【摘要】 目的分析妊娠晚期妇女宫颈高危型人乳头状瘤病毒(HR-HPV)感染及产后自然转归状况。方法选取2010年1月—2011年12月接受孕期产检及分娩的病例3 382例,孕前1年曾接受液基细胞学检测,孕妇于分娩前进行人乳头瘤病毒杂交捕获Ⅱ代(HPV HC-Ⅱ)法检测,产后1年随访HR-HPV阳性病例,仍为阳性者进一步行细胞学、阴道镜及病理学检查。结果 3 382名妊娠晚期妇女宫颈HR-HPV感染率为18.4%(623/3 382),怀孕3次及3次以上者HR-HPV感染率升高(P=0.016),年龄及产次与妊娠晚期HR-HPV感染无明显关系。530名产妇于产后1年随访HR-HPV,仍为阳性的为140例,阳性率为26.4%(140/530)。140例HR-HPV持续阳性者行细胞学检查,正常/炎症90例,非典型鳞状上皮细胞40例,低度上皮内病变6例,高度鳞状上皮内病变4例,50例阴道镜下活检炎症/湿疣变22例,宫颈上皮内瘤变(CIN)Ⅰ16例,CINⅡ4例,CINⅢ8例。结论孕3次以上妊娠晚期HR-HPV感染率升高;孕期HR-HPV感染产后转阴率高,分娩方式与HR-HPV感染转阴无关;产后HR-HPV感染持续存在应密切随访,进一步行细胞学、阴道镜及病理学检查。更多还原

【Abstract】 Objective To investigate prevalence and spontaneous regression of cervical high risk human papillomavirus( HR-HPV) infection of women in final or third trimester pregnancy stage.Methods Form January 2010 to December 2011,a total of 3 382 women with 37 to 42 gestational weeks were enrolled in the study.The women were given ThinPrep cytology test( TCT) before pregnancy and HPV hybrid capture Ⅱ( HPV HC-Ⅱ) before delivery.The infection status of HPV was monitored during one-year-long follow-up after delivery,and those positive cases received cytological test,colposcope and pathological examinations.Results The HR-HPV infection rate was 18.4%( 623 /3 382).The infection rate was significantly higher in women with 3 or over times of pregnancy,whereas age and gravidity had no significant correlation with HR-HPV infection.In 530 positive cases,140 were still positive in the end of follow-up,whose cytological test findings were 90 cases of normal / inflammation,40 cases of atypical squamous cells,6 cases of low grade squamous intraepithelial lesion,and 4 cases of high grade squamous intraepithelial lesion.And 50 cases were given colposcope examination,who were 22 cases of inflammation / HPV,16 cases of cervical squamous intraepithelial lesion( CIN) Ⅰ,4 cases of CIN Ⅱ,and 8 cases of CIN Ⅲ.Conclusion Women with 3 or over times of pregnancy had significantly high infection rate of HR-HPV.HR-HPV infection during pregnancy would spontaneously regress,which had no correlation with delivery mode.Patients with continued HR-HPV infection after delivery should undergo cytological test,colposcope and pathological examinations.更多还原