聚合酶链反应技术在淋病诊断及治愈判定中的价值

THE VALUE OF POLYMERASE CHAIN REACTION IN DIAGNOSIS AND CURE-JUDGING OF GONORRHEA

目的：探讨聚合酶链反应技术（PCR）在淋病诊断及治愈判定中的价值。方法：应用PCR和淋球菌培养法平行检测74例STD门诊疑诊为淋病患者的标本，并对34例确诊患者进行治疗后的随访检测。结果：74例疑诊患者中，两种方法均检出淋球菌的有54例，均阴性的6例，PCR阳性而培养法阴性的14例，PCR阴性而培养法阳性的0例。以PCR和培养法检测结果为“扩大金标准”，则PCR的敏感性为100％（68／68），显著高于培养法的（79．41％）；两者的特异性均为100％（6／6）。对34例确诊患者进行治疗后随访检测结果显示：PCR检测的阴转时间平均33．4±8．7天，明显延迟于培养法（平均6．3±1．8天）。结论：PCR诊断淋病具有高敏、特异、快速的优点，但在治愈判定中的价值不如培养法。PCR阴转则表明病情已愈，有临床意义。

Objective: To detect the value of polymerase chain reaction (PCR) in gonorrhea diagnosis and curejudging. Methods: PCR and culture were used to test N. gonorrhoeae in genitouinary samples of 74 patients with doubiful N. gonorrhoeae and 34 patients with N. gonorrhoeae who had been treated and were symptomatolytic.Result:In the 74 patients with doubtful N. ponrrhoeae 54 cases were postive and 6 cases were negative by both PCR and culture.14 cases were PCR petive but culture ngative.No Postive culture results were found from negative PCR samples.Using PCR plus culture as 'expanded golden standard', PCR had a sensitivty of 100% (68/68)and a speificity of 100% (6/6)while culture had a sensihvity of 79.41% (54/68) and a specificity of 100% (6/6). PCR and culture were used in follow -up test in 34 cases with confirmed diagnosis, and the results showed that the average time of PCR negative conversion was 33.4±8.7 days, obviouly longer than that of cultare(6.3 ±1. 8days). Conclusion: In Gonorrhea diagnosis,the sensihvity of PCR was obviouly higher than that of cultare. The value of PCR in cme - judging for Gonorrhea was less than that of culture,but it indicates absolute care when PCR results becoming negative, and thus has cedrin clinical value.