培养法及聚合酶链反应检测男性非淋菌性尿道炎患者中阴道毛滴虫

Detection of Trichomonas Vaginalis Infection in Male Patients With Non-gonococcal Urethritis by InPouch TV Culture and Polymerase Chain Reaction

目的研究男性非淋菌性尿道炎(NGU)患者中阴道毛滴虫感染的状况;评价尿液及尿道拭子聚合酶链反应(PCR)检测阴道毛滴虫感染的敏感性和特异性,建立一种非侵入性检测男性阴道毛滴虫感染的方法。方法共收集105例患者。每例取2份尿道拭子标本,分别进行InPouchTV培养和PCR检测;取1份尿液标本进行PCR检测。以培养法为“金标准”,将两种PCR法与之比较,分别计算其敏感性、特异性、阳性预测值和阴性预测值。结果InPouchTV培养法检出率为4.76%(5/105);尿液PCR法检出率为3.81%(4/105);尿道拭子PCR法检出率为4.76%(5/105)。尿液PCR法和尿道拭子PCR法的敏感性,特异性,阳性预测值和阴性预测值分别为80%、100%、100%、99%和80%、99%、80%、99%。结论阴道毛滴虫感染是男性NGU的病因之一,在本研究中,阴道毛滴虫感染在男性NGU中的检出率为4.76%。尿液PCR法具有较高的敏感性和特异性且适用于非侵入性标本的检测,是具有临床应用价值的检测阴道毛滴虫的方法。

Objectives To study the incidence of Trichomonas vaginalis(TV)infection in Chinese male patients with nongonococcal urethritis(NGU),to evaluate the sensitivity and specificity of urine-based and urethral swab polymerase chain reaction(PCR)detection,and to set up a method of non-invasive detection for male TV infection.Methods One hundred and five male NGU patients were collected from the STD clinic.Two urethral swabs were obtained from each patient,one for InPouch TV culture system,the other for PCR;one urine specimen(first-void urine or first-catch urine)was also collected for PCR detection.Culture was considered as the'gold standard'.Compared with the culture,the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of two PCR detection were calculated.Results The positive rate of InPouch TV system detection was4.76%(5/105);the positive rate of urine-based PCR and urethral swab PCR detection was3.81%(4/105)and4.76%(5/105),respectively.In comparison with the culture,the sensitivity,specificity,PPV and NPV were80%,100%,100%and99%for urine-based PCR and80%,99%,80%and99%for urethral swab PCR.Conclusions TV is one of the etiological agent for male NGU,the positive rate of TV is4.76%in our study.The urine-based PCR detection has a higher sensitivity and specificity and provides a noninvasive method which is feasible in practice.