广州地区生殖器溃疡性疾病与HIV感染的相关性研究  

Study on the Relationship Between Genital Ulcer Disease and HIV Infection in Guangzhou

作　　者：朱慧兰[1] 谷进[2] 唐志红[3] 叶兴东[1] 林爱华[3] 武明昌[1] 

机构地区：[1]广州市皮肤病防治所,广东广州510095 [2]中山大学附属第三医院妇产科,广东广州510630 [3]中山大学公共卫生学院,广东广州510080

出　　处：《中山大学学报（医学科学版）》2003年第4期404-407,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科委重点攻关项目基金(99049);广东省医学科研课题项目基金(A2001100)

摘　　要：[目的]了解性病门诊生殖器溃疡性疾病(GUD)的HIV感染状况及其与HIV感染的关系。[方法]取GUD患者溃疡处分泌物进行暗视野显微镜检查、多重聚合酶链反应,同时取上述患者和非溃疡性性传播疾病(STD)患者尿道或宫颈或阴道分泌物进行淋球菌、沙眼衣原体、支原体、单纯疱疹病毒、人类乳头瘤病毒、念珠菌、滴虫及加特纳菌等检测;检测所有STD患者血清的HIV抗体及梅毒血清学试验。[结果]在8962例病人中,就诊时生殖器有溃疡的STD与生殖器无溃疡的STD病人中HIV感染率分别为1.75％(5/285)和1.53％(133/8677),两者无统计学意义(x^2=0.09,P>0.05; OR=1.15,95％ CI=0.47～2.81);梅毒、生殖器疱疹和其他STD病人的HIV感染率分别为2.81％(22/784)、0.74％(6/814)和1.49％(110/7364),梅毒病人的HIV感染率明显高于生殖器疱疹和其他STD病人的HIV感染率,有统计学意义(2.81％ vs 0.74％,x^2=9.92,P<0.05,OR=3.89,95％ CI=1.67～9.05;2.81％ vs 1.49％,x^2=7.66,P<0.001,OR=1.90,95％ CI=1.21～3.00)。[结论]本研究提示本组GUD病人HIV感染率较国外低,梅毒与HIV感染有明显相关性;生殖器疱疹病人与HIV感染的关系尚待进一步研究。[Objective] To understand genital ulcer disease (GUD) among patients attending sexually transmited disease (STD) clinics in Guangzhou, China, and its relationship to HIV infection. [Methods] Between September 9, 1997 and October 30, 2002, 8 962 patients with STD were evaluated. 285 patients were diagnosed as GUD based on physical appearance and microbiologic evaluations which included dark field microscopy and serology test for syphilis (RPR, TPPA). Swabs of each genital ulcer were processed in a multiplex PCR assay (M-PCR) for simultaneous detection of HSV, Trepone-ma pallium, and Hemophilus ducreyi. Other STD were classified by routine diagnostic criteria as follow; microscopy or culture for Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma ure-alyticum, Human papillomavirus, Tricomonal vaginitis and Bacterial vaginosis. [Results] Of 8 962 patients with STD, HIV seroprevalence positive rate in patients with genital ulcerative STD and without genital ulcerative STD was 1. 75% (5/285) and 1.53% (133/8677), respectively, there was no difference in statistic (X2= 0. 09, P > 0. 05; OR = 1. 15, 95% CI = 0. 47 - 2. 81). HIV seroprevalence positive rate in patients with syphilis, genital herpes and other STD was 2. 81% (22/784), 0.74% (6/814) and 1.49% (110/7364), respectively. HIV seroprevalence positive rate in patients with syphilis was significantly higher than that in patients with genital herpes and other STD, there was significantly different in statistic(2. 81% vs 0. 74%, ^ = 9. 92, P < 0. 005, OR = 3. 89, 95% CI = 1.67-9.05; 2.81% vs 1. 49% , X2 = 7. 66, P < 0. 001, OR = 1.90, 95% CI = 1.21-3. 00). [Conclusion] The study shows that the seropositive HIV infection in GUD is very low, and there is obviously association between syphilis and HIV infection. But the relationship between genital herpes and HIV infection needs further research.

关 键 词：生殖器溃疡性疾病 人免疫缺陷病毒感染 艾滋病 梅毒 生殖器疱疹 广州 

分 类 号：R759[医药卫生—皮肤病学与性病学] R512.91[医药卫生—临床医学]