湿涂片法和革兰染色法在妊娠期无症状细菌性阴道病诊断中的比较研究

目的比较湿涂片法和革兰染色法在妊娠期无症状细菌性阴道病诊断中的应用价值。方法普查本院2006年9月至2009年1月期间妇产科门诊参加孕前检查无症状妊娠期患者。将临床常用诊断法(阴道分泌物pH值、吹气试验和线索细胞等3项标准中有2项为阳性)与革兰染色诊断法(Nugent标准下细菌性阴道病为7～10分)相比较。结果受试者的群体特征包括:入选孕妇平均为(27.3±6.6)周龄,其中26例为未产妇,受试时的平均孕龄为(15.6±7.6)周。其中27%(18/67)用革兰染色法确诊为细菌性阴道病(bacterial vaginosis,BV)。使用革兰染色法作为诊断细菌性阴道病的标准,常规诊断法(即湿涂片法)灵敏度为56%(95%可信区间为32%～78%),特异性为96%(95%可信区间为90%～100%),阳性预测值为83%,阴性预测值为85%。结论在无症状妊娠期患者中,可用革兰染色法对细菌性阴道病进行可靠诊断。     

两种实验方法诊断细菌性阴道病的比较

[目的]比较Amsel法和革兰染色法对细菌性阴道病诊断价值.[方法]检测104例阴道分泌物异常患者的白带标本,分别采用Amsel法和革兰染色法检查,比较两种方法的检测结果.[结果]革兰染色法检出阳性率为33.7%,与Amsel法检出阳性率(27.9%)比较,差异无显著性(P＞0.05).革兰粢色法的敏感性为93.1%,特异性为89.3%,阳性预测值为77.1%,阴性预测值为97.1%,与Amsel法各数据()比较,差异无显著性(P＞0.05).[结论]革兰染色法的检测试验快速、简便、价廉、结果稳定可靠,是临床诊断细菌性阴道病的有效方法.     

阴道加德纳菌四种临床检测方法的比较

细菌性阴道病是近年来被确定的与性传播有关的疾病 ,其病原体为阴道加德纳菌 ,随着性病病原体感染谱的变化 ,发病率有逐年增高的趋势。目前对加德纳菌的实验诊断 ,主要以直接涂片找线索细胞、分离培养法、免疫荧光法及聚合酶链反应 (ＰＣＲ)技术等。为探讨细菌性阴道病实验诊断方法应用的效果 ,我们对阴道加德纳菌临床 4种检测方法进行比较。报告如下。一、材料和方法1 临床标本 :5 0份宫颈分泌物 ,取自西京医院门诊妇产科就诊的非特异性阴道炎 (ＮＳＶ)患者 ,常规消毒用无菌棉签自宫颈口取分泌物于无菌生理盐水管中。2 革兰染色法 :取无菌…     

细菌性阴道炎阴道分泌物临床检测分析

目的使用细菌性阴道炎快速检测卡对阴道分泌物进行检测,研究其对细菌性阴道病的发病、诊断作用及应用价值。方法以细菌性阴道病Am sel法作为参照,对正常人、非细菌性阴道病和细菌性阴道病不同病情及病期患者的阴道分泌物进行动态观察。结果菌性阴道炎快速检测卡检测细菌性阴道病患者阴道分泌物的敏感性为97.1%、准确性为98.4%、特异性为98.9%、阳性预测值为97.2%、阴性预测值为98.8%,同Am sel法的符合率为96.3%。结论用细菌性阴道炎快速检测卡对细菌性阴道病患者阴道分泌物的测定,简便有效,灵敏度高,适宜临床推广使用。     

