阿奇霉素和交沙霉素分别联合干扰素栓治疗支原体、衣原体性宫颈炎的疗效对比观察

目的 探讨女性生殖道支原体、衣原体感染应用药物治疗的最佳方法.方法 将122例患者随机分为治疗组(61例)和对照组(61例).治疗组口服交沙霉素400mg,3次/d.10d为1疗程;对照组口服阿奇霉素分散片500mg,1次/d,10d为1疗程,两组均同时予干扰素栓(奥平栓)1枚置阴道深部,隔日1次,共7次为1疗程.结果 治疗组有效率达83.6%,对照组有效率78.7%,两组比较无显著性差异(P>0.05).结论 交沙霉素和阿奇霉素治疗支原体、衣原体性宫颈炎疗效相当,两者联合干扰素栓治疗支原体、衣原体性宫颈炎均为有效方法.     

孕妇解脲支原体、沙眼衣原体感染的诊断与药物干预

目的探讨妊娠期孕妇解脲支原体（UU）、沙眼衣原体（CT）感染的发病率及其对感染者的治疗效果。方法对108例妊娠妇女采用核酸杂交的方法检测宫颈分泌物,对标本UU、CT-DNA进行DNA扩增、核酸杂交检测。结果 108例妊娠早中期孕妇宫颈分泌物UU、CT的阳性率分别是33.33%,7.41%,口服阿奇霉素治疗后检测UU、CT阳性率分别是17.59%,1.85%。两组间有显著性差异（P=0.001或P=0.002）。结论解脲支原体、沙眼衣原体是妊娠期妇女感染的常见病原体,临床治疗效果显著值得推广应用。     

阿奇霉素联合妇坤宁治疗宫颈炎100例疗效分析

目的 探讨妇坤宁联合阿齐霉素治疗宫颈炎的疗效.方法 采用随机对照实验方法,将我院妇科门诊宫颈炎患者分成研究组和对照组,研究组用妇坤宁联合阿奇霉素治疗,结合患者的症状、体征判断疗效.结果 研究组和对照组的临床有效率分别为91.56%和42.48%,两者比较有显著性差异(P<0.05).结论 妇坤宁栓联合阿奇霉素中西医结合治疗能明显提高对宫颈支原体感染的宫颈炎的治疗效果,可作为治疗宫颈炎的首选方法.     

红霉素与阿奇霉素转换疗法治疗小儿肺炎支原体肺炎的疗效及成本分析

目的探讨转换疗法治疗小儿肺炎支原体肺炎的最佳方案。方法将102例患儿分为两组。治疗组5％葡萄糖＋红霉素静滴3d，改用阿奇霉素口服3d，停4d，再服3d；对照组5％葡萄糖＋红霉素静滴10～14d。观察疗效及成本分析。结果治疗组与对照组疗效与成本差异显著。结论治疗组疗效及成本明显优于对照组，且有效、安全、方便、经济。     

236例盆腔炎、宫颈炎患者宫颈沙眼衣原体及解脲支原体感染结果分析

目的研究盆腔炎、宫颈炎与宫颈沙眼衣原体(CT)及解脲支原体(UU)感染的相关性.方法对236例盆腔炎、宫颈炎患者进行宫颈CT、UU检测,CT采用抗原免疫法,UU采用培养法.结果 236例盆腔炎、宫颈炎患者中,衣原体感染62例(26.3%),支原体感染99例(42.9%),两者感染的总阳性率68.2%,混合感染26例(11.0%).结论沙眼衣原体及解脲支原体为盆腔炎/宫颈炎重要致病因素,应重视宫颈沙眼衣原体及解脲支原体的检测.     

236例盆腔炎、宫颈炎患者宫颈沙眼衣原体及解脲支原体感染结果分析

目的　研究盆腔炎、宫颈炎与宫颈沙眼衣原体 (CT)及解脲支原体 (UU)感染的相关性 .方法　对 2 36例盆腔炎、宫颈炎患者进行宫颈CT、UU检测 ,CT采用抗原免疫法 ,UU采用培养法 .结果　 2 36例盆腔炎、宫颈炎患者中 ,衣原体感染 6 2例 (2 6 .3% ) ,支原体感染 99例 (42 .9% ) ,两者感染的总阳性率 6 8.2 % ,混合感染 2 6例 (11.0 % ) .结论　沙眼衣原体及解脲支原体为盆腔炎 /宫颈炎重要致病因素 ,应重视宫颈沙眼衣原体及解脲支原体的检测 .     

