312例性病门诊患者病原体感染情况的分析

目的了解性病门诊患者尿道(宫颈)炎病原体的检出情况,为临床治疗性病提供依据。方法 312例尿道(宫颈)炎患者的标本进行分泌物涂片,淋球菌培养、沙眼衣原体检测及解脲支原体和人型支原体培养。结果 312例病例中,单纯淋球菌感染44例,占14.10%;单纯沙眼衣原体感染26例,占8.33%;单纯解脲支原体感染86例,占27.56%;单纯人型支原体感染4例,占1.28%;沙眼衣原体合并解脲支原体感染24例,占7.69%;淋球菌、沙眼衣原体和解脲支原体合并感染6例,占1.92%;淋球菌合并解脲支原体感染10例,占3.21%;解脲支原体合并人型支原体感染38例,占12.19%;另外白色念珠菌感染的10例;滴虫感染的6例;其他查不到病原菌的有58例,占18.59%。结论解脲支原体检出比例较高,混合感染情况增多,建议尿道(宫颈)炎患者进行常规性多病原体检查。     

420例非淋球菌性生殖道感染患者的解脲支原体和沙眼衣原体感染分析

目的了解本地区非淋球菌性生殖道感染患者的解脲支原体和沙眼衣原体感染状况。方法利用实时荧光聚合酶链反应方法(FQ-PCR)对2010和2011年来院就诊的420例非淋球菌性生殖道感染患者的泌尿生殖道分泌物同时作解脲支原体和沙眼衣原体检测。结果检出阳性病例211例,阳性率50.0%,(211/420):其中解脲支原体,沙眼衣原体和混合感染的阳性检出率分别为31.9%(134/420),11.7%(49/420)和6.7%(28/420),沙眼衣原体和解脲支原体的感染差异有统计学意义,解脲支原体高于沙眼衣原体;不同性别在不同病原体感染中有所不同,总体上女性感染高于男性(P<0.05),在解脲支原体单一感染差异两性差异有统计学意义(P<0.05),且女性高于男性,但在沙眼衣原体单一感染和两种病原体混合感染中两性差异无统计学意义。结论本地区解脲支原体是非淋球菌性生殖道感染患者的主要病原体,女性呈明显高感染状况,实时荧光聚合酶链反应可作为临床检测的解脲支原体和沙眼衣原体的实验方法。     

实时荧光PCR检测生殖器单纯疱疹病毒(Ⅱ)核酸

近几年来,皮肤性病门诊患者中临床表现为不典型和无临床表现的单纯疱疹病毒感染逐渐增多。从而使有疱疹史而无临床症状的带菌者成为该病的主要传染源。生殖器单纯疱疹病毒（HSV-Ⅱ）与其它病原菌同时感染时,临床医生往往只注重淋菌、沙眼衣原体、支原体的检测和治疗而忽视HSV-Ⅱ的检测和治疗。本文应用荧光PCR对可疑单纯疱疹感染患者的泌尿道分泌物及生殖器周围皮肤渗出液、疱疹液进行HSV-Ⅱ DNA检测。     

输卵管妊娠与生殖道解脲支原体和沙眼衣原体感染的关系分析

目的 探讨生殖道解脲支原体和沙眼衣原体感染与输卵管妊娠的关系。方法 采用回顾性分析,选择3年来我院输卵管妊娠患者87例为研究对象,选择同期正常早期妊娠妇女106例为对照组。采用宫颈分泌物分离培养及胶体金方法 分别检测解脲支原体和沙眼衣原体感染情况。结果 病例组87例输卵管妊娠患者中有34例(39.08%)UU感染,其中11例(12.64%)同时感染CT,21例(24.14%)为单纯CT感染。对照组106例患者中有20例(18.87%)UU感染,其中例5例(4.71%)同时感染CT,12例(11.32%)为单纯CT感染。病例组与对照组比较,差异有统计学意义P<0.05。结论 生殖道解脲支原体和沙眼衣原体感染增加输卵管炎及盆腔炎的发生,与输卵管妊娠关系密切。     