细菌性阴道病检测的影响因素分析

目的分析细菌性阴道病检测的影响因素,保证细菌性阴道病检测结果的准确性。方法采用唾液酸酶法对400例阴道分泌物标本进行检测,以培养方法和线索细胞为标准对检测结果进行评价,并对影响因素进行分析和验证。结果 400例标本中共检出细菌性阴道病阳性45例(11.3%)。在细菌性阴道病阳性标本中只有20例(44.4%)是由于阴道加德纳菌感染所引起,与总体检出率之间差异有统计学意义(P0.05)。真菌、滴虫、经期血液污染是细菌性阴道病检测的干扰因素,导致细菌性阴道病检测呈假阳性。结论唾液酸酶法检测细菌性阴道病干扰因素包括:真菌、滴虫、血液。实际工作发现,细菌性阴道病阳性标本同时有真菌或滴虫感染,或分泌物有血液污染时,应对分泌物进行线索细胞查找或采用培养方法确定病原菌的感染类型,便于临床医生有针对性地合理用药,减轻患者感染症状。     

免疫荧光法检测阴道加德纳菌的方法学评价

目的探讨运用免疫荧光法检测阴道加德纳菌(GV)的临床应用价值。方法选取2015年4~12月进行细菌性阴道炎检测的2 612例患者作为研究对象,每例患者取双份阴道分泌物标本,分为两组,观察组采用免疫荧光法进行检测,对照组采用分离培养法进行检测,分析免疫荧光法检测GV的敏感度、特异度、准确度以及阳性检出率。结果免疫荧光法检测GV的敏感度为94.31%,特异度为90.75%,准确度为91.20%;分离培养法阳性检出率为34.99%,免疫荧光法阳性检出率为39.01%,两者比较,差异有统计学意义(P0.05)。结论免疫荧光法检测GV具有灵敏度高、特异性强、阳性检出率高、诊断时间短的优点,适用于临床检测。     

细菌性阴道病四联快速检测卡的临床应用及意义

目的探讨阴道分泌物BV四联快速检测在诊断细菌性阴道病（BV）中的临床价值及在其他阴道炎中应用。方法对妇科门诊接受阴道分泌物检查的1051例标本采用0.9%氯化钠溶液直接涂片法观察清洁度及霉菌、滴虫感染情况,同时用Amsel法、Nugent革兰染色法和BV快速检测卡法进行比对检测。结果与传统的Amsel法相比,BV四联快速检测法诊断细菌性阴道病的敏感性为93.07%,特异性为95.51%,一致性为94.67%。与Nugent革兰染色法相比较,BV快速检测卡法敏感性为94.46%,特异性为96.23%,一致性为95.62%。结论 BV四联快速检测法是一种简便、快速的检测BV的方法,结合显微镜滴虫、霉菌检查,提高了妇科阴道炎的诊断率,及早和准确地诊断各种阴道病。     

加德纳菌实验诊断方法的评价和临床意义

目的探讨加德纳氏菌实验室检测方法的应用效果,为细菌性阴道病的诊断和治疗提供切实可行的诊断依据.方法应用革兰氏染色、吖啶橙染色、分离培养鉴定、聚合酶链反应检测阴道或宫颈分泌物中的加德纳氏菌.结果经在50例宫颈分泌物标本中,革兰氏染色阳性检出率为18.0%(9/50)、吖啶橙染色阳性检出率为20%(10/50)、分离培养阳性检出率为16.0%(8/50),聚合酶链反应阳性率为28.0%(14/50).结论通过革兰氏染色、吖啶橙染色、分离培养鉴定、聚合酶链反应检测结果显示,用聚合酶链反应检测阴道或宫颈分泌物中的加德纳氏菌用于细菌性阴道病的快速诊断,明显优于三种常规的检测方法.     

荧光原位杂交技术诊断细菌性阴道病的方法学研究

目的建立荧光原位杂交技术诊断细菌性阴道病的方法,为细菌性阴道病的诊断和治疗提供准确的实验室依据。方法设计针对阴道加德纳菌、阴道阿托波菌、普雷沃菌、乳酸杆菌的荧光探针。对临床确诊的33例细菌性阴道病妇女,健康体检的28例健康妇女阴道分泌物涂片进行荧光原位杂交检测,建立积分标准。与Nugent评分标准进行比对评估。结果荧光原位杂交及积分评价标准对于细菌性阴道病的诊断敏感度、特异度、阳性预测值、阴性预测值和符合率分别为93.9%、96.4%、96.9%、93.1%和95.1%。结论荧光原位杂交方法较传统的实验室涂片染色方法更加客观反映阴道菌群的变化,是一种较Nugent评分更准确的细菌性阴道病实验室诊断方法。     

