素模型:Logit(P)=-11.147+0.982×初次性行为年龄小+1.112×产次次数多+0.987×流产次数多+0.942×≥2个性伴侣数量+1.045×有生殖道炎症;按照危险因素模型绘制预测宫颈病变患者感染高危型HPV发生的ROC曲线,结果显示诊断灵敏度为85.71%、特异度为75.61%。结论宫颈病变患者感染高危型HPV的概率高,初次性行为年龄小、产次及流产次数多、性伴侣数量多、有生殖道炎症与宫颈病变患者感染高危型HPV发生密切相关,据此建立危险因素模型预测宫颈病变患者感染高危型HPV的价值较高,临床可据此予以早期针对性预防及干预,从而降低宫颈感染高危型HPV的风险,减少宫颈病变的发生。OBJECTIVE To investigate the classification of high-risk human papilloma virus(HPV)infection in patients with cervical lesions and its influencing factors,and to construct a logistic regression equation model of risk factors.METHODS A total of 104 patients with cervical lesions admitted to the Central People′s Hospital of Ji′an from Dec 2021 to Dec 2022 were retrospectively analyzed.According to whether high-risk HPV infection occurred,they were divided into the infection group(63 cases)and the non-infection group(41 cases).The distribution of cervical lesions and high-risk HPV typing in the infection group was statistically analyzed.The risk factors of high-risk HPV infection in patients with cervical lesions were analyzed by univariate and multivariate analysis,and the risk factor model was established.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the risk factor for high-risk HPV infection in patients with cervical lesions.RESULTS There were 63 cases of high-risk HPV infection in 104 patients with cervical lesions,and the incidence of high-risk HPV infection was 60.58%.Among the 63 high-risk HPV patients with cervical lesions,cervical intraepithelial neoplasia(CIN)grade Ⅰ,CINⅡ and CINⅢ were the main types,and the main HPV subtypes detected were HPV16,HPV18 and HPV58,accounting for 33.33%,28.57% and 19.05%,respectively.Multivariate logistic analysis showed that young age of the first sexual intercourse,more births,more abortions,≥2 sexual partners and genital tract inflammation were risk factors for high-risk HPV infection in patients with cervical lesions(P<0.05).The risk factor model was established as follows:Logit(P)=-11.147+0.982×young age of first sexual intercourse+1.112×more births>1+0.987×more abortions>1+0.942×number of sexual partners+1.045×genital tract inflammation.The ROC curve for predicting the occurrence of high-risk HPV infection in patients with cervical lesions was plotted,which showed that the diagnostic sensitivity was 85.71%,

关 键 词：宫颈病变 高危型人类乳头状瘤病毒 亚型 危险因素 预测模型 受试者工作特征曲线 

分 类 号：R711.74[医药卫生—妇产科学]