妇科门诊患者性传播疾病病原体感染临床检测分析

<正>性传播疾病(sexually transmitted diseases,STD)是一类以性接触为主要传播方式的泌尿生殖道感染性疾病。STD病原体主要有以下几种:解脲支原体(UU)、沙眼衣原体(CT)、淋球菌(NG)、人乳头瘤病毒(HPV)、单纯疱疹病毒Ⅱ型(HSV-Ⅱ)、部分真菌等。其中UU、CT、NG是3种最常见的性传播疾病的病原体。其中解脲支原体是支原体感染最常见     

尖锐湿疣合并其他病原体感染

目的 探讨尖锐湿疣患者中感染沙眼衣原体、解脲支原体和人型支原体情况。方法 回顾分析了151例尖锐湿疣中检出沙眼衣原体、解脲支原体和成人型支原体123例（81,45）。结论 尖锐湿疣合并沙眼衣原体、解脲支原体和人型支原体的率较高,且与年龄密切相关。     

男性生殖道病原体感染情况分析探讨

目的:探讨成年男性患者生殖道淋球菌、支原体、和沙眼衣原体等多种病原体的感染情况和流行趋势。方法:选择2010年1月-2012年9月在我院皮肤科门诊和泌尿科就诊的成年男性泌尿生殖道感染患者240例,对其生殖器分泌物进行淋球菌(NG)、支原体(UU)和沙眼衣原体CT)等多种病原体的培养和检测。结果:所有病例中检测出病原体193例,总检出率为80.4%。其中支原体70例,沙眼衣原体37例,淋球菌46例。结论:男性泌尿生殖道感染是影响人们健康的一种重要的性传播疾病,主要由解脲脲原体、沙眼衣原体等病原体引起,治疗前病原体检测对临床合理治疗具有重要的指导意义。     

240例儿童性病临床观察及相关因素分析

目的探讨儿童性病的构成与传播途径。方法利用病原体培养法、抗体检测(ELISA、DIGFA)、5％冰醋酸发白试验、病理、快速血浆反应素试验(RPR)等结合临床诊断,并进行详细分析。结果240例患者中感染沙眼衣原体(CT)58例、解脲支原体(UU)46例、人型支原体(Mh)14例、淋球菌(GU)42例、尖锐湿疣(CA)16例、生殖器疱疹(GH)10例、梅毒螺旋体(TP)6例、混合感染48例,以女性儿童感染者多见,主要由家庭成员传染。结论儿童性病主要病种是非淋茵性尿道炎(NGU）、淋病、尖锐湿疣、生殖器疱疹、梅毒(SY)等,与成人性病构成相似。加强健康教育,控制成人感染是预防儿童性病的关键。     

不育患者子宫输卵管造影结果分析

目的:探讨不育患者输卵管不通的因素。方法:选择2009年6月—2011年6月不孕症门诊做子宫输卵管造影(HSG)的患者320例,其中原发不育180例,继发不育140例,年龄19～37岁。术前常规检测沙眼衣原体和解脲脲原体。结果:320例不孕症门诊做HSG的患者输卵管双侧通畅者154例,其中有6例感染沙眼衣原体或解脲脲原体,感染率3.9%;输卵管一侧通畅者76例中有10例感染沙眼衣原体或解脲脲原体,3例同时感染沙眼衣原体和解脲脲原体,感染率17.10%(13/76);输卵管不通者90例患者中28例感染沙眼衣原体或解脲脲原体,8例同时感染沙眼衣原体或解脲脲原体,感染率40.00%(36/90),结果表明输卵管不通与感染沙眼衣原体或解脲脲原体相关,沙眼衣原体或解脲脲原体感染会导致输卵管不通。结论:不育患者输卵管不通与感染沙眼衣原体或解脲脲原体相关。     

