定量PCR和间接免疫荧光法联合检测生殖器疱疹病毒感染

目的：研究间接免疫荧光法（IIF）检测生殖器HSV感染的敏感性和特异性。方法：以定量PCR为对照,用HSV型共同性糖蛋白单克隆抗体为夹心的IIF法,检测了94例临床诊断为生殖器疱疹的患者皮疹中的HSV。结果：IIF法检测HSV的敏感性为74．12％,特异笥为55．60％;总阳性率（71．30％）,明显低于定量PCR法的阳性率（90．40％）（P＜0．05）,但两种方法检测GH患者皮水疱内的HSV阳性率无明显差异（86．20％vers.97.00%),而检测糜烂性皮疹内的HSV时,PCR法的阳性率高于IIF法（P＜0．05）,结论：IIF法具有简单,快捷的优点,适用于检测早期可疑GH患者皮疹内HSV,有临床实用价值。     

女性无生殖器疱疹症状者宫颈单纯疱疹病毒感染的研究

生殖器疱疹（GH）的发病率在迅速上升，亚临床无症状GH是HSV性传播的主要传染源，未及时发现这类感染者并采取相应措施是造成生殖器疱疹流行的重要因素。。为此，我们进行了女性无GH症状者宫颈HSV感染状况的探讨和分析。     

性病门诊患者泌尿生殖道分泌物单纯疱疹病毒的检测及临床特点分析

目的:探讨性病门诊患者泌尿生殖道单纯疱疹病毒(HSV)感染的临床特点。方法:应用酶联免疫吸附试验(ELISA)对性病门诊患者泌尿生殖道分泌物及周围病损渗出液和疱液进行HSV检测。结果:1848例标本应用ELISA法检测HSV。1077例男性尿道分泌物中,伴生殖器疱疹(GH)者(47.9%,227/474)HSV阳性率高于不伴GH者(27.2%,55/202);771例女性中伴GH者宫颈分泌物(34.8%,103/296)HSV阳性率高于不伴GH者(20.7%,76/367)。男性尿道及女性宫颈分泌物HSV阳性率均低于病损渗出液和疱液阳性率。病损渗出液和疱液不同病期HSV阳性率对比,病期<3d者明显高于病期≥4d者。泌尿生殖道分泌物HSV阳性78例,同时并发其他性病病原体阳性312例(39.7%)。结论:在性病患者中部分无GH者的泌尿生殖道分泌物中可检测到HSV感染,且可并发其他性病病原体感染,对无GH的性病患者进行HSV检测是十分必要的。     

性病门诊836例患者单纯疱疹Ⅰ,Ⅱ型检测结果分析

目的探讨性病专科门诊患者中HSV-Ⅰ,Ⅱ型病毒的感染情况及在典型和非典型生殖器疱疹(GH)患者中的分布。方法采用荧光定量聚合酶链反应技术(FQ-PCR)对836例性病专科门诊患者进行HSV-Ⅰ,Ⅱ型DNA的检测。结果836例患者中,HSV-Ⅰ型感染38例(4.54%),男性阳性率5.20%,女性为3.36%,二者差异无显著性;HSV-Ⅱ型感染380例(45.45%),男性阳性率39.96%,女性为55.37%,二者差异有显著性(P<0.05)。具有典型GH或高度可疑GH症状者369例,HSV感染者218例;无明显GH症状者467例,HSV感染者198例,二者差异有显著性(P<0.05)。结论HSV在本地区具有较高感染率,以HSV-Ⅱ型为主。在非典型GH患者中,HSV的检出率较高,须引起临床注意。     

生殖器疱疹HSV定量PCR检测及分析

目的:检测生殖器疱疹(GH)皮损的HSV含量并分析其与复发的关系。方法:用定量PCR技术检测96例临床诊断为GH的患者皮损标本中的HSV量。结果:HSV的阳性率为87.5％,男女性病例之间(2.7×109拷贝对2.1×108拷贝)、初发病例与复发病例之间(4.5×109拷贝对2.3×108拷贝),检出拷贝量的差别没有显著性意义(P>0.05),GH病人发作间歇期长短与检出的HSV拷贝量呈负相关(r=-0.728,P<0.01),病人病期、发疹天数、皮损数目与HSV拷贝量无明显相关关系(P值均大于0.05)。结论:通过定量PCR检测GH病人皮损中的HSV含量,可帮助判断预后并指导治疗。     

