2017年至2018年上海地区男性尖锐湿疣患者人乳头瘤病毒感染的流行病学分析

doi:10.16150/j.1671-2870.2020.06.005

摘要/Abstract

摘要：

目的： 分析上海地区男性尖锐湿疣患者的人乳头瘤病毒（human papilloma virus,HPV）感染流行病学特征,为该病的防治提供依据。方法： 选取2017年3月至2018年3月期间,本院皮肤科门诊确诊的男性尖锐湿疣患者2 202例,采用PCR-反向点杂交法检测皮损部位的HPV感染情况及基因亚型。结果： 2 202例男性尖锐湿疣患者,HPV DNA阳性者有1 136例,阳性率达51.59%。HPV基因型别分布中,低危型以6型和11型阳性率较高,分别为42.78%（486/1 136）和27.02%（307/1 136）;高危型以16型、52型和51型阳性率较高,分别为12.06%（137/1 136）、10.83%（123/1 136）和7.22%（82/1 136）。分析感染模式发现,1 136例HPV DNA阳性患者中,以单一感染为主,占所有阳性患者的56.78%（645/1 136）;多重感染模式中,以二重感染为主,占所有阳性患者的25.62%（291/1 136）。单纯低危型HPV感染患者占44.45%（505/1 136）,最高可达三重感染;其次为高低危混合型感染,占34.07%（387/1 136）,最高可达十重感染;单纯高危型HPV感染占21.48%（244/1 136）,可达六重感染。年龄41~60岁组内阳性检出率最高（60.35%,207/343）,与≤20岁组（49.00%,49/100）及21~40岁组（49.43%,819/1 657）比较, χ²值分别为4.09和13.57,P值均<0.05。比较各年龄组的感染模式发现,21~40岁组以单一基因亚型感染为主（59.71%,489/819）;≤20岁组及≥61岁组以多重感染为主,百分比分别为55.10%（27/49）和59.02%（36/61）。结论： 上海地区男性尖锐湿疣患者的HPV DNA阳性率为51.59%,较河南、浙江及广东东莞地区低;感染亚型主要为6型、11型、16型、52型和51型,感染模式以单一亚型感染和低危型感染为主,41~60岁年龄组为高发人群,而≤20岁和≥61岁以上人群的多重感染百分比明显升高。

关键词: 男性, 尖锐湿疣, 人乳头瘤病毒, 基因型, 流行病学

Abstract:

Objective: To investigate the epidemiological characteristics of human papilloma virus (HPV) infection in male patients with condyloma acuminatum in Shanghai, and to provide evidence for prevention and treatment of the disease. Methods: A total of 2 202 male patients with condyloma acuminatum diagnosed in the dermatology clinic of our hospital were enrolled between March 2017 and March 2018, and HPV infection status was explored. The HPV genotypes in skin lesion were tested with polymerase chain reaction (PCR)-reverse dot blot hybridization. Results: It showed 1 136 out of 2 202 patients were HPV DNA positive and positive rate was 51.59%. The positive rates of low-risk HPV 6 and 11 were 42.78% and 27.02%, while the high-risk HPV 16, 52 and 51 were 12.06%, 10.83% and 7.22% respectively. In 1 136 cases with positive HPV DNA, single infection was the main pattern with a positive rate of 56.78%. In patients with multiple HPV infection, double infection was the main form, accounting for 25.62%. It showed that 44.45% patients were infected with low-risk genotypes of HPV (single,double or triple HPV genotype infection), 34.07% patients had mixed infection of high-risk and low risk genotypes ( up to ten infections); 21.48% were only high-risk HPV infection (up to six infections). The positive detection rate in 41-60 year group was the highest (60.35%), which was significantly higher than the groups of ≤20 year and 21-40 year (all P<0.05, χ²=4.09 and χ²=13.57). Infection patterns among different age groups were as follows: 21-40 year patients were mainly infected by one single genotype,and majority patients in both≤20 year and ≥61 year group had multiple HPV infection. Conclusions: The detection rate of positive HPV DNA in male patient with condyloma acuminatum in Shanghai is 51.59%, and lower than the rates reported in Henan, Zhejiang and Dongguan(Guangdong), and the genotypes include HPV 6,11,16,52,51.The infection was mainly caused by single and low-risk HPV. Detection rate in 41-60 year male is the highest, and the proportion of multiple infections are higher in people ≤20 years and ≥61 years.

Key words: Male, Condyloma acuminatum, Human papilloma virus, Genotype, Epidemiology

中图分类号:

R511

王娟, 李佳. 2017年至2018年上海地区男性尖锐湿疣患者人乳头瘤病毒感染的流行病学分析[J]. 诊断学理论与实践, 2020, 19(06): 572-576.

WANG Juan, LI Jia. Epidemiological analysis of human papilloma virus infection in male patients with condyloma acuminatum during 2017-2018 in Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2020, 19(06): 572-576.

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参考文献 16

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HPV感染模式	HPV感染重数
HPV感染模式	单一感染	二重感染	三重感染	四重感染	五重感染	六重感染	七重感染	八重感染及以上	合计
单纯低危型	456 (40.14)	45 (3.96)	4 (0.35)	0 (0)	0 (0)	0 (0)	0 (0)	0 (0)	505（44.45）
单纯高危型	189 (16.64)	42 (3.70)	8 (0.70)	4 (0.35)	0 (0)	1 (0.09)	0 (0)	0 (0)	244 (21.48)
高低危混合型	0 (0)	204 (17.96)	96 (8.45)	42 (3.70)	21 (1.85)	10 (0.88)	9 (0.79)	5 (0.44)	387 (34.07)
合计	645 (56.78)	291 (25.62)	108 (9.50)	46 (4.05)	21 (1.85)	11 (0.97)	9 (0.79)	5 (0.44)	1 136 (100.00)

年龄分组（岁）	例数(n)	阳性(n)	组内阳性检出率（%）	占总人数比例（%）	单一感染 [n(%)]	多重感染 [n（%）]	单纯低危型 [n（%）]	单纯高危型 [n（%）]	高低危混合型 [n（%）]
≤20	100	49	49.00	2.23	22（44.90）	27（55.10）	17（34.69）	8（16.33）	24（48.98）
21~40	1 657	819	49.43	37.19	489（59.71）	330（40.29）	380（46.40）	178（21.73）	261（31.87）
41~60	343	207	60.35	9.40	109（52.66）	98（47.34）	86（41.55）	46（22.22）	75（36.23）
≥61	102	61	59.80	2.77	25（40.98）	36（59.02）	22（36.07）	12（19.67）	27（44.26）
合计	2 202	1 136	51.59	51.59	645（56.78）	491（43.22）	505（44.45）	244（21.48）	387（34.07）