79例淋病患者沙眼衣原体和解脲支原体混合感染情况分析

目的 探讨淋病患者沙眼衣原体和解脲支原体混合感染情况。方法 采用沙眼衣原体抗原快速检测法和解脲支原体培养法对79例淋病患者进行沙眼衣原体和解脲支原体检测。结果 79例淋病患者中，沙眼衣原体阳性17例(21．5％)，解脲支原体阳性42例(43．2％)，沙眼衣原体和解脲支原体同时阳性6例(7．6％)，总阳性数65例(82．3％)。结论 淋病患者的混合感染情况比较严重，临床上对于淋病患者的检测与治疗，一定不可忽视其沙眼衣原体和解脲支原体的混合感染。     

女性输卵管性不孕与生殖道解脲支原体衣原体感染的相关性分析

目的探讨生殖道解脲支原体、衣原体感染与女性输卵管性不孕的关系。方法68例输卵管因素不孕患者作为观察组,57例非输卵管因素不孕患者作为对照组,取宫颈拭子进行解脲支原体（UU）、衣原体（CT）的培养。结果输卵管性不孕组患者的UU和CT感染高于对照组,有统计学意义;但CT、UU的混合感染差异无统计学意义。结论女性下生殖道CT、UU感染与输卵管性不孕有相关性。     

连云港地区非淋菌性尿道炎患者沙眼衣原体抗原及支原体检测结果分析

目的 分析连云港地区非淋菌性尿道炎患者病原体感染情况及支原体对药物的敏感性,为临床诊断及治疗提供依据。方法 以免疫层析法检测沙眼衣原体抗原,以培养法检测支原体及药物敏感性,并对结果进行分析。结果 144例非淋菌性尿道炎患者中共检出沙眼衣原体11例（7.64%）,检出解脲支原体65例（45.14%）,人型支原体19例（13.19%）;支原体的药物敏感试验情况看,解脲支原体耐药率最低的药物是美满霉素（10.17%）、强力霉素（11.85%）;耐药性最高的药物是氧氟沙星（66.10%）、司帕沙星（40.68%）;人型支原体耐药率最低的是强力霉素（26.32%）、美满霉素（26.32%）;耐药率最高的是阿奇霉素（94.75%）、氧氟沙星（89.47%）、克拉霉素（89.47%）、罗红霉素（89.47%）;多重耐药情况（耐三种及以上）：解脲支原体（55.93%）,人型支原体（89.47%）。结论 连云港地区非淋菌性尿道炎患者以支原体感染为主;支原体药物敏感试验具有重要意义;临床标本中支原体多重耐药现象应引起高度重视。     

Aetiology of male urethritis in patients recruited from a population with a high HIV prevalence

The aetiology of urethritis, the significance of potential pathogens and the relation of urethritis to HIV infection were determined in 335 men (cases) with and 100 men (controls) without urethral symptoms. Urethral swab specimens were tested for different organisms by PCR or by culture for Neisseria gonorrhoeae. The prevalence of N. gonorrhoeae and Chlamydia trachomatis was 52 and 16%, respectively. The potential pathogens: Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis and herpes simplex virus (HSV), were present in 5, 36, 6 and 6% of the cases respectively. M. genitalium was the only potential pathogen associated with microscopic urethritis. After excluding gonococcal infections, U. urealyticum was more frequent in symptomatic patients, while the prevalence of T. vaginalis was similar among cases and controls. These results strongly suggest an a etiological role for M. genitalium in male urethritis, a possible role for U. urealyticum, but not for T. vaginalis. The control group, with 97% genital ulcer disease patients, was not suitable for the investigation of the role of HSV. The sero-prevalence of HIV was 45%. Current infections were not associated with HIV. However, a history of previous urethral discharge was associated with HIV in a multivariate analysis and supported the hypothesis that non-ulcerative sexually transmitted diseases facilitate HIV transmission.     

