PCR检测首次排空尿诊断男性淋病的研究

A study on diagnosis of gonorrhea by polymerase chain reaction with first void urine

目的：对聚合酶链反应（ＰＣＲ）检测首次排空尿（ＦＶＵ）诊断男性淋病的检测效果作出评估。方法：应用ＰＣＲ对２００例男性拟似淋病就诊者的ＦＶＵ进行检测，同时取尿道拭子标本行ＰＣＲ及培养，以培养阳性及ＦＶＵ与拭子ＰＣＲ均阳性作为阳性判断标准，判断各种方法的检测效果。结果：６４例培养阳性，１２例培养阴性而 ＦＶＵ与拭子 ＰＣＲ均阳性。根据判断标准，共有 ７６例阳性。拭子 ＰＣＲ ７４例真阳性，ＰＣＲ／ＦＶＵ ７３例真阳性。 ＰＣＲ／ＦＶＵ的敏感性、特异性分别是 ９６％（７３／７６）和 ９８．４％（１２２／１２４），拭子 ＰＣＲ分别是９７．４％（７４／７６）和９９．２％（１２３／１２４），拭子培养的敏感性是８４．２％（６４／７６）。ＰＣＲ／ＦＶＵ的敏感性显著高于拭子培养（ｘ~２＝４．２７，Ｐ＜０．０５）。结论：ＰＣＲ／ＦＶＵ是具有高度敏感性和特异性的非创伤性男性淋病实验室诊断方法，ＦＶＵ可代替拭子标本行ＰＣＲ诊断男性淋病。

To evaluate the Performance of polymerase chain reaction(PCR)with first void urine(FVU) for the diagnosis of gonorrhea in men. Methods: Samples of FVU collected from 200 male STD clinic patients were tested by PCR assay. Simultaneously, the swab samples collected from urethra were tested by PCR and culture. If either culture of PCR/FVU or PCR/swab was positive, the results were considered as positive(expanded gold standard). Results: Sixty four cases were positive by culture. Twelve cases were negative by culture, but positive by both PCR/FVU and PCR/swab. According to expanded gold standard, samples from 76 cases were positive, among them 73 were PCR/FVU positive and 74 swab/PCR positive. The sensitivity and specificity of swab/culture were 96% (73/76) and 98 .4% (122/124), respectively. Whereas the sensitivity and specificity of swab/PCR were 97. 4% (74/76) and 99. 2% (123/124) respectively. The sensitivity of swab/culture was 84. 2% (64/76). The sensitivity of PCR/FVU was significantly higher than that of swab/culture(x^2 = 4. 27 P < 0. 05). There was no significant difference in sensitivity between PCR/FVU and PCR/swab. Conclusion: In the diagnosis of gonorrhea in men, PCR/FVU are highly sensitive and highly specific, and could substitute for PCR/swab in terms of acceptability and feasibility.