聚合酶链反应在淋病诊断中的应用评价

通过６０例被检者淋病球菌的ＰＣＲ检测法与涂片法、淋菌培养法的对比分析，认为：ＰＣＲ法是淋病诊断最为有效的方法，其在诊断的准确性、敏感性、特异性方面均优于其他方法；二次扩增有助于克服假阴性结果。对隐性感染者的检测也作了探讨。     

PCR对可疑慢性淋病病人淋病奈瑟菌的检测

①目的明确临床上可疑慢性淋病病人的病原学诊断。②方法用聚合酶链反应（ＰＣＲ）对７６例可疑慢性淋病病人的尿道分泌物进行了淋病奈瑟菌检测，并与传统的细菌分离培养法的敏感性进行了比较。③结果聚合酶链反应测出阳性标本２２份（２８．９％），分离培养法测出阳性标本８份（１０．５％）。两种方法敏感性比较，差异有显著性（χ２＝１２．０７，Ｐ＜０．０１）。④结论与细菌培养法相比ＰＣＲ敏感而快速，是明确慢性淋病病原学诊断和指导治疗的好方法。     

淋病奈瑟菌PCR检测的临床应用研究

为评价淋病奈瑟菌ＰＣＲ检测的临床效果,建立了对标准淋病奈瑟菌的ＤＮＡＰＣＲ检测技术。结果显示,ＮＧ ＰＣＲ技术的灵敏度约为３个菌的基因组拷贝。对８种菌株进行ＮＧ ＰＣＲ,只有标准淋病奈瑟菌显示阳性,其余７株非淋球菌菌株均阴性,说明有很好的特异性。对４９例淋病患者同时进行涂片镜检法、细菌培养法和ＰＣＲ法检测的比较,其阳性检出率分别为７６．６％、５２．２％和９５．９％。提示ＮＧ ＰＣＲ方法比涂片和培养法更为敏感,且特异性强,在淋病的诊断,特别是早期诊断中有重要参考价值。     

聚合酶链反应技术在检测淋球菌性尿道炎中的应用

对８４例疑诊尿道感染患者通过聚合酶链反应（ＰＣＲ）技术进行尿休本的淋球菌特异性检测。结果：阳性２８例（３３．３％）阴性５６例（６６．７％）．在ＰＣＲ阳性患者中，１８例为伴有尿道分泌物的急性患者，均进行涂片染色及分离培养，结果１２例阳性，６例阴性；１０例为无尿道分泌物慢性患者，未发现涂片及培养阳性而ＰＣＲ阴性者。实验结果表明同常规方法相比，ＰＣＲ技术在淋球菌性尿路感染，尤其对慢性感染患者具有特异、敏感的诊断价值。     

PCR检测淋球菌的临床应用价值

本文应用聚合酶链反应技术，快速检测淋病奈瑟菌，对高度疑似淋病的７２例检测中，４９例为阳性结果，同时作涂片配对检测，仅２７例为阳性结果（Ｐ〈０．００５）；其中，４２例用ＰＣＲ法和培养法配对检查，ＰＣＲ法阳性为２８例，培养法阳性为１２例（Ｐ〈０．００５）。１０９株淋球菌药敏试验结果表明，耐青霉素类药物菌株仅为２６．６％，仍不失为治疗淋病的首选药物。     

应用PCR技术检测淋病奈瑟菌342例结果分析

对３４２病人进行随机抽样，用聚合酶链反应（ＰＣＲ）技术和分泌物培养两种方法检测淋球菌。ＰＣＲ阳性１１０例，阳性率为３２．１６％；淋球菌培养阳性１２例，阳性率为３．５１％。ＰＣＲ阳性率明显高于培养，说明ＰＣＲ技术对淋病奈瑟菌的诊断具有特异性强、敏感性高的特点。     

干燥分泌物涂片聚合酶链反应诊断淋病

为探讨淋病检测标本的贮存条件,为基层医院提供诊断淋病的方法,应用聚合酶链反应（ＰＣＲ）检测１０８份干燥分泌物涂片,并与淋菌培养进行比较,报道如下。１资料与方法１．１病例来源：本院性病门诊就诊的淋病可疑者１０８例。１．２标本采集：男性取尿道分泌物,女性...     

