PCR-荧光探针法在沙眼衣原体泌尿生殖道感染判愈中的应用

Application of PCR-fluorescent Probe Method in the Determination of Cure Rate of Patients with Chlamydia Trachomatis Urogenital Infection

目的:评估不同判愈标准下罗红霉素治疗沙眼衣原体(C.t)泌尿生殖道感染患者治愈率的差别。方法:回顾性分析2013年1月-2017年12月在赣南医学院第一附属医院门诊确诊为C.t生殖道感染354例患者的临床资料,所有患者采用罗红霉素治疗C.t感染并完成2次随访。临床判愈标准为临床症状消失,病原学判愈标准为PCR检测临床标本C.t DNA阴性,比较不同判愈标准的患者治愈情况。结果:根据临床判愈标准,354例患者中治愈283例,治愈率为79.94%;而第1、2次PCR-荧光探针法检测的治愈率分别为73.45%和72.32%。临床判愈标准的治愈率均明显高于第1、2次PCR-荧光探针法判愈标准,差异均有统计学意义(X^2=4.37、6.07,P=0.04、0.01);但两次PCR-荧光探针法判愈标准的治愈率比较,差异无统计学意义(X^2=0.18,P=0.67)。结论:PCR-荧光探针法可作为C.t泌尿生殖道感染治疗后随访较为客观的病原学判愈方法,推荐采用罗红霉素治疗患者疗程结束后1个月复查1次。

Objective：To evaluate the difference of the cure rates with different standards on the patients with chlamydia trachomatis （C.t） urogenital infection treated by Roxithromycin.Method：The clinical data of 354 patients with C.t urogenital infection diagnosed in the outpatient department of the First Affiliated Hospital of Gannan Medical University from January 2013 to December 2017 were retrospectively analyzed.All patients were treated with Roxithromycin for C.t infection and followed up for two times.The disappearance of clinical symptoms was defined as the clinical standard and the negative detection of C.t DNA in clinical samples by PCR was defined as the pathogenic standard.The cure rate of patients with different standards were compared.Result： According to the clinical standard,283 cases were cured,cure rate was 79.94%,the cure rates of the first and second PCR-fluorescence probe methods were 73.45% and 72.32% respectively.The cure rate of the clinical standard was significantly higher than those of the first and second PCR-fluorescence probes,the differences were statistically significant（χ^2=4.37,6.07;P=0.04,0.01）.However,there was no significant difference in the cure rate between the the first and second PCR-fluorescent probes （ χ^2=0.18,P=0.67）.Conclusion：PCR-fluorescent probe method can be carried out as a method of objective pathogenic detection for the follow-up of C.t urogenital infection.It is recommended that Roxithromycin be used to treat urogenital infection once a month after the end of treatment.