泌尿生殖道感染患者淋病奈瑟菌、沙眼衣原体和解脲脲原体感染临床分析

Analysis on prevalence of Neisseria gonorrhoeae,chlamydia trachomatis and ureaplasma urealyticum of urogenital tract infection patients

目的了解泌尿生殖道感染患者淋病奈瑟菌(NG)、沙眼衣原体(CT)和解脲脲原体(UU)的感染现状及其特点。方法应用实时荧光聚合酶链反应(PCR)检测630例(男性274例,女性356例)泌尿生殖道感染患者泌尿生殖道分泌物的NG、CT和UU核酸,并对其中108例患者行单纯疱疹病毒(HSV)检测,82例行人乳头瘤病毒(HPV6/11/16/18)检测。结果在630例患者中,NG、CT和UU的阳性检出率分别为3.2%(20/630)、9.8%(62/630)和47.1%(297/630),HSV的阳性检出率为2.8%(3/108),HPV6/11/16/18的阳性检出率为8.7%(8/92),其中男性NG、CT和UU的阳性检出率分别为5.1%(14/274)、10.9%(30/274)和21.5%(59/274),女性分别为1.7%(6/356)、9.0%(32/356)和66.9%(238/356),女性UU阳性检出率明显高于男性(P<0.01),男性NG阳性检出率明显高于女性(P<0.05);男性和女性患者中,NG阳性检出率均以<30岁组(7.4%,7/94;3.5%,4/115)较高,男性CT阳性检出率以>40岁组(17.5%,7/40)最高,女性以<30岁组(17.3%,18/104)最高,UU在不同性别各年龄组比较,差异均无统计学意义(P>0.05);CT+UU双重感染的阳性检出率最高,为8.2%(31/379),NG+UU+CT双重感染检出率为1.6%(6/379),HPV 6/11+NG、HPV 6/11+CT混合感染各1例,HSV-Ⅰ/Ⅱ伴UU感染2例。结论泌尿生殖道感染患者NG、CT和UU阳性检出率不尽相同,其中以UU最高,且女性阳性检出率高于男性,两种及以上病原体混合感染较为常见,临床应注意进行多种病原体的检测。

Objective To investigate the prevalence on infection of Neisseria gonorrhoeae （NG）, chlamydia trachomatis （CT） and ureaplasma urealyticum （UU） in 630 patients of urogenital tract infection. Methods NG, CT and UU of gential tract were quantitatively detected by PCR method in patients recruited, as well as herpes sim- plex virus and human papillomavirus in part of cases. Results Among 630 cases, the positive rate of UU （47.1%） was the highest in single infection , followed by CT （9.8%） and NG （3.2%）. As for HSV and HPV 6/11/16/ 18, the positive rate were 2.8% （3/108） and 8. 7%（8/92）. The positive rate of UU was significant higher in male group than that in female （P〈0.01）, while was lower for NG （P〈0.01）. Compared with other age groups, the positive rate of NG was higher in group of 〈30 years. Higher positive rate of CT was found in group of 〈30 years in male and 〉40 years in female. UU＋CT was the most common mixed infection in urogenital tract infection patients （8. 2%）. The positive rate of UU＋CT＋NG was 1.6%. We also found 1 patient coinfected with HPV 6/11 and NG, as well as HPV 6/11 and UU. Meanwhile, 2 cases recruited were coinfected with HSV and UU. Conclusions There were significant differences in positive rate of NG, CT and UU in urogenital tract infection patients. As the most common pathogen, the positive rate of UU was significantly higher in female. More attention should be paid to the variety of pathogen detection clinically.