STD门诊生殖器溃疡性疾病的病原学研究  

The etiology of genital ulcer disease and its relationship to HIV infection among patients attending sexually transmitted disease clinics

作　　者：朱慧兰[1] 苏向阳[2] 赖维[2] 叶兴东[1] 张锡宝[1] 

机构地区：[1]广州市皮肤病防治所性病科,广东广州510095 [2]中山医科大学第三附属医院皮肤科,广东广州510630

出　　处：《中国微生态学杂志》2005年第5期363-364,共2页Chinese Journal of Microecology

基　　金：广东省科委重点攻关项目(2003C34203);广东省卫生厅基金(B2001100)

摘　　要：目的了解生殖器溃疡性疾病(GUD)的发病率、病因及其与H IV感染的关系。方法用暗视野显微镜检查(D-F)、梅毒血清学试验(STS)、酶免疫法(E IA)检测HSV抗原和HD培养等方法检测322例生殖器溃疡标本中TP、HSV和HD,并进行血清H IV抗体检测。结果在8 999例STD门诊患者中,GUD患者322例(3.58%,322/8 999);在322例GUD患者中,梅毒85例(26.4%,85/322),生殖器疱疹74例(26.09%,84/322),软下疳0例(0,0/322),病因不明的GUD为153例(47.52%,153/322);其中GUD患者的H IV感染率为1.86%(6/322),梅毒患者的H IV感染率为4.70%(4/85),生殖器疱疹患者的H IV感染率为1.19%(1/84),其他GUD的H IV感染率为0.65%(1/153)。比较三者的H IV感染率发现,梅毒的H IV感染率高于生殖器疱疹和其他GUD患者(4.70%vs1.19%,2χ=0.24,P>0.05,OR=3.04,95%C I=0.31-29.93;4.70%vs 0.65%,χ2=1.29,P>0.05,OR=5.63,95%C I=0.58-55.06),但两者差异无显著性;GH患者的H IV感染率与其他GUD患者的H IV感染率相比,差异无显著性(1.19%vs 0.65%,χ2=0.00,P>0.05,OR=1.85,95%C I=0.11-30.00)结论在性病门诊中,GUD的主要病因为梅毒和生殖器疱疹,且存在混合性感染;梅毒与H IV的感染有一定关系。Objective To investigate the etiology of-genital ulcer diseases （GUD） in sexually transmitted disease （STD） clinics,and to examine its relationship to HIV infection. Methods Between September 9,1997 and December 30,2004,322 patients with GUD was based on physical appearance and microbiologic evaluations which included dark field microscopy and serology test for syphilis for diagnosis the etiology of GUD. Results 234 men and 88 women were evaluated. The etiology of GUD was TP 26.40% （85/322） ,HSV 26.09% （84/322） ,and multiple infection 3.11% （10/322）. No chancroid case was found. No etiology was identified in 47.52% （153/322）. The seroprevalence of HIV was 1.86 % （6/322）. HIV seroprevalence positive rate in patients with syphilis,genital herpes and other GUD was 4.70% （4/85）, 1.19% （1/84） and 0.65% （1/153）,respectively. HIV seroprevalence positive rate in patients with syphilis was significantly higher than that in patients with genital herpes and other GUD, but there was no significant difference in statistic 4. 70%（4.70% vs 1.19%,）X^2=0.24,P〉0. 05,OR=3.04,95% CI=0. 31-29.93;4.70% vs 0. 65%,X^2=1.29,P〉0. 05,OR=5.63,95% CI=0.58-55.06;1.19% vs 0.65%,X^2 =0.00,P〉0.05,OR=1.85,95% CI=0.11-30. 00）. Conclusions The study showed that syphilis and genital herpes predoinate in patients with GUD. The seropositive HIV infection in GUD was very low,and syphilis ,genital herpes and its relationship to HIV infection need to proceeding a thorough research.

关 键 词：生殖器溃疡性疾病 梅毒螺旋体 单纯疱疹病毒 杜克雷嗜血杆菌 HIV 

分 类 号：R378[医药卫生—病原生物学]