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目的了解农村少数民族已婚妇女宫颈上皮内瘤变(CIN)患病现状及其危险因素,为预防和控制CIN提供依据。方法采取整群抽样方法随机抽取黔南地区18～55岁3 968名农村已婚少数民族妇女进行问卷调查、妇科检查、宫颈细胞涂片液基薄层细胞学(TCT)及宫颈分泌物高危人乳头状瘤病毒(HR-HPV)检测,并对TCT结果异常者行阴道镜下宫颈活组织检查,对结果进行分析。结果 3 968名已婚妇女TCT结果异常者477人,占12.02%(477/3968),病理诊断为CIN者371例,总患病率为9.35%(371/3 968),占TCT结果异常者的77.78%,其中水族234例,患病率为5.89%,毛南族59例,患病率为1.49%,布依族47例,患病率为1.18%,苗族31例,患病率为0.78%;水族CIN患病率与其他3个民族比较,差异有统计学意义(χ2=34.48,P<0.01);多因素Logistic回归分析结果显示,HR-HPV感染、滴虫性阴道炎史、口服避孕药避孕、年龄<40岁、吸烟、性伴侣数≥2、初次性生活年龄<18岁和民族等因素与CIN患病有关。结论黔南地区宫颈上皮内瘤变患病率较高,应加强防治宣传,提高CIN防治知晓率。
Objective To understand the prevalence and risk factors of cervical intraepithelial neoplasia (CIN) among married women from ethnic minorities in rural areas and provide evidence for the prevention and control of CIN. Methods A cluster sampling method was used to randomly select 3 968 rural married women of ethnic minorities from 18 to 55 years old in Qiannan district for questionnaire survey, gynecological examinations, thin layer cytology of cervical smears (TCT) and high risk of cervical secretions Papilloma virus (HR-HPV) test, and TCT results were colposcopic colposcopic cervical biopsy, the results were analyzed. Results Among 3 968 married women, 477 were abnormal TCT, accounting for 12.02% (477/3968), 371 were diagnosed as CIN, the overall prevalence was 9.35% (371/3 968) , 77.78% of which were aquatic, including 234 cases with the prevalence of 5.89%, 59 cases of Maonan with the prevalence of 1.49%, Buyi 47 cases with the prevalence of 1.18% and Miao of 31 with the prevalence of 0.78% (Χ2 = 34.48, P <0.01). The multivariate Logistic regression analysis showed that HR-HPV infection, history of trichomonas vaginitis and oral contraception were significantly higher than those of the other three ethnic groups Drug contraception, age <40 years old, smoking, number of sexual partners ≥ 2, age of first-time sexual life <18 years and ethnic and other factors and CIN related. Conclusions The prevalence rate of cervical intraepithelial neoplasia in Qiannan area is higher. Prevention and control of publicity should be strengthened to raise the awareness rate of CIN prevention and treatment.