涂片、培养和实时荧光定量PCR检测在妇科的临床应用

Detection of gonococcal infection in women patients with FQ-PCR,Gram staining and culture.

目的:比较涂片革兰染色、培养和实时荧光定量PCR(FQ-PCR)检测妇科性病淋球菌感染的临床应用价值,寻找一种快速而敏感的淋球菌检测方法。方法:同时用涂片革兰染色、培养和FQ-PCR检测临床疑诊淋病123例女性阴道标本中的淋球菌,以培养法为“金标准”,将另外两种方法与之比较,分别计算其敏感性、特异性、阳性预期值和阴性预期值。结果:涂片检出率为76.4%、培养法检出率为66.7%、FQ-PCR检出率为69.9%;经配对计数资料χ2检验,FQ-PCR与培养法的检出率比较差异无显著性(P>0.05)。涂片法和FQ-PCR法的敏感性、特异性、阳性预期值和阴性预期值分别为94.2%、66.7%、87.2%、82.8%和97.6%、89.7%、95.3%、94.6%。结论:FQ-PCR检测淋球菌,可弥补涂片法较粗糙、培养法耗时长的缺点。FQ-PCR具有准确快速,敏感性和特异性较高的特点,是一种具有临床应用价值的淋球菌快速定量检测方法。

Objective： To evaluate the clinical Value of Gram staining, culture and real - time fluorescent quantitative polymerase chain reation （FQ - PCR）in detection of gonococal infection in women Patients and find a fast and sensitive method to detect gonococcus.Methods： 123 urogenital specimens were obtained from patients with suspected gonorrhea. These specimens were tested by Gram stain of smear, culture and FO - PCR. Culture was considered as the ＂gold standard＂. Compared with the culture, the sensitivity, specificity positive predictive predictive value （PPV）and negative predictive value （NPV） of two detection methods were calculated. Results： The positive rate of smear detection was 76.4% and that of culture and FQ - PCR detection was 66.7%and 69.9% ,The results of paved comparison Х^2 test indicated that the difference between both of the FQ - PCR and culture were not significant （ P 〉 0.05 ）. In comparison with the culture , the sensitivity, the specificity, specificity, PPV and NPV were 94.2 %, 66.7% ,87.2%, 82.8% for smear and 97.6% ,89.7% ,95.3% ,94.6% for FQ- PCR. Conculsion：The FQ- PCR detection is more accurate and costs less time than the culture detection. The FQ - PCR detection possess features of accuracy, fast, higher sensitivity and higher specificity. FQ- PCR provides a fast method which is feasible in clinical practice for detection of gonococcus.