阿奇霉素序贯疗法治疗小儿支原体肺炎的分析

目的对于在治疗小儿支原体肺炎中阿奇霉素序贯疗法的应用情况和疗效进行统计和分析研究。方法对于我院2013年1月~2014年1月，因小儿支原体肺炎而被收治入院的96例患儿进行随机等分，分别采取阿奇霉素序贯疗法和红霉素进行治疗。结果采取阿奇霉素治疗的实验组患儿的症状消失时间(9.2±2.5)d和住院时间(15.2±3)d要显著低于采取红霉素治疗的对照组患儿的症状消失时间(12.5±4.2)d和住院时间(20.7±5.5)d，6例不良反应例次也显著低于对照组患者的13次不良反应例次。结论阿奇霉素序贯疗法在治疗小儿支原体肺炎的临床实践效果较为明显，且具有见效快、疗效好、副作用少等优点，值得临床进行推广和应用。     

阿奇霉素联合阴道栓剂在非淋菌性宫颈炎治疗中的临床疗效

目的：探讨阿奇霉素联合阴道栓剂在治疗非淋菌性宫颈炎的临床疗效。方法将我院于2013年6月~2014年6月收治的91例非淋菌性宫颈炎患者随机分为研究组46例和对照组45例,研究组患者采用阿奇霉素联合阴道栓剂治疗,对照组患者单一阿奇霉素治疗,两组疗程均为2w,疗程结束后7d观察临床治疗效果及不良反应发生情况。结果研究组的治疗总有效率为89.1%(41/46),对照组的治疗总有效率为68.9%(31/45),对比差异有显著,具有统计学意义(P>0.05);不良反应发生率研究组患者为3例,表现为恶心、头痛头晕、转氨酶增高,对照组患者不良反应4例,两组差异不显著(P>0.05)。结论阿奇霉素联合阴道栓剂治疗非淋菌性宫颈炎的临床疗效显著,不良反应发生较少,临床可广泛应用。     

阿奇霉素对肺炎支原体肺炎的疗效及患儿体液免疫功能的影响

目的：探讨阿奇霉素治疗肺炎支原体肺炎患儿的效果及其对患儿体液免疫功能的调节作用。方法：118例肺炎支原体肺炎患儿均常规退热、止咳、平喘和对症治疗,并随机分为实验组和对照组,前者采用阿奇霉素治疗,后者采用红霉素治疗。比较两组治疗有效率、副反应发生情况及两组患儿治疗前后血清IgM、IgG、IgA、补体C3和C4水平。结果：用药14d后,实验组和对照组的总有效率依次为96．55％和总有效为80％,副反应发生率依次为20．69％和60％,差异均有显著性（P〈0．01）。实验组治疗后的IgG、州、C3和C4水平均低于治疗前,差异有统计学意义（P〈0．01～0．05）。结论：阿奇霉素治疗肺炎支原体肺炎效果较好,并可以改善机体的体液免疫水平。     

阿奇霉素注射液治疗小儿肺炎支原体肺炎疗效探讨

目的：探讨阿奇霉素注射液用于小儿肺炎支原体肺炎治疗临床效果及安全性。方法选取支原体肺炎患儿240例，以随机抽样方法分为对照组(120例)和阿奇霉素注射液组(120例)；对照组患儿给予红霉素静脉滴注治疗；阿奇霉素注射液组患儿则给予阿奇霉素注射液静脉滴注治疗；比较两组患儿近期疗效，症状体征缓解时间及不良反应发生率等。结果阿奇霉素注射液组患儿近期疗效显著优于对照组(<0.05)；阿奇霉素注射液组患儿症状体征缓解时间均显著少于对照组(<0.05)；阿奇霉素注射液组患儿消化道反应和皮疹发生率均低于对照组(<0.05)；但两组患儿注射痛发生率比较差异无统计学意义(>0.05)。结论相较于红霉素，阿奇霉素注射液用于小儿肺炎支原体肺炎治疗在改善症状体征，缩短病程及提高药物安全性方面具有优势。     

Study of the management of chlamydial cervicitis in general practice.

The role of the general practitioner in the detection and management of Chlamydia trachomatis infections of the cervix is uncertain. The management by the primary care team of women presenting with lower genital tract symptoms has therefore been studied in one suburban practice. Of 386 women presenting with lower genital tract symptoms over the two year study period 25 (6%) had a positive cervical MicroTrak (Syva) test for Chlamydia trachomatis. Twenty four of these chlamydia positive patients were given their results and treatment by the practice. Twenty two women returned for a follow-up MicroTrak test after treatment and two of these patients (9%) had a positive test following treatment. A review of the patients' notes indicated that contact tracing had been discussed with 22 of the 25 chlamydia positive patients. The results of the management of chlamydial cervicitis by this primary health care team are acceptable when compared with studies from hospital clinics. Provided the primary care team has access to facilities for the diagnosis of C trachomatis and can follow up non-attenders to ensure they receive their results, provide information about contact tracing and follow up positive patients then chlamydial cervicitis can be managed in general practice.     