生殖器疱疹患者皮损HSV-2病毒载量与外周血细胞免疫功能的关系

目的：研究生殖器疱疹（GH）患者皮损部位单纯疱疹病毒－Ⅱ（HSV－2）载量和外周血细胞免疫功能的相关性。方法：采用荧光定量聚合酶链反应（fluorescent quantitative polymerase chain reaction，FQ—PCR）定量检测28例现症GH患者皮损部位HSV－2DNA载量，采用流式细胞计数的方法监测28例现症GH患者外周血T淋巴细胞亚群、NK细胞及B细胞的比例，用线性相关和回归方法分析现症GH患者病毒载量与细胞免疫功能的相关性。结果：①GH患者皮损内疱液HSV－2检出率为100％，病毒载量为6190714±1962085拷贝／μgDNA。HSV－2病毒载量与患者复发次数呈显著正相关。②GH患者CD3^＋、CD4^＋、CD56细胞数及CD4^＋／CD8^＋比值均较对照组低（P〈0．01），但B细胞数与对照组相比差异无统计学意义（P〉0．05）。GH患者皮损HSV-2病毒载量与患者外周血CD3^＋、CD4^＋、CD8^＋、NK、CD4^＋／CD8^＋细胞呈显著的负相关。结论：GH患者的细胞免疫功能抑制可能是由于外周血T淋巴细胞亚群的变化和NK细胞减少，以及Th及Tc细胞亚群分化失衡造成，这种状态不利于机体抑制病毒复制和增殖，造成GH反复发作。     

927例疑似生殖器疱疹患者单纯疱疹病毒抗原检测结果分析

目的：了解生殖器疱疹疑似患者单纯疱疹病毒(HSV)抗原的检测情况。方法：应用ELISA法，对不同皮损(包括疱液、宫颈糜烂、溃疡及结痂)，以及宫颈拭子、尿道拭子进行HSV抗原检测。结果：生殖器疱液、宫颈糜烂、溃疡及结痂、尿道拭子、宫颈分泌物的阳性率分别为62．1％，45．6％，40．5％，7．2％，4．2％。结论：疱液阳性率最高，对患者出现水疱时应进行检测，可提高检出率，宫颈糜烂面阳性率达45．6％，提示女性宫颈糜烂面取材是检测HSV重要取材部位。     

生殖器溃疡中单纯疱疹病毒的检测和分型

目的：了解性病门诊生殖器溃疡患者中单纯疱疹病毒（HSV）感染情况，并评价聚合酶链反应（PCR）－微孔板反向杂交检测和分型方法在生器疱疹诊断中的意义。方法：采用病毒分离培养、普通PCR和PCR－微孔板反向杂交法同时对200份生殖器溃疡标本作了HSV检测与分型。结果：PCR－微孔板反向杂交法的敏感性和特异性分别为98．1％和95．9％，PCR－微孔板杂交法分型结果与病毒分离培养法和普遍PCR的分型结果完全相符。生殖器溃疡中HSV检出率为30％（60／200），其中HSV－2感染占96．7％（58／60）。结论：HSV－2是性病门诊患者生殖器溃疡的主要病因之一，PCR－微孔板反向杂交法是一种适用生殖器溃疡标本中HSV的检测与分型的快速、敏感和特异的诊断方法。     

生殖器疱疹合并其它性传播感染的临床研究

目的：探讨生殖器疱疹合并其它性传播感染的发生率及其临床特点。方法：对生殖器部位有疱疹性损害或可能由疱疹病毒引起损害的患者进行了临床资料采集和分析，并作了生殖器疱疹、梅毒、尖锐湿疣、生殖器 念珠菌病等性传播感染的病原学检测。结果：在287例入选病例中，确诊生殖器疱疹186例（64．8％），对其中68例（23．7％）患者作了HIV血清抗体检测，未发现HIV感染者。在186例生殖器疱疹病例中，43例（23．1％）合并有其它性传播感染，其中合并尖锐湿疣16例（8．6％）、活动性梅毒及潜伏梅毒13例（7．0％）（包括合并硬下疳6例）、生殖器念珠菌病12例（6．5％）。有合并性传播感染的生殖器疱疹均为HSV－2感染所致。结论：生殖器疱疹易合并其它性传播感染，且可引起其损害形态发生改变。     

140例女性疑似生殖器疱疹患者HSV-Ⅱ抗体检测分析

目的:了解女性疑似生殖器疱疹GH患者感染生殖器疱疹发病情况。方法:对140例女性疑似生殖器疱疹患者血清检测HSV-Ⅱ-IgG抗体,并与140例正常人群作对照检测。结果:140例高危人群血清HSV-Ⅱ抗体阳性率为15%,正常人群阳性率为1.4%,两组阳性率比较有显著性差异(2=17.10,P<0.01)。结论:在性病门诊,对有多个性伴或性伴感染生殖器疱疹的女性高危人群在GH临床症状不明显时,应进行血清HSV-Ⅱ抗体检测。     

Urethritis: an underestimated clinical variant of genital herpes in men?

