正确看待子宫颈支原体阳性的临床意义  

A correct view of the clinical significance of cervical Mycoplasma positive

作　　者：张岱[1] ZHANG Dai(Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院,北京100034

出　　处：《中国实用妇科与产科杂志》2024年第7期692-696,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金面上项目(81971342)。

摘　　要：支原体是一类与女性泌尿生殖道疾病密切相关的微生物,主要包括解脲支原体(Ureaplasma urealyticum,UU)、人型支原体(Mycoplasma hominis,Mh)、生殖支原体(Mycoplasma genitalium,Mg)。不同的支原体具有不同的临床意义。文章探讨了子宫颈支原体阳性的临床意义。UU主要导致尿道炎,女性阴道内无症状UU培养阳性非常常见,妊娠期下生殖道UU培养阳性不能增加妊娠不良结局,子宫颈UU阳性和(或)Mh阳性提示存在细菌性阴道病可能,应进一步检查。UU可进一步分型为微小脲原体(Up)和解脲脲原体(Uu),分型检测有助于帮助判断临床意义。Mg是尿道炎、子宫颈炎、盆腔炎的重要病原体,子宫颈Mg阳性提示可能存在上述炎症,需要积极抗生素干预。我国开展Mg检测较少,亟待普及Mg的核酸检测。Mg耐药较为普遍,有条件应该检测耐药基因,帮助选择抗生素治疗方案。Mycoplasma is a class of microorganisms closely related to female genitourinary tract diseases,mainly including Ureaplasma urealyticum(UU),Mycoplasma hominis(Mh),Mycoplasma genitalium(Mg).Different mycoplasmas have different clinical significance. This article explores the clinical significance of cervical Mycoplasma positive. Ureaplasma urealyticum predominantly causes urethritis,asymptomatic vaginal positive ureaplasma cultures are very common in women,positive cultures of Ureaplasma urealyticum in the lower genital tract during pregnancy do not increase adverse pregnancy outcomes.Cervical ureaplasma and/or Mycoplasma hominis positive suggest the possibility of bacterial vaginosis and should be further investigated. Ureaplasma urealyticum can be further classified into Ureaplasma parvum and Ureaplasma urealyticum,and typing tests can help determine clinical significance. Mycoplasma genitalium is an important pathogen of urethritis,cervicitis,and pelvic inflammatory disease. The positive test for Mycoplasma genitalium in the cervix indicates the possible presence of inflammation and requires aggressive antibiotic intervention. The detection of Mycoplasma genitalium is not common in China,and it is urgent to popularize the nucleic acid detection of Mycoplasma genitalium. Drug resistance to Mycoplasma. genitalium is common,and resistance genes should be tested to help selecting antibiotic therapy.

关 键 词：解脲支原体 微小脲原体 人型支原体 生殖支原体 致病性 

分 类 号：R711.32[医药卫生—妇产科学]