摘要
目的 探讨孕期、产褥期妇女及其新生儿的人乳头状瘤病毒 (HPV)亚临床感染状况。方法 采用聚合酶链反应 (PCR)技术检测 10 3例孕产妇 (观察组 )宫颈及阴道分泌物、外周静脉血标本中HPV 6、11、16、18型DNA ,其中孕早期 30例、孕中期 42例、孕晚期 31例 ,孕晚期妇女监测到产褥期 ;以同期门诊要求带宫内节育器妇女 30例为对照组 ,同时检测孕晚期妇女分娩的新生儿咽部分泌物标本。结果 孕早、中、晚期、产褥期、对照组妇女的宫颈及阴道分泌物HPV总阳性率分别为 :16 .7%、2 8.6 %、74.2 %、2 5 .8%、2 6 .7% ;外周静脉血HPV总阳性率分别为 2 3 .3%、2 6 .2 %、5 8.1%、2 2 .6 %、2 0 .0 % ;各组均以HPV 16 / 18型感染为主 ,其次为HPV 6 / 11+ 16 / 18型 ,而无单独的HPV 6 / 11型阳性。动态检测 31例妇女在孕晚期、分娩前、产后 6周宫颈及阴道分泌物中HPV阳性例数分别为 17例、2 1例、8例 ,其中有 6例在孕期的检测中有波动 ;外周静脉血的HPV阳性例数分别为 14例、13例、7例 ,其中有 7例在孕期的检测中有波动 ;动态检测 31例新生儿在出生时、出生后 48～ 72h、出生后 6周咽部分泌物中HPV阳性例数分别为 13例、6例、1例。结论 整个孕期以孕晚期HPV感染明显 ,而孕早期、孕中期、产褥期与非孕期的HPV感染率差?
Objective To investigate the state of human papillomavirus (HPV) infection in similar average aged pregnant women of different gestational periods, in the puerperium and neonates. Methods Polymerase chain reaction (PCR) assay was employed to detect HPV 6, 11, 16 and 18 DNA in 30 pregnant women in the first trimester, 42 in the second and 31 in the third (who were followed up to their puerperium), and 30 non pregnant women asking for intrauterine device in our out patient clinic were taken as controls. Average age in the four groups showed no significant difference ( P >0.05). Samples from cervical, vaginal exfoliated cells, maternal peripheral blood and nasopharyngeal secretion of the newborns were examined respectively. Results (1) In the first trimester, HPV DNA was detected in the cervical, vaginal exfoliated cells of 5 cases and in the maternal peripheral blood of 7 cases. (2) In the second trimester, HPV DNA was detected in the cervical, vaginal exfoliated cells of 12 cases and in the maternal peripheral blood of 11 cases. (3) In the third trimester, HPV DNA was detected in the cervical, vaginal exfoliated cells of 23 cases and in the maternal peripheral blood of 18 cases. (4) In the puerperium, HPV DNA was detected in samples of cervical, vaginal exfoliated cells of 8 cases and maternal peripheral blood of 7 cases. (5) In the control group, HPV DNA was detected in the cervical, vaginal exfoliated cells of 8 cases and in the maternal peripheral blood of 6 cases. (6) Consecutive examinations were carried out in 31 pregnant women from the third trimester, through labor to 6 weeks of postpartum. HPV DNA was positive in the cervical, vaginal samples of 17, 21 and 8 cases, respectively, according to the perinatal periods, and in the maternal peripheral blood of 14, 13 and 7 cases, respectively. The result through the above gestational stages was fluctuated in the cervical, vaginal samples of 6 cases and in the maternal peripheral blood of 7 cases. (7) Successive examinations in infants at time of birth, 48～72 h and 6 weeks after birth showed positive HPV DNA in the nasopharyngeal secretion of 13, 6 cases and 1 case with respect to the examining periods. (8) The positive cases were mainly infected by HPV 16, 18. Conclusions (1) Infective rate of HPV is statistically significant in the third trimester, but no significant difference exists among the first trimester, the second trimester, the puerperium or the non pregnancies. (2) Examining consecutively, the HPV positive rate is found to be decreased after delivery, the positive expression of HPV during the gestational periods exhibited fluctuation. (3) Infective rate of HPV in the neonatal nasopharyngeal specimens tends to decrease with time after delivery.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2000年第9期523-526,共4页
Chinese Journal of Obstetrics and Gynecology
