女性下生殖道单纯疱疹病毒感染的临床分析  

Clinical analysis of herpes simplex virus infection in female lower genital tract

作　　者：盛浩 SHENG Hao(Dermatology Department,Wuhan Puren Hospital,Wuhan 430080,Hubei,China)

机构地区：[1]武汉市普仁医院皮肤科,湖北武汉430080

出　　处：《中国性科学》2019年第2期132-135,共4页Chinese Journal of Human Sexuality

摘　　要：目的分析女性下生殖道单纯疱疹病毒感染病因及分别分布规律,总结其形态学特征。方法选取2015年1月至2016年12月武汉市普仁医院诊治的女性下生殖道单纯疱疹病毒感染患者241例作回顾性分析,晨抽取患者静脉血3ml,使用免疫酶联吸附法检查患者特异性IgG、IgM。根据试剂盒阳性标准进行判断。人乳头瘤病毒及生殖道沙眼衣原体:叮嘱患者在检查前3d禁止性生活、上药、冲洗,来院检查时使用窥阴器将无菌棉签置于宫颈口外,擦拭分泌物。再取另一棉签置入宫颈口内2cm位置,逆时针旋转4圈,停留10s抽出,送至实验室检查形态学。使用反向法检测人乳头瘤病毒23种类型基因。使用荧光法PCR技术检查生殖道沙眼衣原体。结果 241例患者经检查均发现单纯疱疹病毒特异性抗体,阳性率100%,其中40例为1型感染病毒,121例为2型感染病毒,20例为混合型感染病毒,3种类型单纯疱疹病毒比例差异比较具有统计学意义(P<0.05)。1型单纯疱疹病毒IgM2例、IgG31例、IgM+IgG7例。2型IgG95例、 IgM11例、IgM+IgG5例。1+2型单纯疱疹病毒gG13例、 IgM3例、IgM+IgG4例。其中2型单纯疱疹病毒IgG阳性检出率显著高于1型、1+2型单纯疱疹病毒阳性检出率,差异具有统计学意义(P<0.05)。检出54例人乳头瘤病毒感染者,48例生殖道沙眼衣原体感染者。54例人乳头瘤病毒感染者中高危型36例,低危型10例,高危型+低危型8例,阳性率分为66.67%、40.00%、37.50%。48例生殖道沙眼衣原体感染者中阳性31例,阳性率64.58%。241例患者中102例(42.32%)呈现多核鳞状细胞,形态大小不一,细胞拥挤呈镶嵌状分裂有113例(46.89%),毛玻璃染色质有169例(70.12%),有明显的炎症背景。74例(30.71%)阴道杆菌明显减少,核膜增厚嗜碱性。结论女性下生殖道单纯疱疹病毒感染抗体特异性较高,多为人乳头瘤病毒感染者中高危型,镜下形态学与炎症类似,表现为多核鳞状细Objective To investigate the etiology and distribution of herpes simplex virus(HSV)infection in female lower genital tract and summarize its morphological characteristics.Methods 241 female with HSV infection treated in our hospital from January 2015 to December 2016 were retrospectively analyzed.3ml of morning fasting venous blood were collected for the determination of specific IgG,IgM by immunoenzyme-linked immunosorbent assay.The human papillomavirus infection(HPV)and Chlamydia trachomatis(Ct)infection were also tested.Results The positive rate of detection of HSV specific antibodies was 100.00%,including 40 patients of single HSV1 infection,121 patients of single HSV2 infection,and 20 patients of HSV1 joint HSV2 mixed infection,with statistically significant differences(P<0.05).Among HSV1-infected patients,there were 2 patients positive for specific IgM,31 cases positive for specific IgG and 7 cases positive for IgG plus IgM.Among HSV2-infected patients,there were 95 patients positive for specific IgG,11 cases positive for specific IgM and 5 cases positive for IgG plus IgM.Among patients with HSV1 plus HSV2 mixed infection,there were 13 patients positive for specific IgG,3 cases positive for specific IgM and 4 cases positive for IgG plus IgM.The positive detection rate of IgG among single HSV1 infection was higher than that of single HSV2 infection and HSV1 plus HSV2 mixed infection(P<0.05).A total of 54 cases of HPV infection and 48 cases of genital chlamydia trachomatis infection were detected.Among the HPV-positive patients,36 patients were infected with high-risk HPV(66.67%),10 patients were infected with low-risk HPV(40.00%),and 8 patients had high-risk plus low-risk mixed infection of HPV(37.50%).The Ct positive rate was 64.58%(31/48).Of the 241 patients,102(42.32%)patients showed multinucleated squamous cells with different morphological sizes.There were 113 cases(46.89%)with cell-crowded mosaics and 169(70.12%)cases with ground glass chromatin.The vaginal bacilli of 74 cases(30.71%)were significantly

关 键 词：女性 下生殖道 疱疹 病毒 

分 类 号：R759[医药卫生—皮肤病学与性病学]