育龄男性泌尿生殖道解脲支原体和人乳头瘤病毒感染及影响因素分析
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摘要
目的:了解育龄男性泌尿生殖道解脲支原体(UU)和人乳头瘤病毒(HPV)感染的情况,探讨可能的影响因素,为今后开展生殖道感染的预防提供科学依据。方法:2016年8月至2017年7月,采用分阶段整群抽样的方法,选择上海市松江区的工厂、企事业单位和服务场所的18～50岁的育龄男性,对其进行结构式问卷调查,并采集泌尿生殖道分泌物标本,分别采用培养法和PCR方法进行UU和HPV的检测。结果:本研究共纳入621例育龄男性,泌尿生殖道UU阳性率为44.93%(279/621),HPV感染率为2.90%(18/621),UU和HPV双重感染率为2.42%(15/621)。单因素分析显示吸烟者的UU感染率(50.54%,140/277)高于不吸烟者(40.41%,139/344);高中/技校研究对象HPV感染率(4.84%,12/248)略高于其他文化程度者。二元逐步Logistic回归分析发现:与初中及以下研究对象相比,大专及以上者UU感染的风险较低(OR=0.61,95%CI:0.39～0.96);吸烟者UU阳性的风险高于不吸烟者(OR=1.46,95%CI:1.01～2.01)。结论:上海松江地区育龄男性的UU感染率较高,HPV感染率较低。应加强对文化程度较低(初中及以下)、吸烟育龄男性的UU筛查,以期降低UU的阳性率。
Objective: To investigate the prevalence of urogenital tract infections with Ureaplasma urealyticum(UU) and human papilloma virus(HPV) in males of reproductive age and the associated factors. Methods: Using the multi-stage cluster sampling method and a structured questionnaire, we conducted an investigation among 18-50 years old males in Songjiang District, Shanghai, from August 2016 to July 2018. We collected secretory specimens from the urogenital tract of the subjects and detected the infections of UU and HPV by laboratory examination. Results: Among the 621 males included in this study, 279(44.93%) were found infected with UU, 18(2.90%) with HPV, and 15(2.42%) with both UU and HPV. Univariate analysis showed that smokers had a higher rate of UU infection(50.54% [140/277]) than non-smokers(40.41 [139/344]), and those with senior high school or secondary technical school education had a higher rate of HPV infection(4.84% [12/248]) than others(1.61% [6/373]). Binary stepwise logistic regression analysis revealed a higher risk of UU infection in the subjects with junior high school or lower education than in others(OR = 0.61, 95% CI: 0.39-0.96) as well as in smokers than in non-smokers(OR = 1.46, 95% CI: 1.01-2.01). Conclusion: The prevalence of UU infection is high, while that of HPV is low among men of reproductive age in Songjiang, Shanghai. The screening of UU infection should be enhanced among men of reproductive age, especially among smokers and those with lower education.
Objective: To investigate the prevalence of urogenital tract infections with Ureaplasma urealyticum(UU) and human papilloma virus(HPV) in males of reproductive age and the associated factors. Methods: Using the multi-stage cluster sampling method and a structured questionnaire, we conducted an investigation among 18-50 years old males in Songjiang District, Shanghai, from August 2016 to July 2018. We collected secretory specimens from the urogenital tract of the subjects and detected the infections of UU and HPV by laboratory examination. Results: Among the 621 males included in this study, 279(44.93%) were found infected with UU, 18(2.90%) with HPV, and 15(2.42%) with both UU and HPV. Univariate analysis showed that smokers had a higher rate of UU infection(50.54% [140/277]) than non-smokers(40.41 [139/344]), and those with senior high school or secondary technical school education had a higher rate of HPV infection(4.84% [12/248]) than others(1.61% [6/373]). Binary stepwise logistic regression analysis revealed a higher risk of UU infection in the subjects with junior high school or lower education than in others(OR = 0.61, 95% CI: 0.39-0.96) as well as in smokers than in non-smokers(OR = 1.46, 95% CI: 1.01-2.01). Conclusion: The prevalence of UU infection is high, while that of HPV is low among men of reproductive age in Songjiang, Shanghai. The screening of UU infection should be enhanced among men of reproductive age, especially among smokers and those with lower education.
引文
[1] 曾广丽, 周世林. 重庆市綦江区人民医院2009-2012年7种性病检测率分析. 检验医学与临床, 2013, 10(15): 1944-1947.
[2] Cuzick J, Arbyn M, Sankaranarayanan R, et al. Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine, 2008, 26 (Suppl 10): K29-K41.
[3] 张岱, 刘朝晖. 生殖道支原体感染诊治专家共识. 中国性科学, 2016, 25(3): 80-82.
[4] 周欢群, 周文, 陆杉. 解脲支原体感染对不育男性精液质量的影响. 暨南大学学报(自然科学与医学版), 2015, 36(4): 340-343.
[5] 李玉艳. 人乳头瘤病毒感染与男性生殖健康的关系. 中华男科学杂志, 2017, 23(4): 376-380.
[6] 王友宝, 韩韬, 赵纯雄. 男性健康人群和尖锐湿疣患者阴毛毛囊中人乳头瘤病毒的调查分析. 中华男科学杂志, 2010, 16(9): 783-785.
[7] Parish WL, Laumann EO, Cohen MS, et al. Population-based study of chlamydial infection in China: A hidden epidemic. JAMA, 2003, 89(10): 1265-1273.
