女性生殖道沙眼衣原体感染

沙眼衣原体 (chlamydia trachom atis CT)是一种常见的性传播疾病病原体 ,我国人群中 CT感染率呈上升的趋势 ,可引起前庭大腺炎、宫颈炎、输卵管炎、盆腔炎、异位妊娠、不育等多种疾病。孕妇感染 CT通过宫内感染等方式 ,直接损害发育中的胎儿 ,导致自然流产、早产、胎膜早破、死产、死胎等严重后果。CT感染的细胞表面有 CT抗原存在 ,可诱导机体自身免疫反应 ,造成损害 ;子宫内膜细胞、蜕膜细胞或胎儿滋养层细胞急性或持续性 CT感染 ,可根本性的改变母胎的耐受机制 ,造成妊娠的失败。CT主要通过性交传播 ,母婴间可通过宫内感染、产道感染、产褥期感染等方式垂直传播 CT。 CT的诊断主要依赖实验室检查。 CT的治疗首选四环素类药物、大环内酯类为次选药物、再选喹诺酮类药物、绝大多数的青霉素类药物对 CT无效 ,一般不应使用 ,但可用羟氨苄青霉素治疗。妊娠期感染 CT的孕妇 ,可给予红霉素或阿莫西林治疗 ,不能用四环素类药物和喹诺酮类药物     

女性生殖道沙眼衣原体感染的诊治

生殖道沙眼衣原体感染是最常见的性传播疾病之一,明确诊断需依据实验室检测。由于患者早期症状多不明显,而女性持续或反复感染常导致严重并发症,因而早诊断、及时有效的规范化治疗并追踪随访对患者具有十分重要的意义。近年来核酸扩增等分子生物学技术的发展和标本取材方法的改进都极大地推动了沙眼衣原体感染的筛查,目前最好的公共健康干预手段是增加筛查率和积极治疗感染者,同时不能忽视性健康教育为基础的一级预防。     

女性生殖道沙眼衣原体感染诊治共识

<正>女性生殖道沙眼衣原体感染(female genital chlamydial infections)是由沙眼衣原体(chlamydia trachomatis,CT)感染女性生殖器官引起的性传播疾病(sexually transmitted diseases,STD),主要通过性传播,也可母婴传播,前者可引起STD在社会上的蔓延,后者可导致胎儿及新生儿的感染。目前生殖道CT感染是世界范围内最常见的STD之一,在发达国家占STD首位[1];根据2008年中国疾控     

沙眼衣原体与女性生殖系统的感染

沙眼衣原体病是当今西方国家最常见的性传播性疾病之一。自６０年代至今，沙眼衣原体病的发病率呈现一种上升的趋势。本文综述了沙眼衣原体女性生殖道感染的世界流行趋势；女性下生殖道的感染；盆腔炎；卵管性不孕症；输卵管妊娠；不同避孕方式与沙眼衣原体感染的相关性；以及妊娠期沙眼衣原体的感染。     

生殖道沙眼衣原体检测与临床分析

生殖道沙眼衣原体检测与临床分析纪祥瑞，吴荣，藏秀美，赵玉田，郭成，林爱风，何志诚本研究以女性生殖道的子宫颈、子宫内膜、输卵管感染及流产病例为研究对象，采用免疫组化方法对病变组织进行沙眼衣原体检测。检测结果分析如下。一、材料与方法１．病例选择：组织学证...     

妊娠期沙眼衣原体感染

阴道分娩时沙眼衣原体传播给胎儿可致结膜炎和肺炎;妊娠期沙眼衣原体感染可能与某些并发症如早期破膜、早产、低出生体重和死产有关。沙眼衣原体感染也可能与流产后、剖宫产后和产后母体感染有关。美国疾病控制中心(CDC)推荐采用新的筛查和治疗方案,有利于预防新生儿病率。     

女性生殖道沙眼衣原体感染与细胞凋亡

沙眼衣原体为目前最常见的性传播疾病病原体之一，且感染女性生殖道的机会远远高于感染男性生殖道。由于沙眼衣原体感染常常无症状或症状很轻，所以常不被重视，往往是体检时被发现，这可导致严重并发症的发生及传播更加扩散。本文将就沙眼衣原体感染女性生殖道的风险因素及与其他性传播疾病(STD)之间的关系，以及女性生殖道沙眼衣原体感染所致的细胞凋亡情况做一综述。     

