Geisler William M, Chow Joan M, Schachter Julius, McCormack William M
STD Program, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA.
Sex Transm Dis. 2007 Jun;34(6):335-8. doi: 10.1097/01.olq.0000240344.20665.63.
Nucleic acid amplification tests (NAATs) allow chlamydia screening in asymptomatic women who otherwise may not have pelvic examinations. How often these women have examination findings that may prompt empiric therapy is unclear.
The objective of this study was to assess the relationship of chlamydia with pelvic examination findings in asymptomatic women screened by NAAT.
The authors conducted a retrospective analysis of clinical data from 577 young asymptomatic women screened by chlamydial transcription-mediated amplification (TMA).
TMA was positive in 68 (11.8%). The most common examination finding was vaginal discharge (5.9%) followed by cervical ectopy (3.6%), endocervical mucopus (2.3%) or easily induced bleeding (2.3%), and cervical motion (1.4%) or adnexal (0.7%) tenderness. On multivariate analysis, only easily induced bleeding or mucopus predicted chlamydia (adjusted odds ratio [AOR] = 4.7; P = 0.010 and AOR = 4.4; P = 0.015, respectively).
Abnormal pelvic examination findings were infrequent in asymptomatic young women screened by a chlamydial NAAT. However, endocervical bleeding or mucopus, when present, predicted chlamydia.
核酸扩增检测（NAATs）可对无症状女性进行衣原体筛查，否则这些女性可能不会接受盆腔检查。目前尚不清楚这些女性中有多少人具有可能促使经验性治疗的检查结果。
本研究的目的是评估在通过NAAT筛查的无症状女性中衣原体与盆腔检查结果之间的关系。
作者对577名通过衣原体转录介导扩增（TMA）筛查的年轻无症状女性的临床资料进行了回顾性分析。
TMA检测呈阳性的有68人（11.8%）。最常见的检查结果是白带（5.9%），其次是宫颈外翻（3.6%）、宫颈管脓性分泌物（2.3%）或易诱发出血（2.3%），以及宫颈举痛（1.4%）或附件压痛（0.7%）。多因素分析显示，只有易诱发出血或脓性分泌物可预测衣原体感染（校正比值比[AOR]=4.7；P=0.010以及AOR=4.4；P=0.015）。
在通过衣原体NAAT筛查的无症状年轻女性中，异常盆腔检查结果并不常见。然而，宫颈管出血或脓性分泌物一旦出现，则可预测衣原体感染。
