连接酶链反应检测女性尿标本中的奈瑟淋球菌

Evaluation of Ligase Chain Reaction for Identification of Neisseria gonorrhoeae in Urine of Women

目的评价连接酶链反应（ＬＣＲ）技术诊断女性淋病的价值。方法对 １７０例 ＳＴＤ门诊女性就诊者作宫颈拭子淋球菌培养和尿标本ＬＣＲ检测，对两项检测结果不一致的标本作聚合酶链反应（ＰＣＲ）检测，参照“扩大的金标准”确定ＬＣＲ技术和培养的敏感性和特异性。结果１７０例患者中１６例ＬＣＲ检测阳性（９． ４％），１４例培养阳性（８． ２％），对８例两项结果不一致的标本作了ＰＣＲ检测。ＬＣＲ检测的敏感性、特异性、阳性预期值和阴性预期值分别为９４．１％、１００％、１００％和９９．４％；而培养法分别为８２．４％、１００％、１００％和９８．１％。结论尿标本ＬＣＲ检测对诊断女性淋病具有较高的敏感性和特异性，适宜作大规模的ＳＴＤ普查，使筛查女性无症状感染者的机会大大增加。

Objective To evaluate the value of ligase chain reaction(LCR) in the detection of gonorrhoeae in women. Methods A comparative study of urine LCR and cervical swab culture was performed in 170 women in STD clinic, polymerase chain reaction(PCR) was used to resolve the specimen of LCR - culture discrepancies. Test performance was calculated on the basis of an expanded reference standard. Results 16 of 170 (9. 4 % ) women had positive LCR results and 14 of 170 (8. 2 % ) for cervical swab culture, 8 specimens of LCR culture discrepancies were detected by PCR. The sensitivity, specificity, positive predictive value, and negative predictive value of LCR for the detection of gonorrhoeae in urine specimens were 94. 1 %, 100 %, 100 % and 99. 4 %; whereas 82. 4 %, 100 %, 100 % and 98. 1 % with culturing cervical swabs. Conclusion LCR has a higher sensitivity and specificity for the detection of gonorrhoeae in women. Urine testing for STD diagnosis has the potential to simplify and expand the opportunities for STD screening and surveillance of women.