解脲脲原体不同基因群与男性非淋菌性尿道炎相关性的研究

Study on the association of gene dusters of U.urealyticum with nongonococcal urethritis in males

目的探讨解脲脲原体(Uu)不同基因群与男性非淋菌性尿道炎(NGU)的相关性。方法病例对照研究结合横断面研究收集402例标本,用3对PCR引物对标本进行基因分群。结果3对引物将Uu 14个血清型明确分成两个基因群,细小脲原体(Urealpasma parvum,Up)和解脲脲原体(Urealpasma urealyticum,Uu′)。未做基因分群时,Uu阳性率在NGU组、非NGU就诊者组及健康体检组3组人群间无差异。分群后,Up在NGU组和健康体检组间、非NGU就诊组与健康体检组间的定植率差异有统计学意义,P均＜0．01,而在NGU组和非NGU就诊组间定植率差异无统计学意义,P=0．380。Uu′在NGU组和非NGU组间阳性率差异无统计学意义,P=0．704,但在NGU组和健康体检组、非NGU就诊者与健康体检组间的阳性率差异有统计学意义,P均＜0．01。排除沙眼衣原体感染后,3组人群Uu定植率差异仍无统计学意义,Up在NGU组和健康体检组间定植率的差异有统计学意义．P=0．04；在非NGU就诊者与健康体检组间定植率差异有统计学意义(P=0．005)。Uu′在非NGU就诊组和健康体检组间定植率差异有统计学意义,P=0．01。男男性接触者(MSM组)Up阳性率为3．63％、Uu′阳性率为14．54％,定植情况不同于异性性接触者。结论提示Uu′的定植与高危性行为有关,但与尿道炎无相关性,Up可能是尿道正常定植的菌群。

Objective To assess the association of U. urealyticum biovars （ or gene clusters ） 1 and 2 with male urethritis. Methods Four hundred and two subjects were recruited in a case-controlled, cross sectional study. Three pairs of primers were used to separate the gene clusters of U. urealyticurn. Results There was no significant difference in the positive rate of U. urealyticum among Group G1 （ patients with nongonococcal urethritis, NGU ）, Group G2 （ STD clinic clients without NGU ） and Group G4 （healthy volunteers ） before ureaplasmas were typed. U. urealyticum （biovar 2 or gene cluster 2 ） was found significantly more often in G1 and G2 than that in G4 （ P = 0.003, G1 vs. G4; P = 0.009, G2 vs. G4; respectively ）, but was not significantly different between G1 and G2 （ P = 0.704 ）. However, The colonization rate of U. pravum was lower in GI and G2 than that in G4 （ P = 0.000, GI vs. G4; P = 0.004, G2 vs. G4; respectively ）, but was not significantly different between G1 and G2 （ P = 0.380 ）. When chlamydial infection was excluded, no significant difference was found in the colonization rate of U. urealyticum among G1, G2 and G4; but the rates of Up between G1 and G4 （ P = 0.004 ）, G2 and G4 （ P = 0.005 ） were of significant difference. There was significant difference in the colonization rate of U. urealyticum （ biovar 2 or gene cluster 2 ） between G2 and G4 （ P = 0.01 ）. The pattern of colonization of U. pravum and U. urealyticum （ biovar 2 or gene cluster 2 ） in G3 （ men who have sex with men ） was different from that in the heterosexual men with the prevalence rates of 3.63% and 14.54%, respectively. Conclusions This study suggests that U. urealyticum （ biovar 2 or gene cluster 2 ） colonization is not correlated with NGU, but rather with high risk sexual behavior. The presence of U. pravum in male urethra might be the result of normal colonization and is, therefore, unlikely to play any role in the development of NGU.