Chlamydia trachomatis infections in women with urogenital symptoms.

Chlamydia trachomatis was isolated from 30 to 100 women attending a family physician's office with dysuria, frequency or vaginal discharge, compared with 2 of 30 asymptomatic women. Multiple infections were common: C. trachomatis coexisted with Gardnerella vaginalis, Candida albicans, Trichomonas vaginalis or a bacterial cause of urinary tract infection in 15 patients. C. trachomatis was isolated alone from 15 symptomatic women. The source of the positive culture was not always the site of symptoms. C. trachomatis was isolated from both the cervix and the urine of 9 patients, either simultaneously or sequentially. The probability of finding a chlamydial infection was 30% in young women with vaginal discharge alone, 33% in those with dysuria and frequency alone and 53% in those with abdominal or pelvic pain in addition to lower urogenital tract symptoms.     

阴道支原体、衣原体与子宫颈高危型HPV感染及转归的相关性应丽洁

目的：随诊宫颈筛查及分泌物检查的普及,越来越多的无症状宫颈癌被发现,此次研究阴道支原体、衣原体与子宫颈高危型HPV感染及转归的相关性。选择2008年02月-2018年2月就诊于我院妇科且病理学诊断为宫颈癌者200例为观察组,选取同期我院就诊仅有宫颈黏膜慢性炎症患者150例作为对照组,比较两组HPV、HR-HPV感染率,研究宫颈癌患者 HR-HPV感染与支原体、衣原体感染的关系,探讨HR-HPV感染与支原体、衣原体感染的相关性。研究结果：1. 观察组HPV(+)感染率(99%)、HR-HPV(+)感染率(95%)均明显高于对照组(P＜0.05)。2. 阴道支原体(36.14%)、衣原体(47.22%)感染阳性率在HR-HPV感染阳性患者中发病率均高于HPV(-)患者(P＜0.05)。3. 女性生殖道中衣原体、支原体感染会增加HR-HPV感染患病率(P＜0.05)。结论：宫颈癌HR-HPV阳性患者阴道衣原体、支原体感染率明显增高,阴道衣原体、支原体为HR-HPV感染的高危因素。     

218例宫颈炎症与生殖道支原体和衣原体感染检测分析

目的探讨妇科宫颈炎症患者与解脲支原体（UU）和沙眼衣原体（CT）感染的关系。方法对218例宫颈炎症患者做支原体（培养加药敏）和沙眼衣原体（用检测试剂盒）检测分析。结果1．在218例患者中，肉眼见到脓性或黏液脓性分泌物患者162例（74．31％）；出现宫颈管内出血患者111例（50．92％）；实际阳性病例138例（63．30％），UU阳性114例（52．29％），CT阳性69例（31．65％），其中有45例双重感染（20．64％）。2．生殖道支原体衣原体阳性率与患者年龄、职业、文化程度、孕产次及有无计划生育手术史均有一定的关系。结论生殖道支原体衣原体检测在妇科门诊中具有十分重要的价值，对提高妇女生殖健康水平、防止性传播疾病蔓延起到积极的作用。     

妇科患者支原体和沙眼衣原体感染150例分析

目的探讨妇科不规则阴道流血的患者与解脲支原体（UU）和沙眼衣原体（CT）感染的关系。方法采用聚合酶链反应（PCR）技术对150例不规则阴道流血患者宫颈分泌物中的CT和UU进行检测。结果发现此类妇科病人解脲支原体的阳性率为45．3％，沙眼衣原体阳性率为30．7％，总阳性率为69．3％。结论不规则阴道流血的患者与支原体和沙眼衣原体感染有相关性。对不规则阴道流血的患者通过常规对症治疗或激素治疗无效时，应做支原体和沙眼衣原体检测，尤其是年龄〈30岁、有非婚性行为、Ⅱ度以上宫颈炎、无采用安全套或置宫内节育器者更应检测。     

Serologic evidence of Chlamydia trachomatis infection and risk of preterm birth.

