中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2013年
11期
771-774
,共4页
文佩军%廖绮曼%李雯静%陈木开%马春光%韩建德
文珮軍%廖綺曼%李雯靜%陳木開%馬春光%韓建德
문패군%료기만%리문정%진목개%마춘광%한건덕
疱疹,生殖器%单纯疱疹病毒属%免疫球蛋白G%免疫球蛋白M
皰疹,生殖器%單純皰疹病毒屬%免疫毬蛋白G%免疫毬蛋白M
포진,생식기%단순포진병독속%면역구단백G%면역구단백M
Herpes genitalis%Simplex virus%Immunoglobulin G%Immunoglobulin M
目的 在分析生殖器疱疹患者单纯疱疹病毒(HSV)流行株的基础上,探讨HSV-2 IgM抗体、型特异HSV-2 IgG抗体的敏感性、特异性、阴性预测值和阳性预测值,评价辅助生育中二种抗体检测在诊断生殖器疱疹上的意义.方法 对2009-2011年中山大学附属第一医院皮肤科193例生殖器疱疹患者临床分离病毒株培养并鉴定分型,了解主要的流行病毒型.生殖中心术前筛查HSV-2 IgM和(或)IgG阳性、疑诊生殖器疱疹的女性,丈夫同时抽血检查,共57对为临床观察组；选取HSV培养阳性生殖器疱疹患者68例作为阳性对照组；8 ～ 10岁儿童120例为阴性对照组.血清标本采用酶联免疫吸附法(ELISA)检测HSV-1 IgM和HSV-2IgM抗体及型特异HSV-1 lgG、HSV-2 IgG抗体,对结果进行比对分析.结果 阳性对照组68例中,HSV-1IgM 14例(20.59％)、HSV-2 IgM 9例(13.24％)、HSV-1 IgG 61例(89.71％) 、HSV-2 IgG 62例(91.18％)阳性；阴性对照组120例,分别为26例(21.70％)、16例(13.30％)、49例(40.80％)和0例阳性；两组HSV-1 IgM及HSV-2 IgM阳性率差异均无统计学意义(P＞0.05),但HSV-1 IgG及HSV-2 IgG阳性率差异均有统计学意义(P＜0.01).临床观察组57例女性中,HSV-1 IgM 46例(80.70％)、HSV-2 IgM 52例(91.23％)、HSV-1 IgG 48例(84.21％)、HSV-2 IgG 8例(14.04％)阳性；男性(配偶)分别为11例(19.30％)、5例(8.77％)、50例(87.71％)和7例(12.28％)阳性；两性的HSV-1 IgM及HSV-2 IgM阳性率差异均有统计学意义(P＜0.01),而HSV-1 IgG及HSV-2 IgG阳性率差异均无统计学意义(P＞0.05).HSV-2 IgM诊断生殖器疱疹的敏感性为13.24％,特异性为86.67％,阳性预测值36.00％,阴性预测值63.80％; HSV-2 IgG诊断生殖器疱疹的敏感性91.18％,特异性100.00％,阳性预测值100.00％,阴性预测值95.24％.结论 该地区生殖器疱疹主要流行病毒型为HSV-2,仅5.18％是HSV-1.HSV-2 IgM诊断生殖器疱疹的敏感性、阳性预测值以及特异性、阴性预测值均低于HSV-2IgG;辅助生育中型特异性HSV-2 IgG检测在诊断生殖器疱疹上的意义大于HSV-2 IgM.
目的 在分析生殖器皰疹患者單純皰疹病毒(HSV)流行株的基礎上,探討HSV-2 IgM抗體、型特異HSV-2 IgG抗體的敏感性、特異性、陰性預測值和暘性預測值,評價輔助生育中二種抗體檢測在診斷生殖器皰疹上的意義.方法 對2009-2011年中山大學附屬第一醫院皮膚科193例生殖器皰疹患者臨床分離病毒株培養併鑒定分型,瞭解主要的流行病毒型.生殖中心術前篩查HSV-2 IgM和(或)IgG暘性、疑診生殖器皰疹的女性,丈伕同時抽血檢查,共57對為臨床觀察組；選取HSV培養暘性生殖器皰疹患者68例作為暘性對照組；8 ～ 10歲兒童120例為陰性對照組.血清標本採用酶聯免疫吸附法(ELISA)檢測HSV-1 IgM和HSV-2IgM抗體及型特異HSV-1 lgG、HSV-2 IgG抗體,對結果進行比對分析.結果 暘性對照組68例中,HSV-1IgM 14例(20.59％)、HSV-2 IgM 9例(13.24％)、HSV-1 IgG 61例(89.71％) 、HSV-2 IgG 62例(91.18％)暘性；陰性對照組120例,分彆為26例(21.70％)、16例(13.30％)、49例(40.80％)和0例暘性；兩組HSV-1 IgM及HSV-2 IgM暘性率差異均無統計學意義(P＞0.05),但HSV-1 IgG及HSV-2 IgG暘性率差異均有統計學意義(P＜0.01).臨床觀察組57例女性中,HSV-1 IgM 46例(80.70％)、HSV-2 IgM 52例(91.23％)、HSV-1 IgG 48例(84.21％)、HSV-2 IgG 8例(14.04％)暘性；男性(配偶)分彆為11例(19.30％)、5例(8.77％)、50例(87.71％)和7例(12.28％)暘性；兩性的HSV-1 IgM及HSV-2 IgM暘性率差異均有統計學意義(P＜0.01),而HSV-1 IgG及HSV-2 IgG暘性率差異均無統計學意義(P＞0.05).HSV-2 IgM診斷生殖器皰疹的敏感性為13.24％,特異性為86.67％,暘性預測值36.00％,陰性預測值63.80％; HSV-2 IgG診斷生殖器皰疹的敏感性91.18％,特異性100.00％,暘性預測值100.00％,陰性預測值95.24％.結論 該地區生殖器皰疹主要流行病毒型為HSV-2,僅5.18％是HSV-1.HSV-2 IgM診斷生殖器皰疹的敏感性、暘性預測值以及特異性、陰性預測值均低于HSV-2IgG;輔助生育中型特異性HSV-2 IgG檢測在診斷生殖器皰疹上的意義大于HSV-2 IgM.
