文章摘要

淋球菌、衣原体感染与盆腔炎的相关性

作者: 1刘 毅, 1吴 小莉
1 恩施土家族苗族自治州中心医院妇产科,湖北 恩施 445000
通讯: 吴 小莉 Email: xiaoliwuenshi@163.com
DOI: 10.3978/j.issn.2095-6959.2019.02.014

摘要

目的:研究女性淋球菌、衣原体感染与盆腔炎(pelvic inflammatory disease,PID)发病的相关性,为临床防治提供理论依据。方法:纳入恩施州中心医院2007至2017年住院及急诊315 123例PID女性(出生于1978—1999年)。收集相关宫颈分泌物病理检测报告等病例资料,比较分析淋球菌、衣原体感染与PID发病的相关性。结果:120 748例有衣原体及淋球菌病理检测报告,10 745例有衣原体检测报告,653例仅有淋球菌检测报告,182 977例无检测报告。其中,16 778例(12.8%)检测为衣原体感染阳性,3 195例(2.6%)检测为淋球菌感染阳性,1 874例(1.6%)检测为衣原体合并淋球菌感染。最终确诊4 819例PID患者(2 222例住院患者,2 597例急诊患者)。校准年龄、原住地、成长所在地、社会经济地位因素,与衣原体淋球菌检测均阴性的女性相比,衣原体及淋球菌均阳性的女性PID的相对危险度为4.29(95%CI 3.66~5.03),淋球菌阳性为4.54(95%CI 3.87~5.33),而衣原体阳性为1.77(95%CI 1.61~1.94)。结论:与衣原体感染相比,淋球菌感染更容易引发PID。
关键词: 盆腔炎;淋球菌;衣原体;生殖健康

Risk of pelvic inflammatory disease in relation to chlamydia and gonorrhea infection

Authors: 1LIU Yi, 1WU Xiaoli
1 Department of Obstetrics and Gynecology, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Hubei 445000, China

CorrespondingAuthor:WU Xiaoli Email: xiaoliwuenshi@163.com

Abstract

Objective: To explore the risk of pelvic inflammatory disease (PID) associated with chlamydia and gonorrhea infection and subsequent repeat infections, which provides theoretical basis for clinical prevention and treatment. Methods: A total of 315 123 women, born from 1978–1999, were probabilistically linked to chlamydia and gonorrhea testing records and to hospitalizations and emergency department presentations for PID from 2007 to 2017. Statistical analysis was used to investigate the association between chlamydia and gonorrhea testing, and positivity, and risk of PID. Results: A total of 120 748 women had pathology test records for both chlamydia and gonorrhea, 10 745 chlamydia only, and 653 gonorrhea only. Among those tested, 16 778 (12.8%) had positive chlamydia test, 3 195 (2.6%) were positive gonorrhea test, and 1 874 (1.6%) were positive for both. There were 4 819 PID presentations (2 222 hospitalizations, 2 597 emergency presentations). Adjusting for age, aboriginality, health area, and socioeconomic status, compared to women negative for chlamydia and gonorrhea, the relative risk (adjusted incidence rate ratio) of PID was 4.29 (95% CI 3.66–5.03) in women who were both chlamydia and gonorrhea positive; 4.54 (95% CI 3.87–5.33) in those only gonorrhea positive; and 1.77 (95% CI 1.61–1.94) in those only chlamydia positive. Conclusion: Gonorrhea infection confers a substantially higher risk than chlamydia of hospitalization or emergency department presentation for PID.
Keywords: pelvic inflammatory disease; chlamydia; gonorrhea; reproductive health