两种沙眼衣原体检测方法在男性不同人群中的应用与评价

The application of and the evaluation on QuichVue rapid test and Roche PCR test for Chlamydia trachomatis infections in different male populations

目的:评价QuichVue沙眼衣原体快速检测试剂与Roche Amplicor衣原体PCR酶联检测试剂在男性不同人群中的应用。方法:采用病例对照研究,收集98例性病门诊非淋菌性尿道炎(NGU)病人9、3例性病门诊有非婚性行为但无尿道炎的就诊者及98例健康体检者三组人群的尿道拭子,分别用QuichVue和Amplicor Ct Test进行沙眼衣原体的检测。结果:NGU组QuichVue和Amplicor Ct Test沙眼衣原体的检出率分别为36.73%(36/98)和56.12%(55/98),两者检测阳性率间的差异有显著性(P<0.01);如以Roche PCR为金标准,QuichVue的敏感性和特异性分别为57.14%和90.48%。门诊对照组两种方法的检出率分别为12.15%(13/93)和9.67%(9/93),差异无显著性;QuichVue的敏感性和特异性分别为33.33%和88.1%。健康体检者QuichVue阳性率为7.14%(7/98),PCR阳性率为2.04%(2/98),两者间差异无显著性;QuichVue的敏感性为50.00%、特异性为93.75%。结论:QuichVue快速检测可用于有尿道炎症状的病人的沙眼衣原体检测,不宜用于低感染率人群的筛查。

Objective： To evaluate QuichVue rapid test and Roche PCR test for Chlamydia trachomatis （Ct） infections in different male populations. Methods： A case-control study was undertaken. Swarb samples were collected from 98 men with acute NGU and 93 control subjects who had extramarital sex but without the manifestation of acute NGU at an STD clinic, and 98 subjects as health control. Chlamydia trachomatis was assayed by QuichVue rapid test and the AMPLICOR Ct/NG PCR Test （A - Ct/NG- T, Roche Diagnostic Systems）. Results： The detection rates of Ct in NGU group by QuichVue and A - Ct/NG- T were 36.73% （36/98） and 56.12% （55/98） respectively. There was a significant difference in the detection rate between the two methods （ P = 0. 007）. Taking PCR as a ＂gold standard＂, the sensitivity and specificity of QuichVue was 57.14% and 90.48% respectively. In the control subjects, the detection rate of QuichVue was 12.15% （13/93） and of PCR 9.67% （9/93）. The sensi- tivity and specificity of QuichVue in this group was 33.33% and 88.1% respectively. In healthy group, the positivity rates of QuichVue and PCR were 7.14% （7/98） and 2.04% （2/98）. The sensitivity was 50.00% and specificity 93.75%. Conclusion： QuichVue rapid test can be used in the diagnosis of symptomatic uretritis at STD clinics but is not appropriate for the screening in the populations with low prevalence of Ct infections.