淋球菌感染与其他性传播性疾病感染关系的研究

目的探讨高危妇女中淋病的发生率及与生殖道其他感染的关系。方法应用T—M培养基、连接酶链反应（LCR）、TPHA、RPR、阴液革兰染色涂片等对966例高危妇女进行淋病、衣原体、梅毒、HIV、尖锐湿疣、念珠、滴虫和细菌性阴道炎检查。结果966例自愿者中检出淋病172例，发生率17．80％。合并阴道其他感染87．79％，合并衣原体感染41．27％，合并梅毒11．62％，合并尖锐湿疣7．5％，合并HIV1．74％，总合并感染率高达95．94％，仅为单一的淋病患者4．06％。结论淋病患者合并其他生殖感染及性病发生率高，特别是合并阴道感染发生率最高，因此对反复阴道感染或治疗效果欠佳的阴道炎应注意合并淋球菌感染，对发现淋病的患者应同时进行其他生殖感染及性病的检查，以免漏诊，提高诊断率。     

生殖器疱疹及其疫苗的研究进展

生殖器疱疹由单纯疱疹病毒（herpes simplex virus,HSV）感染所致,在世界范围内广泛流行。HSV可在宿主体内建立终身潜伏感染,并引起严重的复发性疾病。此外,HSV感染还能明显增加HIV感染的机率。虽然目前抗HSV药物有一定作用,但是不能防止潜伏HSV复活。因此, 亟需研制有效的疫苗来控制HSV感染、限制疾病传播和复发。此文对生殖器疱疹的病原学、流行病学及疫苗的研究进展做一综述。     

Reducing the risk of transmitting genital herpes: advances in understanding and therapy

ABSTRACT

Background: This review considers the epidemiology and impact of genital herpes, discusses how herpes simplex virus‐2 (HSV‐2) is transmitted, and reviews data on methods of reducing the risk of HSV transmission.

Scope: Information for the paper was identified through multiple PubMed searches. Information in the section on interventions was identified through PubMed searches using several pairs of key words (herpes and transmission, herpes and treatment, herpes and antiviral, herpes and valacyclovir, herpes and famciclovir, herpes and acyclovir, herpes and condom, herpes and clinical trial). The searches, conducted in January 2005, did not have date limits. Papers were selected for inclusion based on the author's judgment of their relevance to the topic of the review.

Findings: An estimated 45 million persons in the United States have genital herpes infection, and new infections occur at a rate of approximately one million per year. Approximately 85% to 90% of infections are unrecognized and therefore undiagnosed. Individuals with genital HSV‐2 infection shed virus during asymptomatic periods as well as symptomatic periods. In fact, transmission frequently occurs during periods of asymptomatic viral shedding. Asymptomatic viral shedding (1) occurs in the majority of patients with genital HSV‐2 infection; (2) accounts for approximately one third of the days of viral shedding; (3) occurs regardless of duration of infection but is most frequent during the first year after infection; (4) occurs more than 7 days before or after a symptomatic recurrence 50% of the time; and (5) does not differ significantly when comparing patients with 1 to 12 annual recurrences to those with no recurrences. A recently published study of discordant couples counseled on safe sex practices found that once daily suppressive therapy with valacyclovir reduced the risk of transmission of HSV‐2 in heterosexual immunocompetent adult couples discordant for HSV‐2 infection. In an 8-month study, daily valacyclovir compared with placebo reduced the risk of acquisition of symptomatic genital HSV‐2 infection by 75% (2.2% placebo vs. 0.5% valacyclovir; hazard ratio = 0.25; p = 0.008). The overall risk of acquisition of HSV‐2 infection (defined via laboratory-confirmed symptoms or seroconversion) was reduced by 48% (3.6% placebo vs. 1.9% valacyclovir hazard ratio = 0.52; p = 0.04). The most common adverse events in the study were headache, nasopharyngitis, and upper respiratory infection.

