生殖支原体及解脲脲原体在男性不同人群中的感染与定植研究  

A Study on Infection and Colonization of Mycoplasma genitalium and Ureaplasma ureafyticum in Dif- ferent Male Populations

作　　者：蒋娟[1] 叶顺章[1] 韩国柱[1] 王荷英[1] 施美琴[1] 王红春[1] 薛华忠[1] 曹宁校[1] 

机构地区：[1]中国医学科学院中国协和医科大学皮肤病研究所,南京210042

出　　处：《中华皮肤科杂志》2005年第10期600-603,共4页Chinese Journal of Dermatology

摘　　要：目的了解生殖支原体及解脲脲原体在男性不同人群中的流行状况,分析生殖支原体及解脲脲原体与男性非淋菌性尿道炎的相关性。方法病例对照研究结合横断面研究,采集性病门诊非淋菌性尿道炎患者、性病门诊无尿道炎的就诊者、男男性接触者及健康体检者4组人群的尿道拭子标本,运用培养法和套式PCR法检测解脲脲原体,套式PCR和产物DNA测序检测生殖支原体。结果生殖支原体检出率非淋菌性尿道炎患者组为25.0％,无尿道炎的就诊者组6.4％,男男性接触者组5.5％,健康体检者组未检出。各组与健康体检者组比较差异均有统计学意义,而非淋菌性尿道炎患者与无尿道炎的就诊者、非淋菌性尿道炎患者与男男性接触者比较,P均<0.01,无尿道炎的就诊者与男男性接触者比较,P>0.05。多因素回归分析发现,尿道炎与生殖支原体阳性率显著相关,P=0.004,OR=6.754,95％CI1.833～24.893。解脲脲原体PCR阳性率在非淋菌性尿道炎患者、无尿道炎的就诊者、健康体检者组间差异无统计学意义。男男性接触者组的解脲脲原体阳性率明显低于其他三组。结论生殖支原体与非淋菌性尿道炎高度相关,男性高危性行为人群中生殖支原体的感染率较普通人群高。解脲脲原体定植在男性非淋菌性尿道炎患者、性行为高危人群及普通人群间无差异,与非淋菌性尿道炎无相关性。Objectives To investigate the infection and colonization of Mycoplasma genitalium and Ureaplasma urealyticum in different male populations, to explore the association of M, genitalium and U, urealyticum with nongonococcal urethritis （NGU） respectively. Methods A case-controlled, cross sectional study of four different male populations was performed, namely： NGU patients （G1）, non-NGU subjects attending STD clinic （G2）, men who had sex with men participating in a health education program （G3）, and healthy volunteers （G4）. Nested PCR and culture were used to detect U. urealyticum. Nested PCR and PCR product sequencing were applied to detect M. genitalium. Results The prevalence rates of M. genitalium in the four study populations were 25.0%（25/100）, 6.4%（6/94）, 5.5%（6/110） and 0% respectively. Significant difference was found between each two groups except G2 - G3 with a p value of 0.80. By multivariate regression analysis, controlling for the age of first sex, new sexual partners, urethritis and condom use in the previous 3 months, M. genitalium was only associated with urethritis （P = 0.004, OR = 6.754, 95% CI 1.833-24.893）. The direct sequencing of PCR products showed gene mutations, in comparison with the reference sequence in GenBank, in 3 samples. The prevalence rates of U. urealyticum by PCR in 4 groups were 40.0%, 44.7%, 22.7% and 46.9% respectively, and there was no significant difference between G1 - G2, G1 - C,4 or G2-C,4 with a p value of 0.419, 0.325, 0.868 respectively, but the prevalence rate of U. ureolyticum in G3 was significantly lower than that in other groups. Conclusions M. genitalium is strongly associated with NGU and the prevalence rate is significantly higher in groups with high risk sexual behaviors than that in general population. There is no association between the colonization of U. urealyticum and NGU.

关 键 词：支原体属 尿素支原体 尿素分解 尿道炎 同性恋 男性 男性非淋菌性尿道炎 生殖支原体 解脲脲原体 不同人群 

分 类 号：R759[医药卫生—皮肤病学与性病学]