【作者】 其木格；

【导师】 王千秋； 苏晓红； 曾学思； 尹跃平；

【作者基本信息】 中国协和医科大学 ， 皮肤病与性病学， 2008， 博士

【摘要】 第一章解脲脲原体和生殖支原体与女性黏液脓性宫颈炎相关性的研究目的探讨Uu和Mg与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组。采集宫颈拭子标本,运用支原体培养及半定量培养的方法检测Uu,运用PCR技术检测Mg。一般情况、病史和性行为等采用问卷调查。结果Uu在非衣原体非淋球菌感染的MPC患者中的检出率为81.42%(184/226),健康体检人群中的检出率为64.41%(76/118),特别是MPC病例组中Uu半定量培养浓度≥10~4 ccu/mL的阳性率(42.48%)明显高于对照组(16.95%),有高度显著性差异(χ~2=22.61,P＜0.001);Mg在非衣原体非淋球菌感染的MPC患者中的检出率为11.06%(25/226),健康体检人群中的检出率为0.85%(1/118),两组间差异有统计学意义(χ~2=11.58,P＜0.001)。多因素回归分析发现,近3个月非婚性伴数、宫颈口有黏液脓性分泌物及宫颈涂片PMNL≥10个/油镜视野对Mg阳性的影响均有统计学意义(P=0.001、P=0.042和P=0.027)。结论Uu浓度高感染可能在MPC中有一定的致病作用;Mg与性病门诊就诊者中的非衣原体非淋球菌感染的MPC相关。第二章解脲脲原体生物群及基因型与黏液脓性宫颈炎相关性的研究目的探讨Uu生物群及基因型与女性非衣原体非淋球菌感染的MPC的相关性。方法研究对象包括性病门诊就诊的女性非衣原体非淋球菌感染的MPC患者及健康体检人群两组,对Uu培养阳性标本应用PCR-SSCP方法检测Uu的生物群及基因型。结果Uu生物一群中的基因3/14型在两组中的检出率均最高,分别为30.98%(57/184)和43.42%(33/76);MPC病例组中生物二群的Uu基因2B型的检出率为16.30%(30/184)明显高于健康体检组的6.58%(5/76),有显著统计学差异(χ~2=4.367,P=0.037);而健康体检组中主要以生物一群中的基因1、3/14、6型的单型别感染为主占81.58%。结论Uu生物二群中的基因2B型可能与性病门诊就诊者中的非衣原体非淋球菌感染的MPC有一定相关性。更多还原

【Abstract】 ChapterⅠ.Associations of Ureaplasma urealyticum and Mycoplasma genitalium with Mucopurulent cervicitis in WomenObjective To study the association of U.urealyticum and M.genitalium among women with nongonococcal,nonchlamydial mucopurulent cervicitis in women.Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women.Cervical samples were collected from all subjects.The specimens were tested for the presence of U.urealyticum by culture and M.genitalium by polymerase chain reaction,respectively.Information about socio-demographic characteristics,medical history,sexual behaviour was gathered through a questionnaire.Results The rate of positive culture for U.urealyticum was 81.42% (184/226) in patiens with mucpurulent cervicitis,while 64.41%(76/118 ) in heathy women.The rate of positive culture with Uu≥10~4 ccu/mL was significanthy higher in patients with mucpurulent cervicitis(42.48%),than that in control group(16.95%) (χ~2=22.61,P＜0.001).The prevalence of M.genitaliurn was 11.06%(25/226) in patiens with mucpurulent cervicitis,while 0.85%(1/118) in heathy women.There was a significant difference between the two groups(χ~2=11.58,P＜0.001).By multivariate regression analysis,M.genitalium was strongly associated with multiple sex partners,mucopurulent secretion and≥10 polymorphonuclear leukocytes per high-power field on Gram stained cervical smear(P=0.001,P=0.042 and P=0.027).Conclusion This study indicates that infection with U.urealyticum at a high concentration may be related to mucopurulent cervicitis,and M.genitalium is associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic. ChapterⅡ.Association of Ureaplasma urealyticum biovar and genotype with Mucopurulent cervicitisObjective To study the association of U.urealyticum biovar and genotype with nongonococcal,nonchlamydial mucopurulent cervicitis.Methods The study population consisted of two different groups including STD clinic female patients with nongonococcal,nonchlamydial mucopurulent cervicitis and healthy women(as controls).U.urealyticum biovar and genotype were differentiated from U. urealyticum positive cultures by polymerase chain reaction and single-strand conformation polymorphism analysis.Results The rate of mba genotype 3/14 from biovars 1 was the highest in both groups,30.98%(57/184) in patients with mucopurulent cervicitis and 43.42%(33/76) in controls.The rate of genotype 2B from biovars 2 was 16.30%(30/184) in patient group,while 6.58%(5/76) in controls,and there was a significant difference between the two groups(χ~2 = 4.367,P=0.037). Genotype 1,3/14 and 6 from biovar 1 was dominant in healthy population(81.58%).Conclusion This study indicates that genotype 2B of U.urealyticum biovars 2 may be associated with nongonococcal,nonchlamydial mucopurulent cervicitis among female patients attending STD clinic.更多还原