Conclusion: Daily suppressive therapy is recommended as a therapeutic option for HSV‐2-seropositive individuals at risk of transmitting HSV‐2. Because no intervention completely protects against transmission of HSV, infected individuals and their partners should be counseled to use safer sex practices, including the use of condoms.     

Resiquimod: a new immune response modifier with potential as a vaccine adjuvant for Th1 immune responses

Genital herpes is one of the most common sexually transmitted diseases worldwide. Currently, there are three FDA-approved nucleoside analogs and other therapies such as foscarnet and cidofovir used to treat genital herpes. Resiquimod, the latest immune response modifier (IRM), has shown in vivo evidence of efficacy against herpes simplex virus (HSV) type 2. The first clinical trial involving resiquimod demonstrated that it reduced the recurrence rate of genital herpes, but phase III trials were suspended due to lack of efficacy. Resiquimod shows promise for other viral infections and as a vaccine adjuvant.     

两种方法检测梅毒螺旋体结果分析

目的了解不同方法检测梅毒螺旋体结果的符合程度。方法分别采集患者皮损拭净后轻刮或挤压至出渗液,用棉拭子取渗液作为PCR检测梅毒螺旋体标本,或棉拭子扦入男性尿道2~3 cm,女性宫颈管1~1.5 cm处取材作为PCR检测其他性病病原体标本,同时取患者血清作为RPR检测标本。结果两种方法平行检测硬下疳、扁平湿疣及梅毒性斑丘疹患者的结果差异有统计学意义,其检出率也有较大的差异,PCR检测所得的结果均比RPR高。另外,STD患者中单纯梅毒螺旋体感染占构成比例80.68%(71/88)。合并感染其他STD病占19.32%(17/88),其中合并感染淋球病6例,沙眼衣原体4例,解脲支原体3例,人乳头瘤2例,单纯疱疹病毒2例。结论RPR和PCR虽是临床常用的检测方法,但是只是初筛试验,不能作为临床诊断梅毒的指标,需做TPPA进行确诊试验,才能诊断。     

生殖器溃疡116例临床分析

目的探讨在疾病预防控制中心皮肤病性病门诊中以生殖器溃疡为主要临床表现的病因和病种。方法按照统一的诊断标准,实验室检查和临床分析116例生殖器溃疡患者的临床资料。结果116例生殖器溃疡患者中有梅毒患者25例,占21.4%;生殖器疱疹患者27例,占23.2%;尖锐湿疣患者27例,占23.2%;霉菌感染患者12例,占10.3%;还有其他原因引起的龟头包皮炎25例,占21.4%。就诊的本组病例中有生殖器溃疡表现的男性患者有103例,占总数的88.79%。结论结果表明在皮肤病性病门诊中就诊的有生殖器溃疡临床表现的主要病种包括性传播疾病:梅毒、生殖器疱疹、尖锐湿疣和霉菌感染,占到总数的78.4%。     

稽留流产122例的相关因素分析

目的探讨稽留流产的发生原因,寻找预防和降低稽留流产发生的方法和途径。方法总结2011年1至12月122例稽留流产病例,门诊同期正常妊娠人工流产100例作为对照,对与稽留流产相关的各种因素进行分析。结果感染因素所致稽留流产占58．20％（71／122）,其中沙眼衣原体（CT）、解脲支原体（UU）感染占56．56％（69／122）;TORCH（弓形虫、风疹病毒、巨细胞病毒、疱疹病毒总称）感染占1．64％（2／122）。人工流产组沙眼衣原体（CT）、解脲支原体（UU）感染占8．00％（8／100）;TORCH感染未检出（0／100）。稽留流产组沙眼衣原体（CT）、解脲支原体（UU）检出率明显高于人工流产组（P〈0．05）。CT、UU感染与稽留流产密切相关（P〈0．05）,TORCH感染与稽留流产无关（P〉0．05）。结论生殖道解脲支原体（UU）、沙眼衣原体（CT）感染与稽留流产关系密切,是造成稽留流产的病因之一。