细菌性阴道病快速检测法应用价值初探

目的 探讨细菌性阴道病快速检测法的临床应用价值.方法 应用细菌性阴道病快速诊断试剂盒和Amsel诊断法对108例阴道分泌物进行细菌性阴道病检测.结果 两法同时检出阳性64例,同时检出阴性36例,共计100例,总符合率92.6%(100/108).结论 细菌性阴道病快速检测法与Amsel诊断法相比具有高敏感性、高特异性,该法对细菌性阴道病的初诊和筛选具有一定的实用价值.     

细菌性阴道病实验室诊断方法的比较

【目的】比较细菌性阴道病的4种实验室诊断方法。【方法】随机选择就诊病人100例分别用Amsel法,组织多胺试验．一步法唾液酸酶活性的检测试验,革兰染色细菌评分法检测细菌性阴道病。【结果】Amsel法阳性率28％,组织多胺试验阳性率24％,一步法唾液酸酶活性的检测试验阳性率34％,革兰染色细菌评分法阳性率30％;唾液酸酶活性检测法与Amsel法,革兰染色细菌评分法相比较差异无显著性;组织多胺试验与Amsel法,革兰染色细菌评分法相比较差异无显著性;以Amsel法为标准,一步法唾液酸酶活性检测法和组织多胺试验的灵敏度分别为92．9％和71．4％,特异性分别为88．9％和94．4％,阳性预期值分别为76．5％和83．3％,阴性预期值分别为97．0％和89．5％;以革兰染色细菌评分法为标准．一步法唾液酸酶活性检测法和组织多胺试验的灵敏度分别为93．8％和66．7％,特异性分别为92．1％和94．3％,阳性预期值都为83．3％,阴性预期值分别为97．2％和86．8％。【结论】一步法唾液酸酶活性的检测试验和组织多胺试验快速,简便,易于标准化,可以用于临床诊断细菌性阴道病。     

Diagnostic value of clinical examination, direct microscopy, and culture in the Gardnerella vaginalis syndrome

In a general practice 467 women aged 15-49 years with vaginal discharge were consecutively examined in order to compare the diagnostic value in the Gardnerella vaginalis syndrome of the clinical examination, direct microscopy of the vaginal secretion, and culture. We found significant correlations between all relevant combinations of the diagnostic methods. The predictive value of a positive test for the clinical examination, the microscopy, and the clinical examination combined with microscopy, respectively, was 0.75, 0.89 and 0.90, whereas the predictive values of the negative test were 0.59, 0.72 and 0.61, respectively. Because even small numbers of Gardnerella vaginalis may yield growth on selective culture media, the clinical examination and the microscopy are often negative despite positive culture. To avoid overtreatment of a benign condition we therefore conclude that the presence of a characteristic clinical picture and positive microscopy constitute a safe basis for the diagnosis of the Gardnerella vaginalis syndrome, and that the diagnosis should be based on this combination or on the fulfilment of three of the following four criteria: 1) characteristic vaginal secretion; 2) vaginal pH greater than 4.5; 3) positive potassium hydroxide test or characteristic herring-brine smell, and 4) clue cells at microscopy. With the present methods culture for Gardnerella vaginalis should not routinely be performed, until the value of quantitated methods has been proved. Coexistence of other microorganisms rendered the diagnosis difficult. We recommend to treat the most predominant infection first.     

