合肥市性病门诊诊断正确性评估

目的：评估合肥市性病门诊实验室检测和临床医生诊断性传播疾病（STD）的准确性。方法：对就诊的首诊男性病人为调查对象，实验室结果与国家级性病实验室结果进行比较，使用Epi-Infor6.12软件统计分析。结果：347例调查对象中，240例经国家级检测中心检测淋球菌阳性或沙眼衣原体阳性，310例根据临床实验室检测为阳性。衣原体临床实验室检测的灵敏度和阳性预测值（PPS）分别为55％和26％，医师诊断的灵敏度和阳性预测值为61％和24％。临床实验室检测和医师诊断对于发现混合感染的能力较低，医师诊断梅毒和单纯疱疹病毒（HSV）的阳性预测值分别为50％和43％，表明梅毒和HSV存在误诊。结论：性病临床医生和实验室检测质量不高，经常把STD误诊。

Assessment on the validity of diagnosing STD at STD clinic in Hefei

Objective To assess the validity of detecting report of sexually transmitted disease(STD) in clinic laboratory and the validity of the diagnosis of clinical physicians. Methods 4 legitimate clinics of STD in Hefei were selected and the male patients who saw a doctor for the first time from March to July in 2002 were investigated. The detected and diagnosed results of these subjects in the 4 clinics were compared with one in national STD laboratory. Results The sensitivity and the positive predictive value of chlamydiae detecting in STD clinic laboratory were 55% and 26%, that in clinical physicians were 61% and 24%. The positive predictive value of diagnosing syphilis and herpes simplex virus(HSV) in clinical physicians were 50% and 43%, respectively. Conclusions The quality of the clinical physicians' diagnosis and the detecting of laboratory in STD clinics is poor, and it was possible to misdiagnose STD frequently.