OBJECTIVE: To determine whether serologic evidence of Chlamydia trachomatis during pregnancy is a risk factor for preterm delivery (before 37 weeks' gestation). DESIGN: Chart review. SETTING: Antenatal clinics associated with a teaching hospital. PATIENTS: A group of 103 unselected consecutive patients presenting for routine prenatal care. OUTCOME MEASURES: Pregnancy outcome and C. trachomatis serologic status. RESULTS: A total of 21 women (20%) were found to be seropositive for IgG antibodies to C. trachomatis. They were similar to the seronegative women with respect to maternal age, parity, history of preterm birth, obstetric or medical problems, smoking status, history of drug abuse, educational status and psychosocial stressors. The seropositive women were significantly more likely than the seronegative women to have a preterm birth (24% [5/21] v. 7% [6/82]i p = 0.029, odds ratio 3.96, 95% confidence interval 1.08 to 14.57), an infant with a lower mean gestational age at birth (262 [standard deviation (SD) 19] days v. 273 [SD 15] days; p = 0.0052) and an infant with a lower mean birth weight (3125 [SD 692] g v. 3473 [SD 696] g; p = 0.0434). The positive predictive value of a seropositive result for preterm birth was 31% (5/16); the negative predictive value of a seronegative result for preterm birth was 8% (6/76). CONCLUSION: Women with serologic evidence of C. trachomatis may be at risk for preterm birth. Further study is required to determine whether serologic testing for C. trachomatis should be a routine part of prenatal care.     

盆腔炎患者支原体与沙眼衣原体检测结果分析

目的 了解盆腔炎患者支原体与沙眼衣原体的感染情况,探讨支原体、沙眼衣原体感染与盆腔炎之间的关系。方法采集160例盆腔炎妇女和130例正常妇女的宫颈分泌物分别进行解脲原体(Uu)、人型支原体(Mh)、沙眼衣原体(Ct)的培养,统计分析两组感染率的差异。结果 160例盆腔炎患者中Uu阳性检出率为61.3％,Ct阳性检出率为16.9％;对照组130例中Uu检出率为23.8％,Ct阳性检出率为3.8％,两组Uu、Ct检出率差异有统计学意义(P<0.05)。盆腔炎组Uu+Ct混合感染检出17例阳性(10.6%),对照组为3例(2.3％),两组比较差异有统计学意义(P<0.05)。结论 盆腔炎患者中Uu、Ct感染率较高,盆腔炎中可见多种病原体混合感染,其中Uu+Ct感染率最高。     

Cytologic manifestations of cervical and vaginal infections. II. Confirmation of Chlamydia trachomatis infection by direct immunofluorescence using monoclonal antibodies

We found inflammatory patterns of transparent lymphocytes on increased numbers of histiocytes suggestive of chlamydial infection in 68 (56%) of 121 cervical cytologic smears. Chlamydia trachomatis was isolated from 36 (53%) of those with and only two (4%) of those without such inflammatory patterns. Direct stain with fluorescein-conjugated monoclonal antibodies demonstrated elementary bodies of C trachomatis in 30 (79%) of the 38 culture-positive patients, including 29 of the culture-positive patients who had an inflammatory cytologic pattern suggestive of C trachomatis infection. Thus, Papanicolaou smears can be screened for inflammatory pattern, and separate endocervical smears from patients with a pattern suggestive of chlamydial infection can then be stained by immunofluorescence to confirm the presence of C trachomatis infection. This two-step approach detected 29 of 38 infections confirmed by culture in the present study, giving a sensitivity of 76%, a specificity of 100%, and a positive predictive value of 100% in a population having a 31% prevalence of C trachomatis infection.     

性病门诊患者中淋球菌、沙眼衣原体和支原体感染情况及支原体耐药分析

为了解性病门诊患者中淋球菌（Gonococcus,NG)、沙眼衣原体（Chlamydia trachomatis,CT) 和支原体（Mycoplasma)感染分布状况以及支原体的耐药情况，对564例泌尿生殖系感染的现患病人进行分析，结果显示：NG的单一感染率最高，解脲支原体（Uu）的混合感染率最高。药敏实验显示支原体对大部分抗生素均不同程度地耐药。其中壮观霉素耐药率最高，司帕沙星最低。结论：淋球菌与非淋菌性尿道炎的感染模式有所不同，且感染情况存在性别差异。支原体耐药情况不容乐观，因此临床治疗时应根据药敏实验结果选择用药。     

