连接酶链反应检测宫颈沙眼衣原体感染

Ligase chain reaction to detect Chlamydia trachomatis infection of the cervix

为评价连接酶链反应(LCR)诊断宫颈沙眼衣原体(CT)感染的意义，用质粒LCR和聚合酶链反应(PCR)检测170例STD门诊女性就诊者宫颈拭子标本中的CT，对两项检测结果不一致的标本进行校正，对PCR阳性而LCR阴性者，将LCR标本稀释10倍重复LCR或用PCR反应的DNA模板作LCR检测。对PCR阴性而LCR阳性者，用另一对针对沙眼衣原体主要外膜蛋白(MOMP)基因的引物作PCR测试。将以上两项检测结果阳性的标本判断为真阳性，确定LCR和PCR的敏感性和特异性。发现170例患者中24例LCR检测阳性(14.2％)，26例PCR阳性(15.3％)，对8例两项结果不一致的标本作了校正。LCR检测的敏感性和特异性分别为92％，99.3％；而PCR分别为92％，97.9％。结果提示LCR诊断女性宫颈CT感染具有较高的敏感性和特异性。

In order to evaluate the clinical significance of ligase chain reaction(LCR) in the diagnosis of Chlamydia trachomatis(CT) infection of the cervix. A comparative study of plasmid-LCR and polymerase chain reaction(PCR)was performed to detect CT of cervical swab in 170 women in STD clinic.The following methods were used to resolve the specimen of LCR-PCR discrepancies. If the specimen was positive by PCR but negative by LCR, a repeat LCR was performed with a 1∶10 dilution of the LCR medium or the PCR medium. If the specimen was positive by LCR but negative by PCR, another PCR test using primers for the major outer membrane protein(MOMP) gene was done with the original specimen. The specimens which were positive by two or two more methods were regarded as true positivity. According this, the sensitivity and the specificity of this two methods were evaluted. We found that 24 of 170(14.2％) women had positive LCR results and 26 of 170(15.4％) for PCR, and that 8 specimens of LCR-PCR discrepancies were resolved. The sensitivity, specificity of LCR were 92％,99.3％, respectively, whereas 92％, 97.9％with PCR. It suggested that LCR has a higher sensitivity and specificity for the diagnosis of CT infection of the cervix.