Two men had a first clinical episode of genital herpes presenting as nongonococcal urethritis in the absence of any penile lesions. Data on the etiologic function of herpes simplex in patients with nongonococcal urethritis are scarce and conflicting. Considering our cases, the large amount of nongonococcal urethritis of unknown origin, and the high frequency of unrecognized genital herpes, herpes simplex virus may be a significant etiologic agent of nongonococcal urethritis and warrants necessary laboratory investigations in patients with clear mucoid urethral discharge.     

连接酶链反应检测性病患者沙眼衣原体感染

目的 评价连接酶链反应(LCR)诊断性病患者尿道/宫颈中沙眼衣原体(Ct)的意义。方法 STD门诊尿道(宫颈)炎患者276例,取尿道/宫颈拭子,以LCR分析法检测Ct。采用每4份标本相混合的方法分别以LCR分析法检测尿道/宫颈拭子标本中的Ct,其中56例患者同时进行尿道/宫颈拭子Ct细胞培养。差异性结果由PCR法扩增Ct的主要外膜蛋白基因来进行确认,确定LCR分析法检测Ct的敏感性、特异性。结果 LCR分析法检测尿道/宫颈拭子Ct的敏感性、特异性分别为96.7%和100%。采用每4份标本相混合的方法分别以LCR分析法检测尿道/宫颈拭子标本中的Ct,与单独用每份标本逐一进行LCR检测比较,结果完全一致,符合率为100%。结论 以尿道/宫颈拭子为标本,LCR分析法检测Ct的敏感性、特异性高。适用于诊断泌尿生殖道Ct感染。用标本相混合的方法LCR分析检测尿道/宫颈拭子标本中的Ct,适用于Ct感染的普查。     

解脲支原体基因群与非淋菌性尿道(宫颈)炎相关性研究

目的:探讨解脲支原体(Uu)基因群与非淋菌性尿道(宫颈)炎[NGU(MPC)]的相关性。方法:采用病例对照研究,收集单纯Uu阳性的性病门诊NGU(MPC)患者和非NGU(MPC)就诊者尿道拭子/宫颈拭子标本,通过培养法和PCR法检测Uu及基因分群。结果:共收集标本137例。男性组Uu基因群1占24.3%(18/74),基因群2占59.5%(44/74),基因群1,2同时阳性6.8%(5/74);女性组Uu基因群1占38.1%(24/63),基因群2占54%(34/63),基因群1,2同时阳性7.9%(5/63)。男女性别中Uu分布均以基因群2为主,Uu基因群1,2在男性NGU组与非NGU组间、女性MPC组与非MPC组间的分布没有统计学差异(P均>0.05)。结论:不同基因群Uu在尿道(宫颈)炎患者与非尿道(宫颈)炎就诊者之间的分布无差异,提示与非淋菌性尿道(宫颈)炎无相关性。     

荧光多重PCR与血清型特异性抗体检测HSV感染的比较

目的：比较荧光多重PCR和血清型特异性抗体测定在生殖器疱疹临床诊断中的应用价值及评价各自的优缺点。方法：以细胞培养法作为“金标准”对照，分别用荧光多重PCR和血清型特异性抗体检测法对121例临床诊断为生殖器疱疹的标本进行检测。结果：以培养法作标准，并通过结果的差异性分析，荧光多重PCR的敏感性为100％，特异性为88．89％；血清型特异性抗体测定则分别为77．68％和77．78％，荧光多重PCR的敏感性和特异性均显高于血清型特异性抗体测（P＜0．05），但前不能检测出无皮损患HSV的DNA，而后可检测出无皮损患中的HSV抗体。结论：荧光多重PCR和血清型特异性抗体检测各有其自身的优缺点，单独用PCR和其它病毒分离的方法和单独使用血清特异性抗体检测的方法来诊断生殖器疱疹都是不完整的，均可造成漏诊。临床上将两种方法有机的结合起来应用能发挥各自的优势，取长补短，对早期、准确、快速地诊断生殖器疱疹及进行流行病学调查有着十分重要的意义和使用价值。     

Clinical patterns of sexually transmitted diseases, associated sociodemographic characteristics, and sexual practices in the Farwaniya region of Kuwait

