妇科门诊患者人乳头瘤病毒感染情况及随访 分析

Analysis of Human Papillomavirus Infection in Gynecologic Outpatients and Follow Up

摘要: 目的：分析柳州市人民医院妇科门诊女性人乳头瘤病毒(HPV)感染率、病毒亚型分布特点以及阳性病例的随诊情况。方法：回顾性系统分析了2022年3月至2023年3月在该院妇科门诊接受HPV核酸检测的9910例门诊患者的数据。结果：HPV感染总检出率为23.83%，其中检出率位居前三的亚型依次为HPV52 (20.21%)、HPV58 (8.85%)和HPV16 (8.51%)，感染模式以单一感染(17.98%)和高危型感染(16.62%)为主。年龄分层分析表明，不同年龄段感染率存在显著差异，65岁以上人群感染率最高(37.43%)，15~25岁群体次之(37.12%)，而36~45岁群体感染率最低(18.85%)。在随访研究中，高危型感染患者的复诊率最高(54.95%)，其中46.52%的复诊病例仍保持阳性；中低危型感染患者的复诊率最低(51.24%)，其持续阳性率也最低(37.2%)；高危混合型感染的复诊率为52.09%，但其持续阳性率最高(63.58%)；弱阳性病例的复诊率为47.87%，其中43.33%的复诊病例转为阳性。结论：HPV感染的主要亚型包括16型、52型和58型，其感染模式以单一亚型和高危型为主。针对15至45岁以及65岁以上人群，需强化对上述常见亚型的筛查。同时，对于高危型感染、多重感染、高危混合型感染以及弱阳性患者，应加强治疗干预、持续监测和长期随访管理。

Abstract: Objective: To analyze the status of human papillomavirus (HPV) infection, subtype distribution characteristics, and positive case recurrence among women attending the gynecology outpatient clinic of Liuzhou People’s Hospital. Methods: Retrospective systematic analysis of data from 9910 outpatients who underwent HPV nucleic acid testing at the hospital’s gynecology clinic from March 2022 to March 2023. Results: The overall infection rate was 23.83%, and the top three subtypes of infection rate from high to low were HPV52 (20.21%), HPV58 (8.85%), and HPV16 (8.51%), with single infection (17.98%) and high-risk type infection (16.62%) predominating; the difference of infection in each age group was statistically significant, with the highest rate in the group of >65 years old (37.43%), followed by the group of 15~25 years old (37.12%), and the group of 36~45 years old had the lowest rate of infection (18.85%); the high-risk type of infection had the highest rate of recurrence (54.95%), and 46.52% of the recurrence cases were consistently positive; the medium-low-risk type had the lowest rate of recurrence (51.24%), and the lowest number of recurrence cases were consistently positive (37.2%); and the rate of recurrence of high-risk mixed type was 52.09%, with the highest rate of sustained positivity in the retested cases (63.58%); the retesting rate of weakly positive cases was 47.87%, and 43.33% of the retested cases turned positive after retesting. Conclusion: The main subtypes of HPV infection include types 16, 52 and 58, and the pattern of infection is dominated by single subtypes and high-risk types. Screening for these common subtypes should be intensified for people aged 15~45 years and over 65 years. Meanwhile, for high-risk infections, multiple infections, high-risk mixed infections and weakly positive patients, therapeutic interventions, continuous monitoring and long-term follow up management should be strengthened.