文章摘要
裴蕊欣,武彩红,闫佳欣,丁玲,宋丽,吕元婧,王捷,刘虹,孟丹,祁卓,郝敏,王金桃.多环芳烃暴露对高危型人乳头瘤病毒感染转归影响的前瞻性队列研究[J].中华流行病学杂志,2021,42(11):2060-2065
多环芳烃暴露对高危型人乳头瘤病毒感染转归影响的前瞻性队列研究
Effects of polycyclic aromatic hydrocarbons exposure on prognosis of high risk human papillomavirus infection: a prospective cohort study
收稿日期:2021-04-06  出版日期:2021-11-20
DOI:10.3760/cma.j.cn112338-20210406-00278
中文关键词: 多环芳烃;高危型人乳头瘤病毒;转归;队列研究
英文关键词: Polycyclic aromatic hydrocarbon;High-risk human papillomavirus;Prognosis;Cohort study
基金项目:国家自然科学基金(81872705,81473060,81703313);公益性行业科研专项(201402010)
作者单位E-mail
裴蕊欣 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
武彩红 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
闫佳欣 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
丁玲 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
宋丽 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
吕元婧 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
王捷 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
刘虹 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
孟丹 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
祁卓 山西医科大学公共卫生学院流行病学教研室, 太原 030001  
郝敏 山西医科大学第二医院妇产科, 太原 030001  
王金桃 山西医科大学公共卫生学院流行病学教研室, 太原 030001 wangjt59@163.com 
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中文摘要:
      目的 探讨多环芳烃(PAHs)暴露对高危型人乳头瘤病毒(HR-HPV)感染转归的影响。方法 采用前瞻性队列研究方法,以课题组于2014年在山西省建立的自然队列人群中经病理学确诊的564名低度宫颈上皮内瘤变患者为研究对象。在收集人口学特征、HPV感染相关因素等基线资料的基础上,采用高效液相色谱法检测尿液中的1-羟基芘浓度以界定PAHs的暴露水平。于基线和24个月随访时应用导流杂交技术进行HPV分型检测,并以此确定HR-HPV的转归情况(持续感染、阳转阴、阴转阳和持续阴性)。结果 564名研究对象中共有483名完成了随访,随访率为85.6%(483/564),其中,持续感染率为52.4%(75/143)、同型持续感染率为35.1%(51/143)、阳转阴率为47.6%(68/143)、阴转阳率为19.7%(67/340)、持续阴性率为80.3%(273/340)。PAHs高暴露组HR-HPV持续感染率(aRR=3.22,95%CI:1.85~5.62)和阴转阳率(aRR=2.84,95%CI:1.64~4.94)均高于低暴露组,而HR-HPV持续阴性率则低于低暴露组(aRR=0.55,95%CI:0.43~0.70)。经限制性立方样条模型分析显示,PAHs暴露对HR-HPV持续感染和同型持续感染的影响呈上升型线性剂量-反应关系(P>0.01),而对阴转阳和持续阴性的影响分别呈上升和下降型非线性剂量-反应关系(P<0.01)。结论 PAHs高暴露可促进HR-HPV持续感染和同型持续感染的发生,积极预防和控制PAHs的暴露对于阻止HR-HPV感染的发生和持续感染具有重要意义。
英文摘要:
      Objective To investigate the effects of polycyclic aromatic hydrocarbons (PAHs) exposure on the prognosis of high risk human papillomavirus (HR-HPV) infection. Methods In this prospective study, 564 patients with low-grade cervical intraepithelial neoplasia confirmed by pathology were selected from the natural cohort population established by our research group in Shanxi province in 2014. Based on the baseline data of demographic characteristics and factors related to HPV infection, the concentrations of 1-hydroxypyrene in urine samples of the patients were determined by high performance liquid chromatography to define the exposure level of PAHs. At baseline survey and follow-up after 24 months, flow-through hybridization was used to detect HPV infection types, and to evaluate the prognosis of HR-HPV (persistent infection, negative conversion, positive conversion and persistent negative status). Results Of the 564 subjects, 483 completed the follow-up, with a follow-up rate of 85.6% (483/564). Among them, the persistent infection rate was 52.4% (75/143), the persistent homotype infection rate was 35.7% (51/143), the negative conversion rate was 47.6% (68/143), the positive conversion rate was 19.7% (67/340), and the persistent negative rate was 80.3% (273/340). The follow-up results showed that the persistent infection rate (aRR=3.22, 95%CI:1.85-5.62) and positive conversion rate (aRR=2.84, 95%CI:1.64-4.94) of HR-HPV in high PAHs exposure group were higher than those in low PAHs exposure group, while the persistent negative rate (aRR=0.55, 95% CI: 0.43-0.70) of HR-HPV in high PAHs exposure group were lower than those in low PAHs exposure group. Based on restrictive cubic spline analysis, the results showed that the effects of PAHs exposure on persistent HR-HPV infection and persistent homotype infection showed an ascending linear dose-response relationship, while on HR-HPV positive conversion and persistent negative status showed an ascending and declining nonlinear dose-response relationship respectively (P<0.01). Conclusions High PAHs exposure could promote persistent HR-HPV infection and persistent homotypic infection. Reducing PAHs exposure might conducive to HR-HPV continuous negative maintenance. Active prevention and control of PAHs exposure is of great significance to prevent HR-HPV infection and persistent infection.
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