生殖器疱疹患者HSV-2和anti—HSV-2检测的临床意义

目的探讨生殖器疤疹（GH）患者HSV-2PCR及HSV-2抗体（包括IgG、IgM）检测的临床意义，评价其对GH诊断的重要性和实用性。方法对182例生殖器部位有皮损的现症GH患者检测HSV-2PCR及HSV-2抗体（包括IgG、IgM）。结果HSV-2PCR阳性检测率为90．6％（165／182），明显高于HSV-2IgG阳性检测率68．7％（125／182）和HSV-2IgM阳性检测率为14．3％（26／128）；初发患者HSV-2PcR阳性检测率为89．7％（61／68）明显高于HSV-2IgG阳性检测率39．7％（27／68）和HSV-2IgM阳性检测率25％（17／68）；复发患者HSV-2PCR阳性检测率为95．6％（109／114），HSV-2IgG阳性检测率为100％（114／114），两者几无差别，而HSV-2IgM阳性检测率为0；23例皮损不明显患者HSV-2IgG阳性检测率为78．3％（18／23），明显高于HSV-2PCR阳性检测率26％（6／23）和HsV-2IgM阳性检测率13％（3／23）。结论HSV-2PCR检测法对有典型临床症状如水疱和糜烂的GH阳性率高、诊断价值大，对临床症状不典型者阳性率低；HSV-2IgG检测对无皮损和无症状的患者有较大的诊断价值；HSV-2IgM对诊断GH感染的价值不大。

Clinical significance of detection of HSV - 2 and anti - HSV - 2 in genital herpes patients

Objective To investigate the clinical significance of HSV - 2 gene and antibody expression in genital herpes （GH） patients. Methods Polymerase chain reaction （PCR） and ELISA were used respectively to detect the expression of HSV - 2 gene and the corresponding antibody in the 182 GH patients. Results The positive rate of HSV - 2 gene expression, 90.6% （165/ 182） was much higher than that of anti - HSV - 2 antibody, either 68.7% （125/182） for IgG type or 14.3% （26/182）for IgM type. Among the patients suffering GH for the first time, the positive rate of HSV - 2 gene expression, 89.7% （61/68） was much higher than that of anti - HSV - 2 antibody, either 39.7 % （27/68） for IgG type or 25 % （17/68） for IgM type. Whereas among the recurred patients, there was no significant difference in the positive rate between the expression of HSV - 2 gene , 95.6% （109/ 114）, and the corresponding antibody, 100% （114/114） for IgG type and 0 for IgM type. For the 23 patients with indefinite herpes, the positive rate of anti - HSV - 2 IgG antibody, 78.3 % （ 18/23 ）, was significantly higher than that of HSV - 2 gene, 26 % （6/23）, and anti - IgM antibody, 13 % （3/23）, as well. Conclusion Detection of HSV - 2 gene expression might be of significance for the diagnosis of GH patients with characteristic clinical manifestations, whereas for the patients with indefinite manifestations, the IgG antibody might be of significance. In addition, IgM antibody against HSV - 2 might be of little significance for the diagnosis of GH.