聚合酶链反应检测慢性淋巴菌性前列腺炎病原体的研究

为探讨慢性淋菌性前列腺炎的病原学诊断方法，应用聚合酶链反应（ＰＣＲ）对１２７例慢性前列腺炎患者的前列腺液作奈瑟氏淋病双球菌检测，同时以４５例无前列腺炎者作对照，结果实验组淋病双球菌阳性率为１８．９％，对照组均为阴性（Ｐ〈０．０１），检测结果表明淋病双球菌已成为慢性前列腺炎的新病原体。ＰＣＲ检测前列腺液为慢性淋菌性前列腺炎的诊断提供了特异性方法和使用抗生素的依据。     

PCR对可疑慢性淋病病人淋病奈瑟菌的检测

明确临床上可疑慢性淋病病人的病原学诊断。方法用聚合酶链反应对７６例可疑慢性淋病病人的尿道分泌物进行了淋病奈瑟菌检测，并与传统的细菌分离培养法的敏感性进行了比较。结果聚合酶链反应测出阳性标本２２份，分离培养法测出阳性标本８份。两种方法敏感性比较，差异有显著性。     

淋病患者合并解脲支原体感染的临床分析及中西医结合治疗探讨

对１９８例淋病患者和３９例淋病后尿道炎患者同时进行淋球菌和解脲支原体分离培养。结果淋病患者中Ｕｕ阳性１４３例，淋病后尿道炎患者中Ｕｕ阳性３０例，提示淋球菌与Ｕｕ混合感染已达较严重的程度。对６１例混合感染患者治后复查，淋球菌培养的均转阴性，其中单用菌履治或淋必治者１５例，Ｕｕ培养的均阳性；合用中药经验方煎服每日１剂治疗２周者２２例，１８例Ｕｕ培养转阴性，为中西结合治疗淋病合并Ｕｕ感染的有效性提价供了     

涂片、培养和实时荧光定量PCR检测在妇科的临床应用

目的：比较涂片革兰染色、培养和实时荧光定量PCR（FQ-PCR）检测妇科性病淋球菌感染的临床应用价值,寻找一种快速而敏感的淋球菌检测方法。方法：同时用涂片革兰染色、培养和FQ-PCR检测临床疑诊淋病123例女性阴道标本中的淋球菌,以培养法为“金标准”,将另外两种方法与之比较,分别计算其敏感性、特异性、阳性预期值和阴性预期值。结果：涂片检出率为76．4％、培养法检出率为66．7％、FQ-PCR检出率为69．9％;经配对计数资料Х^2检验,FQ-PCR与培养法的检出率比较差异无显著性（P〉0．05）。涂片法和FQ-PCR法的敏感性、特异性、阳性预期值和阴性预期值分别为94．2％、66．7％、87．2％、82.8％和97．6％、89．7％、95．3％、94．6％。结论：FQ-PCR检测淋球菌,可弥补涂片法较粗糙、培养法耗时长的缺点。FQ-PCR具有准确快速,敏感性和特异性较高的特点,是一种具有临床应用价值的淋球菌快速定量检测方法。     

Validity and cost-effectiveness of the Gonozyme test in the diagnosis of gonorrhea.

Although bacterial culture is considered to provide the most definitive diagnosis of gonorrhea, it has limitations when specimens must be transported long distances. A study was carried out to evaluate the validity and cost-effectiveness of an alternative method of diagnosing gonorrhea, the Gonozyme test, a commercially available enzyme immunoassay. Urogenital specimens from 100 men and 100 women with symptoms suggestive of or a history of exposure to gonorrhea were tested for the presence of Neisseria gonorrhoeae by means of bacterial culture and for gonococcal antigen with the Gonozyme test. The specimens from the men were also examined by means of microscopy of Gram-stained smears. The sensitivity and specificity of the Gonozyme test with reference to culture results were 95.6% and 97.4% respectively in the men and 84.2% and 98.7% in the women. The predictive value of a positive result was 91.6% in the men and 94.1% in the women, and the predictive value of a negative result 98.6% in the men and 96.3% in the women. The cost-effectiveness of the Gonozyme test was higher than that of bacterial culture in this population, which had a high prevalence rate of gonorrhea (23% in the men and 19% in the women). The Gonozyme test would be an adequate alternative to culture for the diagnosis of gonorrhea and contact tracing in areas far from diagnostic laboratories.     

28例老年女性淋病奈瑟氏菌药敏试验分析

目的探讨老年女性淋病奈瑟氏菌（淋球菌）药敏试验现状,为淋病患者合理用药提供依据。方法对28例确诊感染淋球菌的老年女性阴道分泌物,做淋球菌培养、鉴定及药敏试验,分析淋球菌耐药现状。结果在进行药敏试验的11种药物中,β-内酰胺类的阿莫西林/克拉维酸、头孢克洛、头孢塞肟和头孢呋辛药物敏感率均为100%,氯霉素为95%,氨卞西林为45%,其它药物的敏感率在氯霉素和氨卞西林之间。结论淋球菌对β-内酰胺类药物普遍敏感,对喹诺酮类、四环素和氯霉素类药物及利福平都表现出一定得耐药性。淋病治疗应首选β-内酰胺类药物。     

聚合酶链反应在诊断淋球菌感染中的应用价值

采用直接涂片法、细菌培养法和聚合酶链反应法检测临床标本２５７人份，其淋球菌检出率分别为２７．２３％、１３．６１％和３７．０４％。经统计学处理，ｘ＾２＝３７．８１，Ｐ〈０．０１，有高度显著性差异。聚合酶链反应法诊断淋病具有灵敏度高、特异性强、能自动化操作、简便快速、标本易贮存和运送等优点，为淋病的快速诊断提供了一种新的检测方法。本文还对三种检测淋球菌方法的优缺点进行了比较，并对聚合酶链反应方法的适应     

