性病病征处理的临床疗效观察

A Clinical Observation on the Therapeutic Effects of Syndromic Management of Sexually Transmitted Diseases

目的 探讨病征处理对淋球菌和沙眼衣原体感染的诊断准确性和临床疗效。方法 选择具有尿道分泌物和阴道分泌物异常的性病门诊初诊患者 ,对其进行病征处理。同时进行病原学诊断。结果 62 4例患者中男 2 90例 ,女3 3 4例。病征诊断对淋球菌和沙眼衣原体感染总的敏感性、特异性和阳性预期值分别为 91.3 %、45 .2 %和 67.0 %。随访患者的治愈率为 72 .2 % ;总有效率为 91.3 %。女性患者的治愈率显著低于男性。副作用少见。结论 具有尿道分泌物的男性患者应用病征处理的原则进行治疗 ,治愈率高 ,安全快捷。对具有阴道分泌物异常的女性患者来说 ,病征处理有一定疗效 ,但还不令人满意。

Objective To observe the diagnostic accuracy and the therapeutic effects of syndromic management of Neisseria gonorrhoeae and Chlamydia trachomatis infections in sexually transmitted disease(STD).Methods Patients with syndromes of urethral discharge and vaginal discharge were selected and managed syndromically according to standard flowcharts.The etiology of the syndromes was detected by laboratory testing.Results A total of 624 patients(male 290 and female 334) was enrolled into the study.The sensitivity for N.gonorrhoeae and C.trachomatis infections by syndromic algorithm was 91.3%;the specificity was 45.2%;and the positive predictive value was 67.0%.In patients followed up,the cure rate and total responsive rate were 72.2% and 91.3%,respectively.The cure rate was significantly lower in women than that in men.Adverse reactions were occasionally seen during the treatment.Conclusion The treatment of patients with urethral discharge is highly effective and safe.For patients with vaginal discharge,syndromic treatment is relatively effective and not satisfied.Further study is needed to improve syndromic protocol for the management of vaginal discharge.