桑拿女工人型支原体宫颈感染率及其可能的临床意义

目的调查分析桑拿女工人型支原体宫颈感染率及其可能的临床意义。方法采用女性阴道分泌物革兰染色方法检测阴道毛滴虫、念珠菌和线索细胞,酶联免疫法检测沙眼衣原体,培养法鉴定淋球菌和支原体。结果1030例样本中。人型支原体阳性52例（5％）,其中5例为单独人型支原体定植,而47例（90．4％）为混合菌感染,以解脲脲原体为主（30／52,57．7％）。宫颈炎组与非宫颈炎组人型支原体的感染率差异无统计学意义（χ2=0．51,P〉0．05）。7例人型支原体阳性的宫颈炎病例同时混合感染沙眼衣原体或淋球菌,10例人型支原体阳性的非宫颈炎病例同时伴有念珠菌或阴道毛滴虫感染,或细菌性阴道病。结论无论女性是否患宫颈炎,人型支原体均可以定植于宫颈管,但并不是单独引起宫颈炎的病原体。     

Chlamydial pelvic inflammatory disease

Pelvic inflammatory disease (PID) is the most important complicationpresent in the female lower genital tract, causing major medical,social and economic problems. Although PID can be caused bymultiple micro-organisms, it results most frequently from theascent of sexually transmitted Chlamydia.trachomatis or Neisseriagonorrhoeae infections from the cervix to the upper genitaltract. The importance of cervical chlamydial infection in thepathogenesis of PID is well recognized. Recent data from manydeveloped countries have shown a striking decrease in the incidenceof gonococcal infections, while the rates of chlamydial infectionsremain high in most countries. Complications of PID are commonand usually irreversible. Emerging evidence suggests that universalor selected screening of defined populations for cervical chlamydialinfection leads to a dramatic reduction in the incidence ofPID. Recent technological advances should further enhance effortsto prevent chlamydial infection and PID. Gene amplification-baseddiagnostic tests, screening by testing first-void urine, andsingle dose antimicrobial therapy greatly facilitate chlamydiacontrol programmes. Thus, screening for chlamydia is the keyapproach in the secondary prevention of PID. The obvious challengeis to make screening for chlamydia the standard for health carefor young, sexually active individuals. Since PID is the mostimportant consequence of sexually transmitted bacterial infections,it is also imperative to develop better treatments to preventthe long-term sequelae of this disease. The development andimplementation of new and effective intervention programmesfor prevention and control of PID is one of the major challengesfor the year 2000 and beyond. Keywords: C.trachomatis/Neisseria gonorrhoeae/pelvic inflammatorydisease     

套式PCR法检测输卵管妊娠者的沙眼衣原体感染研究

目的：为探索输卵管妊娠与生殖道沙眼衣原体的关系。方法：采集５７例输卵管妊娠者的宫颈分泌物、输卵管组织、胚胎组织、并采集３２例卵巢囊肿者的宫颈分泌物、输卵管组织和２９例早孕人流者的宫颈分泌物、胚胎组织。应用套式ＰＣＲ法检测以上标本中的沙肯衣原体ＤＮＡ。结果：输卵管妊娠者的宫颈分泌物阳性率高达４０．４％，明显高于卵巢囊肿者的１２．５％和早孕人流者的１３．７％，ＲＲ为４．４９；输卵这妊娠者的输卵管组织阳     

PCR检测沙眼衣原体与习惯性流产和女性不孕相关性研究

本文应用聚合酶链反应技术（ＰＣＲ），对１２０例不孕和１００例查体妇女的宫颈内膜标本进行沙眼衣原体检测，以了解女性沙眼衣原体感染与自发流产的关系，并与一般细胞培养法进行了比较。结果：不孕妇女中沙眼衣原体感染率为１８．３％，显著高于对照组（８％Ｐ＜０．０５），并且自发流产３次、４次的妇女沙眼衣原体阳性率明显高于对照组（Ｐ＜０．０１）．敏感性也较一般培养法高（Ｐ＜０．０１）。本研究提示：沙眼衣原体感染与自发性习惯性流产关系十分密切，而且ＰＣＲ法在检测沙眼衣原体感染方面较一般培养法更敏感、快速，是早期诊断生殖道沙眼衣原体感染的一项有价值的方法。     