The role of gonococcus in acute pelvic inflammatory disease in Nairobi

The research objective was to determine how often gonorrhea could be found in pelvic inflammatory disease (PID) using a simple bacteriological method. 58 consecutive patients who were admitted to the acute gynecological ward of the Kenyatta National Hospital in Nairobi were investigated. The diagnosis of PID was made clinically. The common presenting features were: pyrexis; pain in the lower abdomen; vaginal discharge; and bilateral adnexal tenderness. Specimens were taken from pus or discharge from the urethra and endocervix. The material was inoculated on the medium of Thayer and Martin and incubated for 24-48 hours in CO2 rich surroundings at 36 degrees. Neisseria gonorrhea was identified on the basis of the aspect of the colonies, a smear from the colonies stained with Gram's method and a positive oxidase reaction. Acute PID accounted for about 12 emergency admissions per week to this ward of the Kenyatta National Hospital. Many more cases were treated as outpatients and a few were found in surgical wards. 30 of the patients studied has received some form of treatment prior to admission. This was antibiotic treatment in at least 10 cases. In another 20 cases the nature of the treatment was unknown. The figures from this single ward, in which only a minority of patients with PID presenting at the hospital are admitted, showed that PID, acute and chronic, is a very common problem encountered in gynecological practice in Nairobi and probably other parts of Kenya. It is a reasonable estimate that in women not more than 3/4 of the actual cases with gonococcal infection will be discovered on a single culture. This is indicated by the 6 cases in whom typical gram negative diplococci were found in the smear, in some of them definitely intracellular, although the culture was negative. The results showed how ineffective the previous treatment was in eliminating the gonococcus from the genital tract. A systematic prophylactic and therapeutic program is urgently needed in Kenya if the problem of gonorreha and its sequelae are to be controlled.     

Gonorrhea screening in male consorts of women with pelvic infection.

Neisseria gonorrhoeae was isolated from 39% of male contacts of women with acute gonococcal pelvic inflammatory disease (PID); 22% of these men were asymptomatic. More than half of those women with gonococcal PID had at least one male sexual consort with gonorrhea. Neisseria gonorrhoeae was isolated from 15% of male contacts of women with nongonococcal PID; 30% were asymptomatic. Since a substantial number of male contacts of women with acute PID will have cultures positive for N gonorrhoeae and are asymptomatic, all male sexual consorts should be examined and have cultures grown for gonorrhea.     

性病后慢性前列腺炎的诊治(附56例报告)

目的 探讨性病后慢性前列腺炎的病原学特点及治疗方法。方法 对56例20-40岁性病后慢性前列腺炎患者的前列腺液用细菌学培养、多聚酶链反应(PCR)进行了细菌、沙眼衣原体、解脲脲原体、病毒的检测，并调查其性生活状况及主观症状改善情况，进行针对性治疗。结果 56例中，前列腺液培养检测病原体阳性率53．6％(30/56)；对前列腺液培养阴性的患者行PCR检测病原体，阳性率92．3％(24／26)，其中衣原体10例(38．4％)，支原体8例(30．8％)，淋病双球菌6例(23．1％)。对全部患者进行了性生活状况调查，发现12例患者放弃性生活或性生活频率减少(≤1次／月)。结论 性病后慢性前列腺炎有单纯性病原体感染，还有复合感染。前列腺液病原体检查对指导性病后慢性前列腺炎的治疗具有重要临床意义，同时还应注意患者的性病后心理治疗。     

性病门诊中阴道念珠菌病的调查

目的：了解性病门诊患者中阴道念珠菌的带菌情况和相关因素。方法：对577例女性患者和50例妇科体检者作真菌涂片和培养检查。结果：577例受检标本中念珠菌培养阳性148例（25．65％）,其中316例性病患者（淋病,尖锐湿疣和梅毒）中念珠菌培养阳性77例（24．37％）,261例性检患者中念珠菌培养阳性71例（27．20％）,均明显高于正常人6％（P＜0．01）,29例淋病患者念珠菌培养阳性5例（17．24％）,17例梅毒患者5例念珠菌培养阳性5例（29．41％）,尖锐湿疣患者280例中念珠菌培养阳性70例（25．0％）,显著高于正常人（P＜0．01）,结论：尖锐湿疣患,梅和性检患者中阴道念珠菌的带菌率明显高于正常人,差异有显著性。     

革兰氏染色与淋球菌培养诊断女性淋病的比较研究

本文用淋球菌培养比较研究对革兰氏染色法在女性淋病诊断中的应用作重新评价.妇科门诊500名病人615价标本的检查结果表明,革兰氏染色法敏感性为94.9%,特异性为95.2%,阳性预报率为74%,阴性预报率为99.2%.该结果提示革兰氏染色法可以用于健康女性的筛选和女性淋病的诊断