缺口-连接酶链反应-酶联免疫吸附法检测孕妇沙眼衣原体感染

Study on the Chlamydia trachomatis infections in pregnant women inChongqing using Gap-LCR-ELISA

目的:用缺口-连接酶链反应-酶联免疫吸附(Gap-LCR-ELISA)法检测重庆地区孕妇沙眼衣原体感染,以了解围生期沙眼衣原体(CT)的感染现状。方法:以512名孕妇首段尿(FVU)及配对宫颈刮片为研究对象,按照扩大金标准,采用质粒探针和外膜蛋白探针Gap-LCR-ELISA法用于不同类型临床标本检测CT感染。结果:①孕妇的CT感染呈很强的隐匿性,由扩大金标准所确证的CT真阳性共42例,所检重庆地区孕妇的CT感染率为8.2%(42/512),其中88.1%(37/42)可同时从尿道和生殖道检出CT,而另9.5%(4/42)和2.4%(1/42)仅能单独分别从生殖道或尿道检出。②Gap-LCR-ELISA用质粒与外膜蛋白作为探针检测FVU中CT的敏感性分别为90.48%和71.43%(P<0.05),质粒Gap-LCR-ELISA用于宫颈刮片和FVU两种标本的敏感性分别为97.62%和90.48%(P>0.05),特异性均为100%。结论:质粒Gap-LCR-ELISA法用于孕妇FVU以检测围生期无症状CT感染患者,是一种非侵袭性的、高度敏感特异的、适合于发展中国家和地区进行大规模流行病学调查的方法。

Objective: To study the current status of Chlamydia trachomatis (CT) infections in pregnant women in Chongqing using Gap-LCR-ELISA methods. Methods: Five hundred and twelve samples of first void urine(FVU) and cervical scraping smears were taken from pregnant women. According to the 'Expanded Gold Standard', the methodology indices of Gap-LCR-ELISA were compared between plasmid probes and omp1 probes in different forms of samples. Results: ①CT infection in pregnant women was strongly insidious. Forty-two positive cases were confirmed by the 'Expanded Gold Standard', indicating the prevalence of infections among pregnant women in Chongqing was 8.20% (42/512). Among those positive cases, CT was detectable from both FVU and cervical scraping smear with the ratio of 88.1% (37/42) while positive results from either cervical scraping smear or FVU alone were found in 9.5% (4/42) and 2.4% (1/42), respectively. ②The sensitivity of Gap-LCR-ELISA using plasmid probes and omp1 probes was 90.48% and 71.43% (P < 0.05), respectively. Meanwhile, the sensitivity of plasmid Gap-LCR-ELISA using cervical scraping smear and FVU was 97.62% and 90.48% (P > 0.05), respectively. The specificity of all the above Gap-LCR-ELISA tests was 100%. Conclusion: FVU plasmid Gap-LCR-ELISA is a noninvasive, highly sensitive and specific method which is suitable for large-scale screening for the perinatal CT infection in pregnant women in developing countries and regions.