使用宫内节育器妇女生殖道感染的病征筛查效果评价

目的:评价病征筛查用于宫内节育器(IUD)使用者生殖道感染(RTI)的效果。方法:对江苏省10 884名使用IUD的育龄妇女RTI感染情况进行横断面调查。结果:RTI感染率为52.55%,经年龄、文化程度和活产数调整,苏中和苏北地区IUD使用者中RTI感染风险分别是苏南地区的1.08倍(95%CI=1.02～1.14)和1.42倍(95%CI=1.32～1.53)。感染RTI的IUD使用者在苏中、苏北地区有症状/体征的风险分别是苏南地区的3.80倍(95%CI=3.32～4.35)和4.71倍(95%CI=3.91～5.67)。卡方趋势性检验结果表明,随着体征种类增加,IUD使用者中RTI阳性比例呈现升高趋势(P<0.0001)。苏南、苏中和苏北3个地区IUD使用者RTI病征筛查方法灵敏度分别为54.70%、82.11%和85.04%,阳性预测值分别为60.82%、65.39%和81.92%。结论:苏南苏中苏北地区IUD使用者中各类RTI感染情况不同;IUD使用者中RTI人群有症状/体征比例存在显著地区差异;RTI体征筛查优于症状筛查;各地应用RTI的病征筛查方法应因地制宜。

Effect Evaluation on Syndrome Screening of Reproductive Tract Infection among Women with Intrauterine Devices

Objective:To evaluate the effects of syndrome screening used for reproductive tract infection (RTI) among the women with intrauterine devices (IUD). Methods:The RTI situations of 10,884 repro-ductive women with IUD in Jiangsu province were investigated using cross-sectional study. Results:The o-verall RTI infection rate reached 52.55%. The risks of RTI among IUD users in central and northern Jiangau were respectively 1.08 times (95% CI:1.02-1.14) and 1.42 times (95 CI%:1.32-1.53) higher than southern Jiangsu after the adjustment of age, educational level and parity. The risk of positive symptoms/signs among IUD users infected RTI in central and northern Jiangau were respectively 3.80 times (95% CI:3.32-4.35) and 4.71 times (95CI%:3.91-5.67) higher than southern Jiangau. The trend chi-square test indicated that the positive rate of RTI presented an increasing trend with the increasing of sign types(P<0.0001 ). The sensitivities of syndrome screening among IUD users with RTI in southern, central and northern Jiangsu were respectively 54.70%, 82.11% and 85.04%, and the positive predictive values were 60.82%, 65.39% and 81.92%, respectively. Conclusions:The situations of various RTI among IUD users in southern, central and northern Jiangsu are different. Signifieandy regional differences are showed on the positive rates of symptom/signs among IUD users with RTI. For RTI, sign screening is superior to symptom screening. Screening of RTI should be individually chosen in different conditions.