汪露 倪笑玲 胡跃英

[摘要] 目的 分析不同年齡段女性高危型HPV感染情况，探讨重组人干扰素α-2b凝胶治疗人乳头瘤病毒（HPV）感染的疗效。 方法 以2018年1～12月在我院行高危型HPV-DNA检测的女性为研究对象，对比不同年龄段HPV感染情况;其中选取病理结果为炎症的100例患者分为治疗组与对照组，每组各50例，治疗组行干扰素凝胶治疗，对照组未行治疗，对比两组HPV的转阴率及下降率。 结果 高危型HPV总体感染率为20.16%，21岁以前HPV感染率为46.88%，明显高于其他年龄段，差异有统计学意义（P<0.05）。宫颈癌和宫颈上皮内瘤变（CIN）III的HPV阳性率为100.00%，CINII和CINI阳性率分别为95.45%、94.95%;治疗组较对照组的HPV转阴率提高17.60%，差异无统计学意义（P=0.085），治疗组较对照组的HPV下降率提高48.10%，差异有统计学意义（P=0.001）。 结论 高危型HPV感染年轻化趋势明显，特别年龄小于21岁有症状者应及早监测，重组人干扰素α-2b凝胶治疗对于宫颈HPV感染有一定治疗作用。

[关键词] 宫颈上皮内瘤变;高危型HPV;重组人干扰素α-2b

[中图分类号] R711.32          [文献标识码] B          [文章编号] 1673-9701（2020）31-0062-04

[Abstract] Objective To analyze the high-risk HPV infection in women of different ages， and to explore the efficacy of recombinant human interferon α-2b gel in the treatment of human papillomavirus（HPV） infection. Methods Women who underwent high-risk HPV-DNA testing in our hospital from January  to December 2018 were selected as the research subjects. The HPV infections of different age groups were compared. Among them， 100 patients with pathological results of inflammation were randomly divided into treatments group and control group， with 50 cases in each group. The treatment group was treated with interferon gel， and the control group was not treated. Two groups' HPV negative rate and reduction rate were compared. Results The overall infection rate of high-risk HPV was 20.16%. The HPV infection rate before the age of 21 was 46.88%， which was significantly higher than that of other age groups and the difference was statistically significant（P<0.05）. The HPV positive rate of cervical cancer and cervical intraepithelial neoplasia（CIN） III was 100.00%， and the positive rates of CINII and CINI were 95.45% and 94.95%， respectively. The HPV negative rate of the treatment group increased by 17.60% compared with that in the control group， but there was no statistically significant difference（P=0.085）. Compared with that of the control group， the HPV reduction rate of the treatment group increased by 48.10%， and the difference was statistically significant（P=0.001）. Conclusion High-risk HPV infection tends to be younger. Those younger than 21 years old with symptoms should be monitored as soon as possible. Recombinant human interferon α-2b gel treatment has a certain therapeutic effect on cervical HPV infection.

[Key words] Cervical intraepithelial neoplasia; High-risk HPV; Recombinant human interferon α-2b

2015年我国子宫颈癌新发病例9.89万人，死亡病例3.05万人，子宫颈癌的发病率在中国女性生殖系统恶性肿瘤中居第1位[1]。宫颈癌的发生是一个渐变的过程，要经历宫颈癌前病变即从宫颈上皮内瘤变进展为宫颈癌大约需要10年甚至更久[2]。持续性的高危型HPV感染才是引起子宫颈癌的主要因素，约70%的宫颈癌与HPV16型和18型感染有关[3]。HPV类型与其致病性密切相关，对HPV的检测分型对宫颈癌的筛查及癌前预警具有重要作用[4]。因此，阻断高危型HPV病毒的持续感染是预防宫颈癌的关键，现在已有多种HPV疫苗上市应用，但鉴于疫苗的吸收率和成本并不完全明确，寻求宫颈癌筛查方法的优化和多种治疗宫颈癌前病变方式仍然必要。干扰素具有抑制病毒、免疫治疗及抗肿瘤等多重生物学作用。本研究收集11 685例高危型HPV-DNA检测患者，其中病理检查为炎症患者中各随机抽取50例作为治疗组和对照组，再研究干扰素凝胶治疗效能。……