男性性传播性尿道炎病原体治疗前瞻性研究

A Prospective Study of the treatment of Pathogens in Male Patients with Sexually Transmitted Urethritis

目的 :了解男性性传播性尿道炎经治疗后无症状患者的性病原体DNA阳性率。方法 :选择首次出现尿道炎症状的男性患者 ,将其分为甲乙两组 ,即左氧氟沙星组及左氧氟沙星加阿奇霉素治疗组。治疗 2周后用荧光定量 PCR(FQ PCR)方法筛选出淋球菌 (Ng)、解脲脲原体 (Uu)、沙眼衣原体 (Ct)DNA阳性者 (包括有症状和无症状者 ) ,对病原体DNA阳性者重复治疗 2周 ,再次筛选出Ng、Uu、CtDNA阳性者 (包括无症状和有症状 )。结果 :无症状患者的病原体DNA阳性检出率 :治疗 2周后甲组 3 5 .2 % ,乙组 2 0 .8% ;对病原体DNA仍阳性者重复治疗 2周后 ,甲组 5 0 .0 % ,乙组 :15 .8%。结论 :男性性传播性尿道炎经治疗后无症状患者有较高比例病原体DNA检出率 ,应重视该人群的追踪治疗。

Objective:To investigate the positive result rates of DNA of pathogens in male STU patients without symptoms after treatment. Methods:We chose the male patients who had the first onset of symptoms of urethritis as subjects of the study, and divided them randomly into groups A and B. All the subjects in group A were treated with levofloxacin, while those in group B with levofloxacin and azithromycin for two weeks, respectively. After treatment, DNA of Ng, Uu and Ct were detected by means of FQ PCR. Then those with positive DNA of Ng, Uu and Ct (including patients with and without symptoms) were selected, and treated for two weeks, followed by detection of the DNA of Ng Uu and Ct again. Identification of those asymptomatic but positive pathogen DNA was made. Results:The positive rates with DNA of Ng, Uu and Ct among the subjects without symptoms in groups A and B were 35.2% and 20.8%, respectively, after 2 weeks post treatment, and 50.0% and 15.8%, respectively, after 2 weeks further of treatment was still postive DNA of pathogens. Conclusion:The positive rates DNA of Ng, Uu and Ct DNA among the subjects without symptoms were high in the male STU patients after treatment. Further treatment should be focused on asymptomatic patients with positive pathogen DNA.