沙眼衣原体感染不同检测方法的比较

Comparison of different assays for detection of Chlamydia trachomatis

目的研究不同方法检测沙眼衣原体感染的灵敏度和特异度。方法采取213例女性非淋菌性泌尿生殖道感染者宫颈分泌物,分别用直接免疫荧光法(DFA)、免疫层析法(ICA)和实时荧光定量PCR法(FQ-PCR)检测沙眼衣原体。结果采用DAF法和FQ-PCR法与采用ICA法检测沙眼衣原体阳性率比较差异有统计学意义(P<0.05);DFA法、ICA法和FQ-PCR法的灵敏度分别为95.1%、60.2%和97.3%,特异度分别为93.2%、99.2%和99.3%。DFA法和FQ-PCR法的灵敏度高于ICA法,差异有统计学意义(P<0.05),ICA法和FQ-PCR法的特异度高于DFA法,差异有统计学意义(P<0.05)。结论 FQ-PCR法有较高的灵敏度和特异度,可为临床诊断沙眼衣原体感染提供可靠依据。基层医疗卫生单位适合用ICA法检测沙眼衣原体。

Objective To investigate the sensitivity and specificity of different assays for detection of Chlamydia trachomatis . Methods Chlamydia trachomatis was determined in samples of cervical secretions from 213 patients with nongonococcal urethritis or genitourinary tract infection by direct immunofluorescence assay （DFA ） ,gold-immunochromatographic assay （ICA ） and real-time fluorescence quantitative polymerase chain reaction （FQ-PCR） .Results Comparing the positive rates of Chlamydia trachoma-tis detected by adopting the DAF ,FQ-PCR and the ICA methods showed the statistical difference （P＆lt;0 .05） .The sensitivity and specificity of Chlamydia trachomatis detected by DFA ,ICA and FQ-PCR were 95 .1% ,60 .2% ,97 .3% and 93 .2% ,99 .2% , 99 .3% ,respectively .The sensitivity of the DFA and FQ-PCR methods was higher than that of the ICA method ,difference was sta-tistically significant（P＆lt;0 .05） ,The specificity of the ICA and FQ-PCR methods was higher than that of the DFA method ,differ-ence was statistically significant （P＆lt;0 .05） .Conclusion The FQ-PCR method has higher sensitivity and higher specificity for the detection of Chlamydia trachomatis and can provide the reliable basis for clinically diagnosing the infection of Chlamydia trachom-atis .The primary medical units is suitable to adopt the ICA method for detecting Chlamydia trachomatis .