快速抗原检测法对生殖道沙眼衣原体的诊断效果评价  

Diagnostic effect on rapid antigen detection for urogenital Chlamydia trachomatis infection

作　　者：孙思 田丽闪 吴秋红 刘兰兰 张莉 罗珍胄 陈祥生[2] Sun Si;Tian Lishan;Wu Qiuhong;Liu Lanlan;Zhang Li;Luo Zhenzhou;Chen Xiangsheng(Department of Dermatology and Venereology,Nanshan Center for Chronic Disease Control,Shenzhen 518000,Guangdong,China;Institute of Dermatology,Chinese Academy of Medical Sciences,National Center for Sexually Transmitted Disease Control,Chinese Center for Disease Control and Prevention,Nanjing 210042,China)

机构地区：[1]深圳市南山区慢性病防治院皮肤性病防治科,深圳518000 [2]中国医学科学院皮肤病研究所,中国疾病预防控制中心性病控制中心,南京210042

出　　处：《国际流行病学传染病学杂志》2020年第5期406-409,共4页International Journal of Epidemiology and Infectious Disease

摘　　要：目的了解快速抗原检测(胶体金)对育龄妇女生殖道沙眼衣原体(CT)感染的诊断效果以及相关的影响因素。方法于2018年12月至2020年6月收集深圳市南山区7936名育龄妇女的阴道拭子样本和尿液样本,应用快速抗原检测和核酸扩增检测法检测CT,以核酸扩增检测为标准,评价快速抗原检测的效果,同时检测拭子样本的念珠菌、线索细胞、阴道清洁度和尿液样本的尿潜血、尿蛋白和尿白细胞,分析与快速抗原检测结果相关的影响因素。结果7936名育龄妇女的尿液样本核酸扩增检测检出CT感染269例(3.39%),拭子样本快速抗原检测检出CT感染69例(0.87%)。快速抗原检测法的灵敏度为16.73%,特异性为99.69%,阳性预测值为65.22%,阴性预测值为97.15%。单因素分析提示线索细胞检测阳性与CT快速抗原检测假阳性有关(P<0.05)。结论快速抗原检测诊断价值低,且结果假阳性与线索细胞检测阳性有关,临床医生可结合线索细胞检测结果判断,必要时进行核酸扩增检测。Objective To study the diagnostic effect of rapid antigen detection(gold colloid)for Chlamydia trachomatis(CT)infections in reproductive women and the related influencing factors.Methods Vaginal swabs and urine specimens from 7936 reproductive women were collected in Nanshan district,Shenzhen,during December 2018 and June 2020.CT was detected by rapid antigen detection and nucleic acid amplification test,respectively.Compared with nucleic acid amplification test as the standard,the effect of rapid antigen detection was evaluated.Meanwhile,tests of Candida,clue cells and vaginal cleanliness for swab samples and tests of occult blood,proteins and leucocytes for urine samples were conducted to analyze the influencing factors related to rapid antigen detection.Results Among the 7936 reproductive women,269 cases(3.39%)with CT infections were detected by nucleic acid amplification test from urine samples,69 cases(0.87%)were detected by rapid antigen test from swab samples.The sensitivity,specificity,positive predictive value and negative predictive value of rapid antigen detection were 16.73%,99.69%,65.22%and 97.15%,respectively.Univariate non-conditional Logistic regression analysis showed that the positive clue cell(P<0.05)was a risk factor for false positive result of CT by rapid antigen detection.Conclusions Rapid antigen detection is of low diagnostic value,and the false positive result is related to positive clue cell.Clinicians can diagnose CT infection combined with the results of clue cells,and nucleic acid amplification test can be performed when necessarys.

关 键 词：胶体金 衣原体 沙眼 核酸扩增检测 线索细胞 

分 类 号：R518[医药卫生—内科学] R446.6[医药卫生—临床医学]