两种方法检测泌尿生殖道沙眼衣原体的比较

Comparison of Two Methods for Detection of Urogenital Chlamydia Trachomatis

目的比较两种方法检测泌尿生殖道沙眼衣原体的敏感性、特异性、阳性预测值和阴性预测值。方法收集2012年3月-2013年3月性病门诊1240例就诊者的宫颈或尿道分泌物标本,分别应用沙眼衣原体抗原检测法(胶体金法)、聚合酶链式反应法(PCR)检测沙眼衣原体感染,并以细胞培养法作为诊断金标准,比较两种检测方法的敏感性、特异性、阳性预测值和阴性预测值。结果在1 240例临床标本中,PCR法检测出阳性标本54例,与金标准相符22例,而胶体金法检出阳性标本41例,仅6例与金标准相符,PCR法在敏感性(84.62%)、特异性(97.36%)、阳性预测率(40.74%)及阴性预测率(99.66%)方面均较胶体金法有明显优势,差异有统计学意义(P<0.01)。结论针对性病门诊筛查诊治泌尿生殖道沙眼衣原体,PCR法比传统胶体金法检测具有较高敏感性、特异性、阳性预测率及阴性预测率,在符合技术开展条件下可作为临床应用。

Objective To compare the sensitivity,specificity,positive predictive value and negative predictive value between two methods for the detection of urogenital Chlamydia trachomatis. Methods Cervical or urethral discharge samples from 1 240 STD clinic patients from March 2012 to March 2013 were tested for Chlamydia trachomatis antigen with both the antigen detection method(colloidal gold) and polymerase chain reaction(PCR). Cell culture method served as the standard reference method. The sensitivity,specificity,positive predictive value and negative predictive value were compared between colloidal gold and PCR methods. Results Among 1 240 clinical specimens,the PCR method showed 54 positive,22 of which were consistent with the standard method,while colloidal gold found 41 positive,6 of which were consistent with standard method. With PCR method,the sensitivity,specificity,positive predictive rate and negative predict rate were 84. 62%,97. 36%,40. 74%,and 99. 66%,respectively. The differences in sensitivity,specificity,positive predictive value and negative predictive value were significant between colloidal gold and PCR methods. Conclusion In screening urogenital Chlamydia trachomatis at STD clinic,the PCR method has higher sensitivity,specificity,positive predictive rate and negative predictive rate than the traditional colloidal gold method. The clinical application of the PCR method in detecting urogenital Chlamydia trachomatis could become possible if certain requirements can be met.