淋球菌、支原体和沙眼衣原体在慢性前列腺炎中的感染分布及耐药性分析

目的 :了解淋球菌、支原体和沙眼衣原体在慢性前列腺炎中的感染分布和耐药情况。方法 :用培养法对淋球菌和支原体进行分离鉴定和药敏试验 ,用头孢硝噻吩法对淋球菌进行 β 内酰胺酶检测 ,用单克隆抗体胶体金标法测定沙眼衣原体。结果 :在 2 90 0份前列腺液标本中 ,淋球菌、支原体和沙眼衣原体的分离率分别为3.3 %,12 .8%和 0 .9%。淋球菌 β 内酰胺酶的产生率为 12 .6 %,淋球菌对青霉素的耐药率为 73.7%,对氧氟沙星和环丙沙星的耐药率均为 91.6 %,对壮观霉素和头孢菌素的敏感性均较高。支原体对四环素、乙酰螺旋霉素、红霉素和氧氟沙星的耐药率均达到或超过 5 0 .0 %,而罗红霉素、强力霉素、左旋氧氟沙星、美满霉素、交沙霉素和阿奇霉素的敏感率均达 70 .0 %～ 80 .0 %。结论 :支原体在慢性前列腺炎中的分离率高于淋球菌和沙眼衣原体。监测淋球菌和支原体的耐药性对指导临床合理使用抗生素有重要意义。     

淋球菌、支原体和沙眼衣原体在慢性前列腺炎中的感染分布及耐药性分析

目的：了解淋球菌、支原体和沙眼衣原体在慢性前列腺炎中的感染分布和耐药情况。方法：用培养法对淋球菌和支原体进行分离鉴定和药敏试验，用头孢硝噻吩法对淋球菌进行β-内酰胺酶检测，用单克隆抗体胶体金标法测定沙眼衣原体。结果：在2900份前列腺液标本中，淋球菌、支原体和沙眼衣原体的分离率分别为3．3％，12．8％和0．9％。淋球菌β-内酰胺酶的产生率为12.6％，淋球菌对青霉素的耐药率为73.7％，对氧氟沙星和环丙沙星的耐药率均为91．6％，对壮观霉素和头孢菌素的敏感性均较高。支原体对四环素、乙酰螺旋霉素、红霉素和氧氟沙星的耐药率均达到或超过50．0％，而罗红霉素、强力霉素、左旋氧氟沙星、美满霉素、交沙霉素和阿奇霉素的敏感率均达70．0％-80、0％。结论：支原体在慢性前列腺炎中的分离率高于淋球菌和沙眼衣原体。监测淋球菌和支原体的耐药性对指导临床合理使用抗生素有重要意义。     

孕前体重指数及孕期体重变化与新生儿出生体重的关系

目的 探讨孕妇孕前体重指数(BMI)、孕期总增重、孕中晚期增重速度的现状及对新生儿出生体重的影响.方法 收集了部分于2014年9月至2015年7月于首都医科大学宣武医院正常产检并分娩的孕妇进行前瞻性纵向研究.结果 ①孕中晚期增重速度及孕期总增重超出IOM标准组大于胎龄儿发生率高于低于IOM标准组.②孕中期增重速度与新生儿出生体重(r=0.439,P＜ 0.001)呈正相关.孕晚期增重速度与新生儿出生体重(r=0.224,P＜0.001)呈正相关.结论 孕中晚期增重速度与新生儿出生体重呈正相关.建议首都医科大学宣武医院加强孕妇孕期营养知识的宣教及孕期体重的监测及干预.     

从剖宫者产羊水和宫颈标本中检出沙眼衣原体的研究

目的;三文通过检查配对母胎标本中的沙眼衣原体（Ｃｒ）,拟探讨Ｃｔ垂直传播的机制。方法：应用细胞培养,聚合酶链反应（ＰＣＲ）检查配对对母胎标本（宫颈、羊水、新生儿睑结膜）中的沙眼衣原体（Ｃｒ）。结果：１０２例剖宫产配对母胎标本中,宫颈、羊水、新生儿睑结膜均为阳性有２４例。宫颈阴性、羊水、新生儿睑结膜阳性共６例。宫颈阳性、羊水、新生儿睑结膜阴性共４例。宫颈、羊水、新生儿睑结膜均为阴笥有６８例。孕妇的Ｃ     

Chlamydia trachomatis cervical infection: prevalence and determinants among women presenting for routine gynecologic examination.