Microbiology of vaginal discharge in general practice

Three groups of women were examined by culture for Gardnerella vaginalis and Candida. Group I consisted of 427 women, who complained spontaneously of vaginal discharge, group II of 311 women who did not complain of vaginal discharge until questioned prior to gynaecological examination, and group III of 100 women who denied vaginal discharge. Groups I and II also had cultures made for Trichomonas vaginalis and Neisseria gonorrhoica. In group I with spontaneous complaints the one-year prevalence rate of vaginal discharge was 3.4%. Candida, Trichomonas vaginalis and Neisseria gonorrhoica were cultured in 24%, 8% and 1% respectively. Gardnerella vaginalis was cultured in half of the women in all groups. A characteristic discharge or a positive microscopic finding was related to high concentration of Gardnerella vaginalis. A characteristic discharge even without spontaneous complaints of vaginal discharge was related to a high prevalence of Gardnerella vaginalis. Women complaining from discharge had higher concentrations of Gardnerella vaginalis than non-complaining. This leads to the conclusion that clinical disease may not be present unless concentrations of Gardnerella vaginalis have risen above some minimum level. The Gardnerella vaginalis syndrome defined by positive culture, clinical finding and microscopy was found in 20% of symptomatic women.     

Validity of the symptomatic approach used by nurses in diagnosing vaginal infections

Aims and objectives. To examine the validity and effectiveness of a symptomatic approach based on symptoms, administered by a nurse working in women’s health area, in identifying vaginal infections in women with or without vaginal discharge. Design. Survey. Methods. Between November 2005–August 2006, 300 married women were included. A questionnaire and vaginal discharge assessment form were used for data collection. The modified algorithm of a symptomatic approach without speculum examination was used to manage participants. Three diagnoses were made for each participant. The first diagnosis was made by the research nurse using the vaginal discharge assessment form; the second diagnosis is the clinical diagnosis which was made after the gynaecological examination by a physician; and the third diagnosis is the microscopic diagnosis made by the physician when assessing the collected specimens. Results. In the methodological part of this study, the sensitivity, specificity, positive predictive value and negative predictive value of the symptomatic approach were 91·5, 69·7, 87·7 and 77·5%, respectively. The symptomatic approach had 27·7% sensitivity for bacterial vaginosis, 16·6% for trichomonas vaginalis and 62·8% for candida albicans, compared to the microscopic results. The sensitivity of the approach was higher for the identification of candidiasis compared to bacterial vaginosis and trichomonas vaginalis. Conclusion. From the results, it is suggested that the symptomatic approach model can be used by nurses who work in women’s health area to diagnose vaginal infections. Relevance to clinical practice. This study showed that trained clinician nurses will be able to diagnose and manage vaginal infections – especially candidiasis – by using the symptomatic approach. Moreover, the symptomatic approach will encourage women not to delay or fail to seek treatment for their health problems, especially for vaginal infections in conservative societies.     

血清CA125检测结合CT对卵巢肿瘤的诊断价值

【目的】探讨血清CA125检测结合CT对卵巢肿瘤的诊断价值。【方法】回顾分析手术病理证实的99例卵巢肿瘤（其中良性47例,恶性52例）患者术前CT表现和血清CA125水平。【结果】CT联合血清CA125水平诊断卵巢恶性肿瘤敏感度为76．9％,特异度为83．0％,阳性预测值83．3％,阴性预测值76．5％。【结论】CT结合血清CA125检测诊断卵巢恶性肿瘤特异度较高;其阳性预测值高。     

ICU患者血浆内毒素定量检测在革兰阴性菌败血症早期诊断中的应用

目的研究血浆中内毒素定量检测在革兰阴性菌败血症早期诊断中的临床应用价值。方法采集医院疑似革兰阴性菌败血症的112例重症监护病房患者静脉血标本,同时进行血浆内毒素定量检测和血培养检测,比较两种检测方法的差异。结果革兰阴性菌败血症患者组血浆内毒素含量为(109.6±112.1)pg/mL,明显高于非败血症组的(6.5±5.9)pg/mL,差异有统计学意义(P<0.01)。以20pg/mL为临界值时,血浆内毒素含量检测阳性49例(43.7%),阴性63例(56.3%);血培养阳性24例(21.4%),阴性88例(78.6%)。血浆内毒素检测具有较好的敏感度(85.7%)和特异度(90.3%),阳性预测值(87.6%)和阴性预测值(92.3%)均较高;血培养的敏感度较低(46.2%),但特异度较高(92.4%),阳性预测值和阴性预测值分别为86.5%和80.7%。两种方法联合检测后敏感度提高至95.2%,特异度为88.9%。结论血浆内毒素定量测定具有快速、敏感的特点,对革兰阴性菌败血症的早期诊断具有一定的临床应用价值。     