大鼠生殖道沙眼衣原体感染后C3a 、γ干扰素和白血病抑制因子在子宫蜕膜的表达及其意义

目的 观察生殖道沙眼衣原体(CT)初次感染后妊娠大鼠在胚胎着床窗口期子宫蜕膜C3a,γ干扰素(IFN-γ)和白血病抑制因子(LIF)表达量的变化. 方法 选择成年健康状况良好的雌性SD大鼠35只(除去不符合标准的雌鼠5只,最终以30只作统计学分析),随机均分为实验组和对照组两组.实验组通过阴道接种沙眼衣原体D型株,对照组阴道注射等量生理盐水.分别在大鼠妊娠后第5、第6和第7天(即胚胎着床窗口期)处死大鼠,并从子宫取材,通过免疫组织化学法定量检测在胚胎着床窗口期子宫蜕膜C3a 、IFN-γ和LIF表达量. 结果 30只大鼠子宫蜕膜组织均有C3a 、IFN-γ和LIF表达.实验组C3a 和IFN-γ表达量均低于对照组(P<0.01);实验组在妊娠第5天和第6天LIF比对照组低表达(P<0.01),妊娠第7天两组表达量无显著差异(P>0.05).实验组中IFN-γ和C3a 在子宫蜕膜中的表达呈正相关(r=0.9965),IFN-γ与LIF的表达无相关性(r=0.2331). 结论 生殖道感染CT后,子宫局部C3a 、IFN-γ和LIF表达量有变化并与着床有密切联系.     

Chlamydial endometritis.

Endometrial biopsies were obtained from 32 women with suspected pelvic inflammatory disease, of whom 23 (72%) had histopathological evidence of endometritis. Chlamydia trachomatis was isolated from the endometria of nine (39%) women (chlamydia group) but not from the other 14 (non-chlamydia group). Severe plasma cell endometritis and lymphoid follicles with transformed lymphocytes were significantly more common in the chlamydia group than in the non-chlamydia group. This suggests that C trachomatis is an invasive endometrial pathogen which often causes severe inflammation. The association was independent of predisposing factors such as use of intrauterine contraceptive devices.     

保妇康栓治疗妊娠合并慢性宫颈炎的疗效分析

目的 观察保妇康栓治疗妊娠合并慢性宫颈炎的临床疗效。方法 将我院2016年3月~2017年8月收治的82例妊娠合并慢性宫颈炎患者随机分为试验组和对照组,各41例。对照组患者采用甲硝唑片治疗,试验组患者用保妇康栓治疗,观察两组临床症状改善情况,评估其临床疗效及不良反应发生情况。结果 试验组下腹腰骶疼痛、白带增多、排尿异常、宫颈糜烂等症状消失时间分别为（4.23±1.43）d、（7.53±1.45）d、（4.46±1.25）d、（10.24±2.07）d,均短于对照组的（7.06±1.02）d、（9.73±1.41）d、（6.82±1.06）d、（15.52±1.32）d,差异均有统计学意义（P均＜0.05）;试验组总有效率为95.12%,高于对照组的80.49%,差异有统计学意义（P＜0.05）;试验组不良反应发生率为2.44%,低于对照组的19.51%,差异有统计学意义（P＜0.05）。结论 保妇康栓治疗妊娠合并慢性宫颈炎,可加快患者临床症状的缓解速度,疗效明显,安全性高,值得应用。     

A study of prevalence of Chlamydia trachomatis infection in women with first trimester pregnancy losses

The study included 125 patients in the first trimester of pregnancy, who were divided into group A (50 control subjects with normal intrauterine pregnancy), Group B (50 patients with spontaneous abortion), group C (25 patients with ectopic pregnancy). All the patients were investigated including routine blood and urine tests and special tests related to the cause of pregnancy loss. The patients were tested for IgG antibodies to Chlamydia trachomatis by ELISA technique and conjunctival smear were tested for presence of inclusion bodies to C. trachomatis. It was concluded that C. trachomatis is one of the important cause of spontaneous abortion and ectopic pregnancy. It is highly prevalent in our population, the prevalence being 10% in group A, 26% in group B, 28% in group C. Conjunctival smear showed presence of inclusion bodies in 0.8% patients. With abortions then risk of lower genital tract chlamydia infection spreading to upper genital tract increases. ELISA for C. trachomatis should be done when women are being investigated for the cause of spontaneous abortion and ectopic pregnancy.     

General practice update: chlamydia infection in women.

The prevalence of cervical Chlamydia trachomatis infection in general practice populations ranges between 2% and 12%. Untreated infection can cause pelvic inflammatory disease, tubal infertility and ectopic pregnancy. These risks are increased by cervical invasive procedures, especially termination of pregnancy. However, most women with chlamydia infection have no symptoms. General practitioners and practice nurses carrying out pelvic examinations should have facilities for taking endocervical specimens for chlamydia. Routine chlamydia screening, should be considered if the local prevalence of infection is over 6%. Otherwise chlamydia testing should be offered to women requesting termination of pregnancy and to those who have risk factors: aged less than 25 years, absence of barrier contraception, recent change of sexual partner, vaginal discharge, friable cervix or sterile pyuria. Women found to have chlamydia infection need appropriate antibiotics, advice about contact tracing and referral to a genitourinary medicine clinic. Good communication between general practitioners and genitourinary physicians is essential. Both general practitioners and practice nurses have an important role to play in reducing the prevalence of cervical chlamydia infection and its potentially devastating consequences.