孕妇性传播疾病高危因素评分系统模式的建立  

Risk factor scoring model of STD for pregnant women in antenatal clinic

作　　者：符玉良[1] 黄以宁[1] 张维森 张秀兴[1] 刘岩平[1] 何桂荷[1] 武秋林[1] 肖燕青[1] 梁玉屏[1] 邓艳香 温素玲 

机构地区：[1]广州市妇婴医院

出　　处：《中华医学杂志》1997年第2期87-90,共4页National Medical Journal of China

基　　金：世界卫生组织全球艾滋病性传播疾病控制署资助

摘　　要：通过高危因素评估，建立起我国的孕妇性传播疾病（ＳＴＤ）的高危评分系统。方法前瞻性多中心随机抽取孕妇１６５６例，进行ＳＴＤ相关因素问卷、妇科检查及实验室检查，进行双盲检测系列ＳＴＤ、Ｃｏｘ比例风险模型等多项统计学处理。结果６种主要ＳＴＤ的总患病率为２０．９％（３４６／１６５６），发病率首位是沙眼衣原体性宫颈炎，为１９．１％（３１６／１６５６）。建立了ＳＴＤ高危因素评分模式三三分制。用该模式验证３４６例ＳＴＤ孕妇，其敏感性与特异性均大于６０．０％（分别为６１．７％与６７．３％），优于国外模式。结论三三制ＳＴＤ高危因素评分模式较国外多分制评分简便易行，更切合我国国情。Objective To develop a case finding strategy for STD among pregnant women based on risk assesment in China. Methods A prospective, random/double blind study of the high risk factors for STD in 1 656 pregnant women was conducted from June 1995 to February 1996. It was carried out at four Guangzhou hospitals on nine types of STD, their relative risk factor questionnaire and gynecologic examination. Results The total prevalence of six main STD was 20.89%(346/1656); No HIV and syphilis cases were found; The most common disease is cervical chlamydial trachomatis at (19.08% 316/1 656). Through statistcal calculations with COX proportional hazard model, STD symptoms' high risk factors scoring system revealed the following:(1) More than one sexual partner in the preceeding one year; (2) Vulvular lesion vegetation; (3) Dysusia/increased vaginal dishcarge; plus one of the following: ① unemployed status; ② sex partner unemployed; ③ age (less than 25 years or between 30～34 years of age). These six items with 'three-three' scoring system can be used as a model to primary screening new STD cases using clinical data. Both sensitivity and specificity exceeded 60% (61.7% and 67.3% erespectively). Conclusion These are significantly better than the foreing recommended model and the scoring system in China. It is simple, convenient and applicable.

关 键 词：孕妇 性传播疾病 比例危险度模型 高危因素 

分 类 号：R714.259[医药卫生—妇产科学] R195.4[医药卫生—临床医学]