钟永军+韦海鹏+陈镇+陈国英+张娟华+苏腾良+黄慧嫦+曾华

【摘要】目的了解本地區泌尿生殖道感染首诊患者解脲支原体（UU）、沙眼衣原体（CT）、淋球菌（NG）、梅毒螺旋体（TP）、人类免疫缺陷病毒（HIV）等性传播疾病病原体感染检出情况，为规范化性病门诊的干预和防治提供参考。方法前瞻性收集2014年6月1日至2016年8月1日期间590份以泌尿生殖道症状为主诉的首诊患者泌尿生殖道标本的病原学检测及血清TP抗体、HIV抗体检测结果进行统计学描述与分析。结果对590名患者泌尿生殖道分泌物标本进行UU、CT和NG检测，采集血液标本进行TP抗体、HIV抗体检测，共检出阳性标本300 份（阳性检出率50.85%）。其中泌尿生殖道感染阳性标本293 份（占49.66%），TP阳性6 例（占1.02%），HIV为1 例（占0.17%）。三种病原体（UU、CT、NG）阳性病例中单一感染275 例（占46.61%），其中UU、CT和NG检出率分别为39.83%、4.58%和2.20%，三者结果间差异有统计学意义（P<0.01）；混合感染18 例（占3.05%），其中UU+CT、UU+NG、CT+NG以及UU+CT+NG的阳性率分别为1.86%、0.51%、 0.34%和 0.34%，差异无统计学意义（P>0.05）；三种病原体（UU、CT、NG）的单一感染检出率比三种病原体混合感染检出率高（P<0.05）。女性病原体总阳性率为66.00%，高于男性的44.09%，差异有统计学意义（P<0.05）。结论泌尿生殖道UU感染检出率在三种病原体中最高，有必要进行常规检查；单一感染模式病原体检出率显著高于混合感染模式；女性在三种病原体总体传播过程中相比男性更容易感染。对泌尿生殖道症状首诊患者应同时进行多项病原体、血清TP抗体及HIV抗体检测，尽早实施规范化性病门诊对性传播疾病的防治有着重要意义。

【关键词】泌尿生殖道病原体；梅毒螺旋体；人类免疫缺陷病毒；规范化性病门诊

中图分类号：R512.91文献标识码：ADOI：10.3969/j.issn.1003-1383.2017.04.008

【Abstract】ObjectiveTo study the detection of pathogen infection of sexually transimitted disease（STD），such as Ureaplasma mycoplasma（UU），Chlamydia trachomatis（CT），Treponema pallidum（TP）and human immunodeficiency virus（HIV），etc on initially-diagnosed patients with urogenital tract infection in Beihai，Guangxi，so as to provide reference for intervention and prevention of standardized STD clinic.Methods590 initially-diagnosed patients with genitourinary tract symptoms were prospectively collected from June 1，2014 to August 1，2016.And then，the detection results of etiology，serum TP and HIV antibodies of urogenital specimens among these patients were statistically described and analyzed.ResultsUU，CT and NG of the urogenital tract secretion specimens among 590 patients were tested，and blood samples were collected for TP antibody and HIV antibody laboratory tests.A total of 300 positive specimens（positive rate was 50.85%）were detected，of which 293 positive samples of urogenital tract infection were detected（accounted for 49.66%），6 TP positive samples were detected（accounted for 1.02%），and 1 HIV positive sample was detected（accounted for 0.17%）.Of the three pathogens （UU，CT，NG）positive cases，275 cases were with single infections（accounted for 46.61%），and the detection rate of UU，CT and NG was 39.83%，4.58% and 2.20% respectively，so there was statistically significant difference between the three groups（P<0.01）.And 18 cases（accounted for 3.05%）were with mixed infection，of which positive rate of UU+CT，UU+NG，CT+NG and UU+CT+NG was 1.86%，0.51%，0.34% and 0.34% respectively，difference was not statistically significant（P>0.05）.The single infection detection rate of UU，CT and NG was higher than that of the mixed infection detection rate of them（P<0.05）.Additionally，the total positive rate of pathogens was 66.00% in female，which was significantly higher than that（44.09%）of male（P<0.05）.ConclusionThe detection rate of UU infection in genitourinary tract is the highest among the three pathogens，and routine examination is necessary.The rate of physical examination in single infection mode was higher than that in mixed infection mode.Females are more likely to become infected than males in the overall transmission of the three pathogens.Therefore，multiple pathogens，serum TP antibodies and HIV antibodies of initially-diagnosed patients with urogenital tract symptoms should be tested.And to implement standardized STD clinics as soon as possible is of great significance to the prevention and treatment of STD.endprint

【Key words】urinary tract pathogens；TP；HIV；standardized STD clinic

泌尿生殖道感染是指生殖器、内生殖器、尿道及附属腺体受到不同病原体的侵犯，导致发生病变，功能损害。解脲支原体（UU）、沙眼衣原体（CT）、淋菌（NG）是泌尿生殖道感染较常见的病原体[1]。近年来我国泌尿生殖道感染的人数日益上升，并呈年轻化趋势，它的危害性极强，若不及时有效治疗，容易反复发作，迁延难愈，对生殖健康造成极大的损害。梅毒、艾滋病对人类的身体健康及心理健康产生极大的影响，也威胁着社会的经济发展。……