生殖器溃疡性疾病的病因与人类免疫缺陷病毒感染的关系  

The etiology of genital ulcer disease and its relationship to HIV infection

作　　者：朱慧兰[1] 赖维[2] 武明昌[1] 叶兴东[1] 张锡宝[1] 

机构地区：[1]广州市皮肤病防治所性病科,510095 [2]中山大学第三附属医院皮肤性病科

出　　处：《中国抗感染化疗杂志》2004年第1期11-13,共3页Chinese Journal of Infection and Chemotherapy

基　　金：广东省科委重点攻关项目(编号:99049);广东省卫生厅基金(编号:B2001100)

摘　　要：目的:了解生殖器溃疡性疾病(GUD)的病因及其与人类免疫缺陷病毒(HIV)感染的关系。方法:用暗视野显微镜检查(D-F)、梅毒血清学试验(STS)、酶免疫法(EIA)检测单纯疱疹病毒(HSV)抗原和杜克雷嗜血杆菌(HD)培养等方法检测285例生殖器溃疡标本中梅毒螺旋体(TP)、HSV和HD,并进行血清HIV抗体检测。结果:在285例患者中,梅毒75例(26.3％),生殖器疱疹74例(26.0％),病因不明的GUD为136例(47.7％)。GUD患者的HIV感染率为1.8％(5/285),梅毒患者为4.0％(3/75),生殖器疱疹患者为1.4％(1/74),其他GUD为0.7％0(1/136)。比较三者的HIV感染率发现,梅毒的HIV感染率高于生殖器疱疹和其他GUD患者,但两者差异无显著性;生殖器疱疹患者的HIV感染率与其他GUD患者的HIV感染率相比,差异无显著性(两者分别为1.35％和0.74％,X2=0.19,P>0.05;OR=1.85,95% CI=0.11～30.00)。结论:在性病门诊中,GUD的主要病因为梅毒和生殖器疱疹,且存在混合性感染;梅毒和生殖器疱疹与HIV感染的关系尚待进一步研究。Objective: To investigate the etiology of genital ulcer disease (GUD) and the relationship between GUD and human immunodeficiency virus (HIV) infection. Methods: Dark field microscopy, serology test were used to detect Treponema pallidum (TP) , Herpes simplex virus (HSV) was detected by enzyme immunoassay, Haemophilus ducreyi (HD) was detected by culture method, and serum HIV antibody was tested in 285 patients with GUD. Results:285 patients with GUD were studied. TP and HSV were detected in 75(26. 3%) and 74(26. 0 %) patients, respectively, both the two pathogens were detected in 9(3. 2%) patients, no HD was found. No pathogen was identified in 136(47. 7%) patients. The seroprevalence of HIV was 1.8% (5/285). HIV seroprevalence positive rates in patients with syphilis, genital herpes and remaining patients with GUD were 4. 0%(3/75) , 1. 4%(l/74) and 0. 7%(l/136) , respectively. HIV seroprevalence positive rate in patients with syphilis was higher than the patients with genital herpes and the remaining GUD patients, however, there were no statistically significant difference. Conclusions:The major pathogens of GUD are syphilis and genital herpes. The seropositive HIV infection in GUD is very low, further studies are needed to elucidate the relationship between syphilis, genital herpes and HIV infection.

关 键 词：生殖器溃疡性疾病 梅毒螺旋体 单纯疱疹病毒 杜克雷嗜血杆菌 人类免疫缺陷病毒 

分 类 号：R512.91[医药卫生—内科学]