单纯疱疹病毒Ⅰ、Ⅱ型感染的临床和实验诊断研究  

Clinical and laboratory studies of infection of herpes simplex virus type Ⅰ and Ⅱ

作　　者：金宁[1] 梁金珠[1] 杨琳[1] 韩莹[1] 刘文力[1] 

机构地区：[1]沈阳市第七人民医院皮肤科,辽宁沈阳110003

出　　处：《中国艾滋病性病》2007年第3期248-249,共2页Chinese Journal of Aids & STD

摘　　要：目的探讨生殖器疱疹(GH)患者单纯疱疹病毒Ⅰ型、Ⅱ型(HSV-Ⅰ、Ⅱ)抗原检测的临床意义,评价其实验诊断的必要性和实用性。方法应用酶联免疫吸附试验(ELISA)对有GH皮损或无GH皮损但有泌尿生殖道症状的1859例患者(男1104例,女755例)检测HSV-Ⅰ、Ⅱ抗原,无GH症状者同时检测其他性病病原体。结果1104例男性患者中,无GH皮损但有尿道症状者498例,检出HSV抗原阳性159例,阳性率31.9%;有GH皮损者606例,检出HSV抗原阳性367例,阳性率60.56%。有和无GH皮损两组HSV抗原阳性率的差异有非常显著的统计学意义(χ2=88.70,P<0.001)。755例女性患者中,无GH皮损但阴道分泌物不正常或外阴不适者333例,有GH皮损者422例,HSV抗原阳性率分别为30.63%(102/333)和35.31%(149/422)。有和无GH皮损两组HSV抗原阳性率无显著性差异(χ2=1.63,P>0.05)。男、女无GH皮损组分别有90例和36例,除HSV抗原阳性外,还伴有其它性病病原体阳性。结论应对有GH皮损患者进行HSV抗原检测,但在无GH皮损患者中也可在泌尿生殖道中查到较高的HSV抗原检出率,提示对有泌尿生殖道不适症状者,即使没有皮损,也可发生HSV感染。所以对该类患者除检测常规性病病原体外,还应同时检测HSV,防止漏诊。Objective To explore the clinical significance of detecting herpes simplex virus（HSV）type Ⅰ and Ⅱ antigens in genital herps（GH）patients,and to evaluate practicability and necessity of this laboratory assay. Methods Enzyme linked immunosorbent assay（ELISA）was used to detect HSV- Ⅰ and Ⅱ antigens in 1 859 patients with or without GH cutaneous lesions,but with urogenital symptoms（1 104 male cases and 755 female ones）, and other STD pathogens were detected in patients without GH symptoms. Results In 1 104 male patients,498 cases were without GH cutaneous lesion, but with urogenital symptoms, and 606 cases were with GH symptoms, and the positive rate of HSV antigen was 31.9 % （159/498）and 60.56 % （367/606）, respectively. The difference in the positive rate of HSV antigen between these two groups was significant. In 755 female cases,333 cases were without GH lesion but with abnormal vaginal secretion or vulva discomfort, and 422 cases were with GH symptoms or cutaneous lesion, and the positive rate of HSV antigen was 30.63 % （102/333 ） and 35.31% （149/422）, respectively. The difference in HSV positive rate between these two groups with and without GH symptoms were insignificant. In male and female groups without GH symptoms but with positive HSV antigen,90 and 36 cases were detected respectively to be positive in other STD pathogens.Conclusion The HSV antigen detection should be done for GH patients. Since in patients without GH cutaneous lesion higher rate of HSV antigens were detected, it is suggested that HSV infection may happen in patients with abnormal vaginal secretion, even without cutaneous lesion. Therefore,other than conventional detection of sexual pathogens, HSV should be detected simultaneously to avoid possible misdiagnosis.

关 键 词：单纯疱疹病毒 抗原 酶联免疫吸附试验 

分 类 号：R752.11[医药卫生—皮肤病学与性病学]