肛肠部沙眼衣原体感染的临床实验室研究  

Chlamydia trachomatis causing anorectal infections:a clinical laboratory study

作　　者：陈建江[1] 陈国英[2] 单平囡[1] 卢志勇[1] 谈素红[1] 茹金城[1] 许德顺[1] 

机构地区：[1]中国医科大学绍兴医院检验中心,浙江绍兴312030 [2]绍兴文理学院附属医院肿瘤科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2011年第17期3743-3745,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨肛肠部沙眼衣原体(Ct)感染的实验室筛查和临床诊断,以提高临床检出率,减少误诊、误治的发生。方法采用涂片查包涵体、斑点免疫层析试验(DICA)和(或)PCR-荧光探针法,对53例疑似肛肠部Ct感染患者进行检测和临床分析。结果 53例肛肠部感染的分泌物Ct抗原阳性率为52.8%,总误诊率为75.0%;对2种采样方式选取的30例标本检测阳性率作一致性分析,两种采样方法的检测结果存在一致性(U=4.065,P<0.05);15例分泌物3种方法检测Ct,PCR与包涵体测定配对定性资料χ2检验分析,差异有统计学意义(P<0.05);PCR与免疫金标法测定配对,差异无统计学意义;免疫金标法较佳,包涵体法检出率最低。结论临床医师应重视肛肠部Ct感染的筛查和诊断,应用斑点免疫层析试验作检测是高效的选择,不要用染色涂片法检测包涵体检测肛肠部沙眼衣原体感染。OBJECTIVE To investigate the clinical diagnosis value of Chlamydia trachomatis to improve the clinical detection rate and reduce the misdiagnosis and mistreatment.METHODS The stain smear for inclusion body,dot immuno-chromatographic assay（DICA） and polymerase chain reaction（PCR） fluorescence probing were used for detecting Ct antigen and clinically analyzing 53 suspected patients with anorectal Ct infections.RESULTS It founded that 52.8% of Ct antigen-positive rate and 75.0% of total misdiagnosis rate in the secretions of 53 patients with anorectal infection.The results of statistics on the positive rates of two sampling methods were consistency in 30 patients with Ct infection（U=4.065,P〈0.05）.Comparison of three different methods of detecting for Ct in 15 secretions there was a significant difference between the methods of PCR and qualitative measure of inclusion body by χ2 test（P=0.031）,however,in comparison PCR with immunogold method,there was no significant difference between the two methods（P=1.00）.In all the method of immunogold was the best and the method of detecting inclusion body was the worst.CONCLUSION Clinicians should pay attention to the screening and diagnosis of anorectal Ct infection.DICA is an effective choice,and do not use the method of staining smears for detecting inclusion bodies to diagnose anorectal Ct infection.

关 键 词：沙眼衣原体感染 斑点免疫层析试验 聚合酶链反应 误诊 

分 类 号：R374[医药卫生—病原生物学]