OBJECTIVE: To determine the prevalence of and risk indicators for Chlamydia trachomatis cervical infection among women presenting for a periodic medical examination. DESIGN: Prevalence study. SETTING: Centre local de services communautaires (CLSC) Saint-Louis du Parc, Montreal. PATIENTS: All women presenting for a routine gynecologic examination from May 1985 to July 1986. Of the 773 (99%) who agreed to participate 56 were excluded because of inadequate diagnostic tests (34), antibiotic intake in the preceding 6 weeks (19) or loss to follow-up after the initial visit (3). OUTCOME MEASURES: Culture was the diagnostic standard, but rapid diagnostic tests were also used. From the identified cases logistic regression analysis was used to evaluate the following risk indicators: age, place of residence, use of oral contraceptives, sexual partners and frequency, history of sexually transmitted disease (STD) and abnormalities found on genital examination. MAIN RESULTS: Fifty-one of the women were found to have C. trachomatis infection, for a prevalence rate of 7.1%; 32 (63%) were completely asymptomatic. Three independent indicators were found: age of 25 years or less (odds ratio [OR] 3.2, 95% confidence limits [CL] 1.8 and 5.9), cervical erythema, contact bleeding or mucopurulent exudate (OR 2.5, 95% CL 1.4 and 4.5) and residency in the CLSC area (OR 2.3, 95% CL 1.1 and 5.1). A history of STD or vaginitis had a significant protective effect in women 30 years of age or more (OR 0.2). CONCLUSIONS: Case-finding for chlamydial infection could be an effective public health measure among women 25 years of age or less and among those with signs of cervicitis when they present for a Papanicolaou test.     

继发不孕症和早期妊娠妇女宫颈沙眼衣原体感染的研究

目的 :了解继发不孕症和早期妊娠妇女宫颈分泌物沙眼衣原体 (CT)的感染率。方法 :收集早期妊娠、继发不孕症及对照组妇女宫颈分泌物 ,用CT PCR试剂盒进行CT DNA检测。结果 :早期妊娠组和继发不孕组CT感染率(13.33%和 14.2 8% )明显高于对照组 (3.33% ) (均P <0 .0 5 ) ,且前二者间无统计学差异 (P >0 .0 5 )。结论 :早期妊娠和继发不孕妇女均有较高的CT感染率 ,临床医生对需再生育的早孕妇女应常规作CT检测和围术期治疗。     

继发不孕症和早期妊娠妇女宫颈沙眼诊原体感染的研究

目的：了解继发不孕症和早期妊娠妇女宫颈分泌物沙眼衣原体（CT）的感染率。方法：收集早期妊娠、继发不孕症及对照组妇女宫颈分泌物,用CT-PCR试剂盒进行CT-DNA检测。结果：早期妊娠组和继发不孕组CT感染率（13.33%和14.28%）明显高于对照组（3.33%）（均P＜0.05),且前二者间无统计学差异（P＞0.05)。结论：早期妊娠和继发不孕妇女均有较高的CT感染率,临床医生对需再生育的早孕妇女应常规作CT检测和围术期治疗。     

The association between Chlamydia trachomatis and ectopic pregnancy. A matched-pair, case-control study

We performed a case-control study of the association of past exposure to Chlamydia trachomatis and ectopic pregnancy with 306 case patients with an ectopic pregnancy and 266 pregnant patients who served as controls. The geometric mean antichlamydial antibody titer among cases was 75 +/- 10.2 vs 13 +/- 11.0 among controls. The matched-pair odds ratio for ectopic pregnancy and IgG titer of 1:64 or greater to C trachomatis was 3.0 (95% confidence interval, 2.1 to 4.4). Adjusting for age at first intercourse, total lifetime partners, douching, history of infertility, and parity yielded a relative risk of 2.4 (95% confidence interval, 1.5 to 3.3). Current douching remained an independent risk factor after controlling for chlamydial exposure, with an adjusted relative risk of 2.1 (95% confidence interval, 1.3 to 3.5). The population attributable fraction for chlamydial infection was 0.47 and that for douching was 0.45. The results stress the need for control of C trachomatis infections and for further study of specific douching behaviors as risk factors for ectopic pregnancy.     