宫腔镜与阴道超声诊断绝经后妇女子宫内膜病变的比较研究

[目的]比较宫腔镜与阴道超声对绝经后妇女子宫内膜病变的诊断价值.[方法]2006年3月至2009年3月诊治243例绝经后妇女,平均年龄61.4岁,平均绝经后时间为11.3年,对其子宫内膜宫腔镜及阴道超声结果进行分析.[结果]6.6%的病例经病理确诊为子宫内膜增生和子宫内膜癌.阴道超声的诊断灵敏度为95.6%,特异度为7.4%,阳性预测值为53.3%,阴性预测值为60%,诊断准确率为53.7%.宫腔镜的诊断灵敏度为95.7%,特异度为83%,阳性预测值为82.2%,阴性预测值为95.9%,诊断准确率为88.7%.[结论]宫腔镜较阴道超声诊断子宫内膜疾病的准确性更高.     

16层螺旋CT冠状动脉成像对男性和女性冠状动脉粥样硬化性心脏病的诊断价值

目的比较16层螺旋CT冠状动脉成像(16SCTCA)对男性和女性冠状动脉粥样硬化性心脏病(CAHD)的诊断价值。方法入选疑诊为CAHD的受检者共105例(男61例,女44例),对其分别行16SCTCA检查和选择性冠状动脉造影(CAG)检查,以CAG为诊断CAHD的金标准,评估检查结果。结果105例受检者中,16SCTCA共显示1 184个冠状动脉节段可进行评价。16SCTCA诊断男性受检者冠状动脉显著狭窄的敏感性为93.6%,特异性为95.1%,阳性预测值为73.9%,阴性预测值为99.0%,符合率为94.9%;诊断女性受检者冠状动脉显著狭窄的敏感性为84.1%,特异性为94.4%,阳性预测值为77.9%,阴性预测值为96.2%,符合率为92.4%;女性受检者接受16SCTCA检查诊断冠状动脉显著狭窄的敏感性和阴性预测值低于男性(P<0.05)。结论16SCTCA在显示冠状动脉病变时具有较高的诊断准确率,尤其适用于男性。     

乳胶快速凝集与常规培养方法检测阴道毛滴虫的比较研究

目的　用阴道毛滴虫的粘附蛋白制备单克隆抗体,并研制成乳胶凝集试剂,在临床上初步应用。方法 　从阴道中收集分泌物,分别用乳胶凝集法和常规培养方法对197份妇科门诊患者的阴道分泌物标本进行检 测。结果　与常规培养方法比较,乳胶凝集法的敏感性为89.9%,特异性为95.5%,阳性预测值为68.0%,阴性 预测值为98.8%。结论　该单克隆抗体研制成的乳胶凝集法快速、简便,具有较高的特异性和较好的敏感性,能 提高临床滴虫性阴道炎的诊断率。     

Role of color Doppler sonography in the assessment of musculoskeletal soft tissue masses.

Fifty-six patients with soft tissue masses of the limbs (36 benign, 20 malignant) prospectively underwent sonography (color Doppler and pulsed Doppler examinations) to assess the role of Doppler interrogation in differentiating benign from malignant lesions. Sonography showed 60% sensitivity, 55% specificity, 71% negative predictive value, 42% positive predictive value, and 57% accuracy. Color Doppler evaluation showed 85% sensitivity, 88% specificity, 91% negative predictive value, 80% positive predictive value, and 87% accuracy. Diastolic and venous velocities and pulsatility index values were not statistically significant. Mean systolic velocity was 0.27 m/s in benign lesions and 0.55 m/s in malignant lesions. By combining sonographic and Doppler data, a correct diagnosis was obtained in 51 of 56 patients (90% sensitivity, 91% specificity, 85% positive predictive value, 94% negative predictive value, 91% accuracy). Color Doppler and pulsed Doppler evaluations represent a useful adjunct to sonography and should be routinely included in the evaluation of musculoskeletal soft tissue masses by ultrasonography.