本文選題：男男性行為人群 + 人類乳頭瘤病毒��； 參考：《青島大學》2017年碩士論文

【摘要】：目的本研究旨在通過探究MSM人群肛管HPV的感染情況及其基因亞型分布情況,分析MSM人群中肛管HPV感染的相關(guān)危險因素,以為臨床早期防治MSM人群的HPV感染提供有力依據(jù)。方法2014年9月~2016年8月,選取在青大附院性健康中心檢測(山東省VCT檢測門診、國家哨點檢測單位)、青島市MSM項目工作組招募及皮膚科門診主動尋求治療的現(xiàn)患肛門肛管尖銳濕疣(condyloma acuminatum,CA)的MSM作為研究對象。通過“一對一”匿名問卷訪談方式,獲取研究人群的社會人口學及行為學特征等相關(guān)信息;采集研究對象靜脈血,進行HIV血清學檢測;同時采集肛管拭子標本,通過PCR技術(shù)對HPV基因亞型檢測,包括18種高危型(HPV 16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、82和83)和5種低危型(HPV6、11、42、43和81)共23種基因型。相關(guān)危險因素分析采取單因素分析及多因素Logistic回歸分析。結(jié)果共收集病例167例,其中完成問卷調(diào)查、抽取靜脈血及采集肛拭子者共計116例,為有效病例。結(jié)果發(fā)現(xiàn):1.研究對象年齡為18至52歲之間,平均年齡為29.41±6.86歲。主要社會人口學特征分析顯示,20~29歲年齡組、高中或中專文化、未婚及獨居的MSM人群中,HPV感染相較高發(fā);2.116例樣本中檢測出HPV 82例,陽性率70.69%,部分樣本存在多重HPV感染。3.經(jīng)典型CA患者占79.27%,以HPV16陽性檢出率最高,占36.92%,多重感染中則以HPV6+HPV11的感染幾率最高,占6.15%;扁平型CA患者占20.73%,以HPV16感染率最高,占23.53%,多重感染中主要以HPV6+HPV16的陽性感染率最高,占11.76%;4.高危型HPV亞型中,以HPV16感染陽性率最高,共計28例,占24.14%;低危型HPV亞型分布中,以HPV6的陽性率最高,共計21例,占18.10%;HPV高危組中合并HIV陽性比例59.62%(31例),明顯高于HPV低危組中陽性比例30.00%(9例),組間比較差異顯著(P0.05),具有統(tǒng)計學意義;5.HPV高危型感染患者同時合并HIV感染的幾率明顯高于HPV低危亞型感染的患者(P0.05),經(jīng)Pearson檢驗分析,高危型HPV感染與HIV感染呈明顯的正相關(guān)(r=0.4325,P0.05);6.多因素Logistic回歸分析顯示,近3個月發(fā)生過肛交的男性性伴數(shù)量≥10人及曾出現(xiàn)過性病相關(guān)癥狀者,與MSM人群肛門肛管CA患者HPV感染的發(fā)生存在明顯的相關(guān)性(P0.05)。結(jié)論招募的研究對象中HPV感染率70.69%,其中HPV6和HPV16為常見的感染基因亞型,MSM人群肛門肛管HPV感染的危險因素可能與發(fā)生肛交的男性性伴數(shù)量以及性病相關(guān)癥狀的出現(xiàn)存在明顯相關(guān)性,盡早開展有針對性干預對于早期防控MSM人群的HPV感染非常重要。
[Abstract]:Objective the purpose of this study was to analyze the risk factors of anal HPV infection in MSM population by investigating the situation of HPV infection and its gene subtype distribution in MSM population, so as to provide evidence for early prevention and treatment of HPV infection in MSM population. Methods from September 2014 to August 2016, the patients were selected to be tested in the sexual health center of Qingda affiliated Hospital (Shandong Province). MSM of condyloma acuminatum (condyloma acuminatum) of anus and anal canal, which was recruited by MSM project working group of Qingdao city and actively sought treatment in dermatological outpatient department, was used as the research object. Through the "one to one" anonymous questionnaire interview, to obtain the social demographic and behavioral characteristics of the study population and other relevant information; collect the blood of the study object vein, HIV serological test; collect anal swab samples, at the same time, The subtypes of HPV gene were detected by PCR technique. There were 23 genotypes including 18 high risk HPV16HPV16HPV16HPV16HPV16HPV16HPV16HPV161HPV16HPV161HPV161HPV161HPV161HPV161HPV161HPV161HPV161HPV161HPV161HPV161HPV31HPV31HPV31HPV31HPV31HPV31HPV31HPV31HPV31HPV31HPV31HPV31HHPV16HPV16HPV@@ The risk factors were analyzed by univariate analysis and multivariate Logistic regression analysis. Results A total of 167 cases were collected, among which 116 cases were collected venous blood and anal swab. It turned out that 1: 1. The subjects were 18 to 52 years old, with an average age of 29.41 鹵6.86 years. The analysis of main social demographic characteristics showed that 82 cases of MSM infection were detected in 29 years old group, middle school or technical secondary school group, unmarried and single population, 82 cases of HPV infection were detected in 2.116 samples, the positive rate was 70.69%, and some samples had multiple HPV infection .3The positive rate was 70.69%, and the positive rate was 70.69%. Classical CA patients accounted for 79.27, with the highest positive rate of HPV16 (36.922um), the highest rate of HPV6 HPV11 infection among multiple infections (6.15%), flat CA patients (20.73%), HPV16 infection rate (23.53%), and HPV6 HPV16 infection rate was the highest in multiple infections. About 11.76%. Among the high risk subtypes of HPV, the positive rate of HPV16 infection was the highest (28 cases, 24.14%), and the distribution of HPV subtype of low risk type was the highest in HPV6 (21 cases). The positive rate of HIV in the high risk group of 18.10 HPVs was 59.62%, which was significantly higher than that in the low risk group of HPV (30.009 cases), and the difference between the two groups was significant (P 0.05). 5. The probability of HIV infection in the patients with HPV-high risk type infection at the same time was significantly higher than that in the patients with HPV-high risk group (P < 0.05). Patients with low risk subtype HPV infection were analyzed by Pearson test. There was a significant positive correlation between high risk HPV infection and HIV infection. Multivariate Logistic regression analysis showed that the number of male sexual partners who had anal sex in the past 3 months or more and those who had STD-related symptoms were significantly correlated with the incidence of HPV infection in MSM patients with anal and anal CA. Conclusion the infection rate of HPV is 70.69% in the study subjects. HPV6 and HPV16 are the common risk factors of HPV infection in anus and anus, which may be associated with the number of male sexual partners who have anal intercourse and the occurrence of STD-related symptoms. There is a clear correlation, Early targeted intervention is very important for early prevention and control of HPV infection in MSM population.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R752.53

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