Association of preterm birth with long-term survival, reproduction, and next-generation preterm birth

Context  Preterm birth is a major cause of infant morbidity and mortality. Less is known about long-term health among persons born preterm. Objective  To determine the long-term effects of preterm birth on survival, reproduction, and next-generation preterm birth. Design, Setting, and Participants  Population-based, observational, longitudinal study using registry data from 1 167 506 singleton births in the Medical Birth Registry of Norway in 1967-1988. The cohort was followed up through 2002 for survival. The cohort was truncated to births from 1967-1976 for assessment of educational achievement and reproductive outcomes through 2004. Main Outcome Measures  In relation to sex and gestational age at birth, absolute mortality, risk of fetal, infant, child, and adolescent mortality, and incidence and risk of reproduction and next-generation preterm birth. Singleton term (37-42 weeks) fetal deaths and live births, stratified by sex, served as the reference group for all analyses. Results  The percentage who were born preterm was higher among boys (5.6%) than among girls (4.7%). Preterm participants had an increased risk of mortality throughout childhood. For boys born at 22 to 27 weeks, mortality rates were 1.33% and 1.01% for early and late childhood death, with relative risks (RRs) of 5.3 (95% confidence interval [CI], 2.0-14.2) and 7.0 (95% CI, 2.3-22.0), respectively. The mortality rate for girls born at 22 to 27 weeks was 1.71% for early childhood death, with an RR of 9.7 (95% CI, 4.0-23.7); there were no late childhood deaths. For 28 to 32 weeks, the early and late childhood mortality rates among boys were 0.73% and 0.37%, with RRs of 2.5 (95% CI, 1.6-3.7) and 2.3 (95% CI, 1.3-4.1), respectively. Girls born at 28 to 32 weeks did not have a significantly increased risk of childhood mortality. Reproduction was diminished for index participants born preterm. For men and women born at 22 to 27 weeks, absolute reproduction was 13.9% and 25%, with RRs of 0.24 (95% CI, 0.17-0.32) and 0.33 (95% CI, 0.26-0.42), respectively. For 28 to 32 weeks, absolute reproduction was 38.6% and 59.2% for men and women, with RRs of 0.7 (95% CI, 0.66-0.74) and 0.81 (95% CI, 0.78-0.85), respectively. Preterm women but not men were at increased risk of having preterm offspring. Conclusion  In persons born in Norway in 1967-1988, preterm birth was associated with diminished long-term survival and reproduction.      

G蛋白β3亚单位C825T等位基因多态性与妊娠期体重增加和产后肥胖的相关性研究

目的研究温州地区汉族人群妇女GNB3 C825T等位基因多态性与妊娠期间体重增加和产后超重及肥胖的相关性。方法在肥胖专科门诊、体检中心随机选取309例已产妇女,分为产后超重及肥胖组和产后体重正常对照组,PCR/RFLP检测基因型。结果(1)与对照组比较,产后超重及肥胖组的TT基因型携带率显著增加(P<0.01),TT/CT致产后肥胖的比数比(OR值)为2.6(95%可信区间1.4～4.6,P<0.01);TT/CC致产后肥胖的OR值为2.6(95%可信区间1.3～5.1,P<0.01);等位基因T与C比,致产后肥胖的OR值为1.5(95%可信区间1.1～2.1,P<0.01)。(2)妊娠期间体重增加值比较,TT型比CC型和CT型体重增加更显著(P<0.01),CT型比CC型体重增加亦明显(P<0.01);妊娠前后体重变化值比较,TT型比CC型和CT型产后体重明显增加(P<0.01),而CT型与CC型相比,其产后体重虽有增加,但差异无统计学意义(P=0.076)。结论GNB3 825T等位基因与妊娠期间体重较多增加和产后超重及肥胖密切相关。GNB3 825TT基因型可作为早期预测产后超重及肥胖的遗传学指标之一。