合肥市性病门诊诊断正确性评估

Assessment on the validity of diagnosing STD at STD clinic in Hefei

目的 评估合肥市性病门诊实验室检测和临床医生诊断性传播疾病 (STD)的准确性。方法 对就诊的首诊男性病人为调查对象 ,实验室结果与国家级性病实验室结果进行比较 ,使用Epi- Infor 6 .12软件统计分析。结果 347例调查对象中 ,2 4 0例经国家级检测中心检测淋球菌阳性或沙眼衣原体阳性 ,310例根据临床实验室检测为阳性。衣原体临床实验室检测的灵敏度和阳性预测值 (PPS)分别为 5 5 %和 2 6 % ,医师诊断的灵敏度和阳性预测值为 6 1%和 2 4 %。临床实验室检测和医师诊断对于发现混合感染的能力较低 ,医师诊断梅毒和单纯疱疹病毒 (HSV )的阳性预测值分别为 5 0 %和 4 3% ,表明梅毒和 HSV存在误诊。结论 性病临床医生和实验室检测质量不高 ,经常把

Objective To assess the validity of detecting report of sexually transmitted disease(STD) in clinic laboratory and the validity of the diagnosis of clinical physicians. Methods 4 legitimate clinics of STD in Hefei were selected and the male patients who saw a doctor for the first time from March to July in 2002 were investigated. The detected and diagnosed results of these subjects in the 4 clinics were compared with one in national STD laboratory. Results The sensitivity and the positive predictive value of chlamydiae detecting in STD clinic laboratory were 55% and 26%, that in clinical physicians were 61% and 24%. The positive predictive value of diagnosing syphilis and herpes simplex virus(HSV) in clinical physicians were 50% and 43%, respectively. Conclusions The quality of the clinical physicians' diagnosis and the detecting of laboratory in STD clinics is poor, and it was possible to misdiagnose STD frequently.