微创医学

目的探讨超高倍多媒体显微仪直接镜检法在检测衣原体、支原体感染上的可靠性。方法取女性宫颈分泌物直接涂片后置于超高倍多媒体显微仪（MMDI）镜下直接观察涂片，抽取MMDI支原体、衣原体阳性标本及阴性标本各132例，再用荧光定量PCR（FQPCR）法检测沙眼衣原体（CT）和解脲脲原体（UU），以PCR为“金标准”分析MMDI的检测灵敏度及特异度。结果纳入实验的132例超高倍显微仪镜检阳性的标本中，PCR荧光探针法显示CT阳性者12例，UU阳性者59例，36例为CT和UU均阳性，25例为PCR阴性；132例MDDI检测为阴性的样本其PCR荧光探针法检出CT或UU阳性4例。结果判定改为支原体、衣原体是否阳性后，MMDI和PCR结果经成组卡方检验表明两种检测方法的结果有很好的相关性。以PCR作为金标准，264例结果分析MMDI检测支原体、衣原体的方法学性能，得MMDI的灵敏度为96.40%，特异度为83.66%，阳性结果预期值为81.06%，阴性结果预期值为96.97%。总有效率为89.02%。结论超高倍多媒体显微仪直接镜检法（MMDI）在快速筛查支原体、衣原体感染上具有不可取代的优势，尤其是在支原体、衣原体的排除诊断中具有极其重要的价值；MMDI技术能对分泌物的整体微生态状态进行评价，为疾病诊断提供全面的病理信息；MMDI技术在区分衣原体、支原体上尚存在不足，对于MDDI筛选出的支原体、衣原体阳性标本可通过PCR进一步鉴定。

ObjectiveTo analysis on the reliability of detecting Chlamydia Trachomatis(CT) and Ureaplasma Urealyticum (UU)by multimedia ultramicroscope. MethodsWe used multimedia ultramicroscope to detect the smear of cervical secretions. 132 CT or UU positive specimens and 132 negative specimens had been found and then all of them were detected by fluorescence quantitative PCR (FQ PCR). The sensitivity and specificity of the multimedia ultramicroscope assay were compared with those of the FQ PCR using primers. ResultsIn 132 multimedia ultramicroscope positive specimens, FQ PCR detecting showed 12 CT positive, 59 UU positive, 36 both CT and UU positive, and 25 totally negative. Among 132 multimedia ultramicroscope negative specimens, 4 were found CT or UU positive by FQ PCR. Two methods showed good correlation when the decision criteria did not distinguish between CT and UU. Considering PCR as golden standard, the sensitivity and specificity of multimedia ultramicroscope were 96.40%, 83.66%, respectively, positive and negative predictive value were 81.06%, 96.97% respectively, and total effective rate was 89.02%. ConclusionsMultimedia ultramicroscope has irreplaceable advantages on rapid screening CT or UU infections, especially in excluding diagnosis. It can also evaluate the whole endovaginal microecologics and provide comprehensive pathological information for diagnosis. However, MMDI is still insufficient in distinguishing between CT and UU, which can be complemented by using PCR