BACKGROUND: Sexually transmitted diseases (STDs) are common worldwide, but there are few studies available on STDs from the Gulf countries, including Kuwait. Our goal was to determine the clinical patterns, sociodemographic factors, and sexual practices of patients with STDs who attended a government hospital in the Farwaniya region of Kuwait. METHODS: All patients seen over a 1-year period (July 2003 to June 2004), who presented with signs and symptoms suggestive of STDs, were included. Sociodemographic details and clinical findings were recorded. The diagnosis of each STD was based mainly on standard World Health Organization (WHO) criteria and available data. Serologic tests for syphilis and human immunodeficiency virus (HIV) were offered to all patients. RESULTS: One thousand and ninety-six patients (1068 male, 28 female) with STDs constituted 2.84% of all new dermatology patients seen; most (866) were in the 21-40-year age group. The STDs were acquired from commercial sex workers in 844 patients (77%). Heterosexual encounter (99.3%) was the most common mode of acquiring STDs. Urethral discharge was noted in 54.1% of patients, followed by genital ulcers (17.8%), papules/growths (16.4%), and urethral/pubic pain without associated discharge/ulcers (5.9%); these were the four most common presenting complaints. Evaluation revealed gonorrhea in 31.5% of patients, nongonococcal urethritis in 23.6%, chlamydia in 4.1%, nonspecific urethritis in 19.5%, concomitant gonorrhea and chlamydia urethritis in 2.7%, genital warts in 13.7%, chancroid in 13.0%, genital herpes in 4.8%, molluscum contagiosum in 2.7%, and lymphogranuloma venereum in 1.4%. CONCLUSIONS: Urethral discharge, gonorrhea, and nonspecific urethritis (presenting with urethral discharge), followed by genital warts, chancroid, and genital herpes (ulcers), were the most common STDs among male patients in the Farwaniya region of Kuwait. Although no case of HIV or syphilis was detected, health authorities and physicians need to remain vigilant.     

Seroprevalence of herpes simplex virus type 1 and type 2 in Turkey

BACKGROUND: Herpes simplex virus (HSV) infections are among the most common infectious diseases in humans. The prevalence of herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2) varies widely across the world. HSV-2 infection is the primary cause of genital herpes. It is highly prevalent in human populations in many parts of the world, and is the most common cause of genital ulcer disease worldwide. In spite of the large prevalence and growing incidence of herpes simplex infection (HSV-1 and HSV-2), relatively few data have been published regarding the seroprevalence of herpes simplex infection, while no data exist regarding the Turkish population. METHODS: We aimed to investigate the prevalence of HSV-1 and HSV-2 in selected populations in Turkey. A cross-sectional study was conducted involving 2082 serum samples of 725 adults, 300 pregnant women, 200 blood donors, 483 sex workers and 110 patients with genital warts and 264 hotel staff in Istanbul, Turkey. All serum samples were assessed for HSV1 and HSV-2 IgG antibodies using an HSV-type specific, enzyme-linked immunosorbent assay (ELISA). RESULTS: The prevalence of HSV-2 and HSV-1 antibodies was 4.8 and 85.3% in sexually active adults; 5.5 and 96% in blood donors; 5 and 98% in pregnant women, 17.3 and 93.6% in patients with genital warts; 8.3 and 97.3% in hotel staff; and 60% and 99% in sex workers. CONCLUSION: These results confirm a higher prevalence of HSV infection than estimated, especially in high risk groups in Turkey. The high prevalence of HSV infection underlines the need for education among these populations.     

微量细胞培养法检测疑似非淋菌性尿道炎患者的沙眼衣原体

采用微量细胞培养法分离１０７例疑似非淋菌性尿道炎或宫颈炎患者泌尿生殖道标本中的沙眼衣原体。总衣原体感染率为２４．３％，男、女衣原体感染率分别为２５．７％和２１．２％。对衣原体培养阳性的患者做了临床分析。并对向量细胞培养与传统的玻璃瓶增减法进行了比较。结果表明：在本组人群中沙眼衣原体感染有较高的流行率。     

Male Genital Herpes Complicated with Urethral Infection

A 26-year-old man had a primary infection or reinfection of genital herpes due to herpes simplex virus (HSV) type 2 complicated with herpetic urethritis. By analysis of the restriction endonuclease digestion pattern of the viral DNA, two isolates, one from the penile lesion and one from the urethra, were identified as the same strain.     

口服盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎临床观察

目的 观察口服盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎的临床疗效和安全性.方法 沙眼衣原体或/和解脲脲原体感染引起的非淋菌性尿道(宫颈)炎患者504例,采用盐酸莫西沙星口服,每次400 mg,每日1次,连续12天.结果 504例患者痊愈率为68.4%,总有效率为83.1%.沙眼衣原体和解脲脲原体感染清除率分别为84.8%和87.2%.不良反应发生率为7.9%.结论 盐酸莫西沙星治疗非淋菌性尿道(宫颈)炎疗效好,安全性高.