[8] 朱精华, 王沛. 生殖道感染与不孕不育关系的研究进展. 国际检验医学杂志, 2012, 33(2): 201-204.
[9] Zea-Mazo JW, Negrette-Mejía YA, Cardona-Maya W. Virus of sexual transmission: Semen and virus relationship. Actas Urol Esp, 2010, 34(10): 845-853.
[10] 陈雪礼, 陈越, 刘晓峰, 等. 4种性病病原体感染16450例流行病学调查报告. 九江学院学报(自然科学版), 2004, 19(2): 79-81.
[11] 阳仕雄, 王方平, 张平安, 等. 孝感地区解脲支原体与沙眼衣原体和淋球菌及人乳头瘤状病毒感染情况调查. 中华实用诊断与治疗杂志, 2018, 32(7): 704-705.
[12] 寿叶女, 金秀萍, 蒋锦琴. 291例男性泌尿生殖道感染患者支原体感染及耐药情况. 中国卫生检验杂志, 2016, 26(18): 2721-2722, 2725.
[13] 张永乐, 施新萍, 魏建波, 等. 男性人乳头瘤病毒感染及基因型的分布分析. 中华男科学杂志, 2018, 24(7): 666-668.
[14] 韩韬, 赵纯雄, 王友宝, 等. HPV在健康人阴毛毛囊中感染情况的调查分析. 国际泌尿系统杂志, 2009, 29(2): 160-162.
[15] 赵学英, 刘学伟, 翁韶波, 等. 成年男性包皮高危型人乳头瘤病毒感染检测分析. 河北医科大学学报, 2016, 37(5): 592-594.
[16] 毛燕燕, 蔡建华, 胡云, 等. 我国九省市男性生殖道感染发生率及其多水平影响因素分析. 中华生殖与避孕杂志, 2010, 30(3): 187-192.
[17] 郭燕丽, 王东丽, 周建波, 等. 文化程度对男男性行为者高危性行为及HIV、梅毒螺旋体感染率的影响. 中华预防医学杂志, 2014, 48(4): 307-311.
[18] 陕文生. 提高男性生殖健康的政策与策略. 甘肃科技纵横, 2011, 40(3): 189-190.
[2] Cuzick J, Arbyn M, Sankaranarayanan R, et al. Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine, 2008, 26 (Suppl 10): K29-K41.
[3] 张岱, 刘朝晖. 生殖道支原体感染诊治专家共识. 中国性科学, 2016, 25(3): 80-82.
[4] 周欢群, 周文, 陆杉. 解脲支原体感染对不育男性精液质量的影响. 暨南大学学报(自然科学与医学版), 2015, 36(4): 340-343.
[5] 李玉艳. 人乳头瘤病毒感染与男性生殖健康的关系. 中华男科学杂志, 2017, 23(4): 376-380.
[6] 王友宝, 韩韬, 赵纯雄. 男性健康人群和尖锐湿疣患者阴毛毛囊中人乳头瘤病毒的调查分析. 中华男科学杂志, 2010, 16(9): 783-785.
[7] Parish WL, Laumann EO, Cohen MS, et al. Population-based study of chlamydial infection in China: A hidden epidemic. JAMA, 2003, 89(10): 1265-1273.
[8] 朱精华, 王沛. 生殖道感染与不孕不育关系的研究进展. 国际检验医学杂志, 2012, 33(2): 201-204.
[9] Zea-Mazo JW, Negrette-Mejía YA, Cardona-Maya W. Virus of sexual transmission: Semen and virus relationship. Actas Urol Esp, 2010, 34(10): 845-853.
[10] 陈雪礼, 陈越, 刘晓峰, 等. 4种性病病原体感染16450例流行病学调查报告. 九江学院学报(自然科学版), 2004, 19(2): 79-81.
[11] 阳仕雄, 王方平, 张平安, 等. 孝感地区解脲支原体与沙眼衣原体和淋球菌及人乳头瘤状病毒感染情况调查. 中华实用诊断与治疗杂志, 2018, 32(7): 704-705.
[12] 寿叶女, 金秀萍, 蒋锦琴. 291例男性泌尿生殖道感染患者支原体感染及耐药情况. 中国卫生检验杂志, 2016, 26(18): 2721-2722, 2725.
[13] 张永乐, 施新萍, 魏建波, 等. 男性人乳头瘤病毒感染及基因型的分布分析. 中华男科学杂志, 2018, 24(7): 666-668.
[14] 韩韬, 赵纯雄, 王友宝, 等. HPV在健康人阴毛毛囊中感染情况的调查分析. 国际泌尿系统杂志, 2009, 29(2): 160-162.
[15] 赵学英, 刘学伟, 翁韶波, 等. 成年男性包皮高危型人乳头瘤病毒感染检测分析. 河北医科大学学报, 2016, 37(5): 592-594.
[16] 毛燕燕, 蔡建华, 胡云, 等. 我国九省市男性生殖道感染发生率及其多水平影响因素分析. 中华生殖与避孕杂志, 2010, 30(3): 187-192.
[17] 郭燕丽, 王东丽, 周建波, 等. 文化程度对男男性行为者高危性行为及HIV、梅毒螺旋体感染率的影响. 中华预防医学杂志, 2014, 48(4): 307-311.
[18] 陕文生. 提高男性生殖健康的政策与策略. 甘肃科技纵横, 2011, 40(3): 189-190.