衣原体抗体在孕妇和青春期女孩宫颈分泌物中的诊断效力

Diagnostic efficacy of chlamydial antibodies in cervical secretions from pregnant women and adolescent girls.

作者信息

Thejls H, Rahm V A, Gnarpe J, Gnarpe H

机构信息

Department of Obstetrics and Gynaecology, Länssjukhuset, Gävle, Sweden.

出版信息

Genitourin Med. 1995 Dec;71(6):370-4. doi: 10.1136/sti.71.6.370.

DOI:10.1136/sti.71.6.370

PMID:8566976

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1196107/

Abstract

OBJECTIVE

To assess the prevalence of cervical antibodies to Chlamydia trachomatis in two different populations and to correlate the findings to culture, direct fluorescent antibody test (DFA) and serum antibodies.

SETTING

Antenatal clinics and clinic for teenage counselling in Gävle.

PATIENTS

1078 pregnant women attending for routine follow up in the third trimester of pregnancy and 256 teenage girls.

OUTCOME MEASURES

Cervical IgG and IgA antibodies to Chlamydia trachomatis. Cervical cultures for chlamydia. Serum IgG antibodies. DFA tests were used only in the teenage group.

RESULTS

The prevalence of positive culture was 2.0% in pregnant women and 8.6% in teenage girls. In pregnant women cervical IgG > or = 8 and IgA > or = 8 were found in 7.2% and 5.8% respectively and in teenage girls in 6.6% and 2.0% respectively. The agreement between cervical IgG > or = 8 and humoral IgG > or = 32 was 0.76 in the pregnant group and 0.95 in the teenage group. The sensitivity, specificity and positive predictive value (PPV) for cervix IgG > or = 8 to predict a positive culture was 0.64, 0.94 and 0.18 respectively in pregnant women and 0.41, 0.97, 0.53 respectively in teenage girls. Of 31 teenage girls with either positive culture or positive DFA 12 had cervical IgG > or = 8 while five of 225 with negative chlamydia tests had cervical IgG > or = 8 (sensitivity 0.40 and PPV of 0.71). Cervical IgG > or = 16 was found in eight of 31 with positive chlamydia tests and in one of 225 with negative tests (sensitivity 0.26 and PPV 0.89).

CONCLUSIONS

The finding of cervical IgG > or = 16 predicts current chlamydia (culture or DFA) in nearly 90% in a teenage population. It might indicate current infection in spite of negative culture in some cases. For low titres and in a low prevalence pregnant population cervical IgG are not useful for the diagnosis of chlamydia. As the sensitivity is low cervical antibodies cannot be used for screening purposes.

摘要

目的

评估衣原体抗体在两个不同人群中的流行情况，并将结果与培养法、直接荧光抗体试验（DFA）及血清抗体进行相关性分析。

地点

耶夫勒的产前诊所和青少年咨询诊所。

患者

1078名妊娠晚期接受常规随访的孕妇和256名青少年女性。

观察指标

衣原体的宫颈IgG和IgA抗体、衣原体宫颈培养、血清IgG抗体。DFA试验仅用于青少年组。

结果

孕妇衣原体培养阳性率为2.0%，青少年女性为8.6%。孕妇中宫颈IgG≥8和IgA≥8的比例分别为7.2%和5.8%，青少年女性中分别为6.6%和2.0%。孕妇组宫颈IgG≥8与体液IgG≥32之间的一致性为0.76，青少年组为0.95。孕妇宫颈IgG≥8预测培养阳性的敏感性、特异性和阳性预测值（PPV）分别为0.64、0.94和0.18，青少年女性分别为0.41、0.97和0.53。在31名培养阳性或DFA阳性的青少年女性中，12名宫颈IgG≥8；而在225名衣原体检测阴性的青少年女性中，5名宫颈IgG≥8（敏感性0.40，PPV为0.71）。在31名衣原体检测阳性的青少年女性中，8名宫颈IgG≥16；在225名检测阴性的青少年女性中，1名宫颈IgG≥16（敏感性0.26，PPV 0.89）。