生殖道沙眼衣原体感染与发生输卵管妊娠的关系

沙眼衣原体 (ＣＴ)感染已成为主要的性传播疾病 ,与异位妊娠发生有关[1] 。本研究目的是探讨生殖道ＣＴ感染与发生输卵管妊娠的关系。一、资料与方法1 研究对象 :为 1996年 10月至 1998年 3月在同济医科大学附属同济医院、广东省东莞市妇幼保健院经手术和病理检查确诊为输卵管妊娠患者 ,6 0例 (观察组 ) ,平均年龄 32 .5岁 ;同期选择行输卵管结扎术、卵巢囊肿行附件切除术或子宫肌瘤行子宫及部分输卵管切除术患者 6 0例 ,为对照组 ,平均年龄为 33.4岁 ,无异位妊娠史。2 方法 :(1)标本收集 :均抽取静脉血 3ｍｌ,取血清待检。手术前 ,将棉签…     

男性生殖道沙眼衣原体感染及其对生育力的影响

早在1900年就首次报告沙眼衣原体和鹦鹉热衣原体引起沙眼和各种生殖道感染。1956年以后．广泛深入地研究了该病原体所致男女性生殖道感染，八十年代后，报道了该类感染可致输卵管因素不育。目前沙眼衣原体感染列为最常见的性传播疾病．美国生殖道沙眼衣原体感染的发病人数为4百     

沙眼衣原体感染与妊娠

沙眼衣原体是目前感染率最高的性传播性疾病病原体,为引起妊娠期下生殖道感染的重要病原体。因其感染常呈亚临床状态,实验室检测对设备及技术要求高,临床医师相关知识欠缺,以及缺乏充足条件筛选高危人群并进行追踪治疗性伴侣,其潜在危害十分重大。妊娠期沙眼衣原体感染对妊娠有诸多不良影响：病原体本身造成的损伤机制及其引发的免疫反应是造成流产、胎儿生长受限、胎儿窘迫、胎膜早破、早产、低出生体质量儿、死胎、宫内感染、新生儿感染、产褥期感染和产后出血的原因之一。因此,有针对性地及时检查和治疗沙眼衣原体感染是降低母婴病率,提高围生期保健质量的重要举措。     

Limitations of screening tests for the detection of Chlamydia trachomatis in asymptomatic adolescent and young adult women

OBJECTIVE: The purpose of this study was to examine the performance of different test types, specimen sources, and collection methods for screening of genital Chlamydia trachomatis infection in young women. STUDY DESIGN: Asymptomatic women aged 16 to 25 years collected their own vaginal swabs and a first-voided urine specimen; a clinician collected urethral, vaginal, and endocervical swabs for culture and nucleic acid amplification tests, polymerase chain reaction and ligase chain reaction. A positive culture, 2 positive nucleic acid amplification tests, or 1 positive nucleic acid amplification test confirmed by a separate nested polymerase chain reaction comprised the criterion standard to define a C. trachomatis-infected woman. RESULTS: The prevalence of C. trachomatis was 22% (30/139 women). All 9 test results were available for 126 participants (91%). Sensitivities were comparable for polymerase chain reaction and ligase chain reaction (52%-63%), except for urine polymerase chain reaction (44%), and were lower for culture (22%-37%); specificities were 99% to 100%, except for urine ligase chain reaction (91%). Positive predictive values were >93%, except for urine ligase chain reaction (65%); negative predictive values were 83% to 91%. Combining nucleic acid amplification test results from 2 different specimens improved sensitivities without compromising specificity. CONCLUSION: When C. trachomatis infection was defined by multiple tests from different specimen sources, the sensitivity of any 1 test from a single specimen source was lower than generally reported. The limitations of the use of a single test to identify C. trachomatis infection should be considered when test type, specimen source, and collection method for screening young women is being determined.     

客观评价子宫内膜癌筛查方法

子宫内膜癌发病率上升,高危人群增多,应该高度关注子宫内膜癌筛查,临床上应用的子宫内膜癌筛查方法有子宫内膜脱落细胞学检查、子宫内膜脱落细胞块病理检查和子宫内膜微量组织获取检查。3种方法各有优缺点。目前,尚缺乏理想的子宫内膜癌筛查方法。     

The long term follow-up of asymptomatic women with Chlamydia trachomatis

Summary A community oriented intervention program was initiated in 1985 in 12 rural communities in southern Israel to identify and treat women of reproductive age with markers of Chlamydia trachomatis (CT) infection. Among 860 women tested, 21 (2.4%) had CT IgG antibody titers ≥128, or CT IgA antibody titers ≥16, and 9 of these women had positive cultures for CT. The 21 women, as well as their male partners, received specific anti-CT treatment, and were followed up for 5 years to assess obstetric complications, and to evaluate the effectiveness of treatment. In 9 women positive cultures became negative. In 13 out of the 17 cases with sequential follow-up a four fold decrease in IgG specific antibody titers was observed. Yet, in all but two of the cases, IgA specific antibody titers remained ≥16.     

应用宫内节育器的妇女沙眼衣原体感染与子宫内膜中铜含量的关系

目的:探讨女性生殖道沙眼衣原体(CT)感染与宫内节育器(IUD)种类及内膜中铜含量的关系。方法:用聚合酶链反应检测65例置含铜IUD及97例置不锈钢单环的妇女宫颈分泌物CT;对因症取出IUD的20例妇女,取器后刮取子宫内膜,用原子吸收分光光度法测子宫内膜铜含量。结果:放置含铜IUD者CT感染率(3.1%)明显低于置不锈钢单环者(12.3%),P<0.05;放置含铜IUD的妇女子宫内膜铜含量明显高于置不锈钢单环者(P<0.05)。结论:含铜IUD对生殖道CT感染有抑制作用。含铜IUD可能通过释放的铜离子来发挥抗CT作用。     

Effect of treatment for Chlamydia trachomatis during pregnancy.

OBJECTIVES: To screen and treat chlamydial infection in pregnant women in order to assess the effects of therapeutic intervention on the outcome of Chlamydia trachomatis-infected pregnancy. METHODS: Enrolled in the study were 350 women in the first to third trimesters of pregnancy. Endocervical swabs were collected for C. trachomatis diagnosis by DFA and PCR. A few STD infections, viz.: Neisseria gonorrhoeae, Candida spp., bacterial vaginosis, Trichomonas vaginalis and Treponema pallidum were ruled out. After excluding 22 patients infected with other sexually transmitted infections, a cohort of 328 pregnant women comprised the study population. Anti-chlamydial treatment (viz.: oral therapy with erythromycin stearate, 500 mg 4 times daily for 7 days) was given to 17 women (group I) and their partners. Fifteen patients of group I were retested by DFA and PCR assay for C. trachomatis infection 2 weeks following therapy. Other Chlamydia-positive patients (n=42) who were lost to follow-up were classified as untreated positive cases (group II) while group III included C. trachomatis negative cases (n=269). Data on obstetric outcome were recorded in a total of 164 cases. Statistical comparison of the data were done using the chi(2)-test and means were compared using Student's t-test. RESULTS: Among the 350 pregnant women enrolled initially for the study, C. trachomatis positivity was found to be 18.8% (n=66) in the endocervix by DFA and PCR assay. Co-infection with Candida spp., bacterial vaginosis, T. vaginalis and T. pallidum was 2.0%, 1.7%, 1.7% and 0.5%, respectively. None of the pregnant women was infected with N. gonorrhoeae. Pregnant women at an increased risk of chlamydial infection included those who had multiple births and were in second trimester of pregnancy. Fifteen patients of group I became Chlamydia-negative following treatment. Data on obstetric outcome were recorded in 11, 26 and 127 patients of groups I, II and III, respectively. The mean duration of gestation for premature deliveries was found to be significantly higher in group I in comparison with group II [35.5 vs. 33.1 weeks (P<0.05)], thereby showing an improved effect of treatment on pregnancy outcome. The mean of low birth weight births was higher in group I compared with group II (2200.0 vs. 2113.3 g), however, this was statistically non-significant. Stillbirths were significantly higher among group II in comparison with group III [11.5% vs. 4.7% (chi(2)=1.79; P<0.5)]. No stillbirths were recorded in patients who had taken anti-chlamydial treatment. CONCLUSIONS: Our findings suggest that routine screening and treatment of C. trachomatis infection in pregnant women, especially those in high risk groups, should be mandatory to reduce the adverse effects on obstetric outcome.     

孕妇沙眼衣原体、解脲支原体感染对围产结局的影响

目的研究孕妇沙眼衣原体(CT)和解脲支原体(UU)的感染对围产结局的影响。方法选取门诊行产前检查及住院待产的正常孕妇149例,采用ELISA方法检测母体血清中的抗UUIgG和抗CTIgG抗体,二者均未检出者作为对照组,对所有对象随访至妊娠结束,并详细记录分娩过程及新生儿情况。结果与对照组相比,UUIgG阳性组及复合阳性组[UUIgG( )且CTIgG( )]其早产、胎膜早破及死胎、畸胎的发生率具有显著性差异(P<0.05,P<0.05,P<0.05;P<0.01,P<0.05,P<0.01)。结论UU、CT感染可以引起不良妊娠结局,如早产、胎膜早破、畸胎、死胎,应积极预防和治疗。