목적 재분석생식기포진환자단순포진병독(HSV)류행주적기출상,탐토HSV-2 IgM항체、형특이HSV-2 IgG항체적민감성、특이성、음성예측치화양성예측치,평개보조생육중이충항체검측재진단생식기포진상적의의.방법 대2009-2011년중산대학부속제일의원피부과193례생식기포진환자림상분리병독주배양병감정분형,료해주요적류행병독형.생식중심술전사사HSV-2 IgM화(혹)IgG양성、의진생식기포진적녀성,장부동시추혈검사,공57대위림상관찰조；선취HSV배양양성생식기포진환자68례작위양성대조조；8 ～ 10세인동120례위음성대조조.혈청표본채용매련면역흡부법(ELISA)검측HSV-1 IgM화HSV-2IgM항체급형특이HSV-1 lgG、HSV-2 IgG항체,대결과진행비대분석.결과 양성대조조68례중,HSV-1IgM 14례(20.59％)、HSV-2 IgM 9례(13.24％)、HSV-1 IgG 61례(89.71％) 、HSV-2 IgG 62례(91.18％)양성；음성대조조120례,분별위26례(21.70％)、16례(13.30％)、49례(40.80％)화0례양성；량조HSV-1 IgM급HSV-2 IgM양성솔차이균무통계학의의(P＞0.05),단HSV-1 IgG급HSV-2 IgG양성솔차이균유통계학의의(P＜0.01).림상관찰조57례녀성중,HSV-1 IgM 46례(80.70％)、HSV-2 IgM 52례(91.23％)、HSV-1 IgG 48례(84.21％)、HSV-2 IgG 8례(14.04％)양성；남성(배우)분별위11례(19.30％)、5례(8.77％)、50례(87.71％)화7례(12.28％)양성；량성적HSV-1 IgM급HSV-2 IgM양성솔차이균유통계학의의(P＜0.01),이HSV-1 IgG급HSV-2 IgG양성솔차이균무통계학의의(P＞0.05).HSV-2 IgM진단생식기포진적민감성위13.24％,특이성위86.67％,양성예측치36.00％,음성예측치63.80％; HSV-2 IgG진단생식기포진적민감성91.18％,특이성100.00％,양성예측치100.00％,음성예측치95.24％.결론 해지구생식기포진주요류행병독형위HSV-2,부5.18％시HSV-1.HSV-2 IgM진단생식기포진적민감성、양성예측치이급특이성、음성예측치균저우HSV-2IgG;보조생육중형특이성HSV-2 IgG검측재진단생식기포진상적의의대우HSV-2 IgM.
Objective To determine the prevalent herpes simplex virus (HSV) strain in patients with genital herpes (GH),and to evaluate the sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV) of anti-herpes simplex virus type 2 (HSV2) IgG and IgM antibodies in the diagnosis of genital herpes (GH) before in vitro fertilization (IVF).Methods Totally,193 HSV2 clinical strains isolated in cell culture from the lesions of patients with GH in the Department of Dermatology,First Affiliated Hospital,Sun Yat-sen University between 2009 and 2011 were typed by using type-specific fluorescein isothiocyanate (FITC)-labelled anti-HSV monoclonal antibodies.Serum samples were obtained from 57 anti-HSV2 IgM/IgG antibody-positive females with suspected GH as well as their husbands (clinical observation group),68 HSV culture-positive patients diagnosed with GH (positive control group),and 120 children aged 8-12 years (negative control group).Enzyme-linked immunosorbent assay (ELISA) was performed to detect anti-HSV1/HSV2 IgG/IgM antibodies in these serum samples.Statistical analysis was carried out using chi-square test.Results There was a significant difference between the positive control group and negative control group in the positivity rate of anti-HSV1 IgG (89.71％ (61/68) vs.40.80％ (49/120),P ＜ 0.01) and anti-HSV2 IgG (91.18％ (62/68) vs.0,P ＜ 0.01),but not in that of anti-HSV1 IgM (20.59％ (14/68) vs.21.70％ (26/120),P ＞ 0.05) or anti-HSV2 lgM (13.24％ (9/68)vs.13.30％ (16/120),P ＞ 0.05).In the clinical observation group,the positivity rate of anti-HSV1 and anti-HSV2 IgM antibodies,anti-HSV1 and anti-HSV2 IgG antibodies was 80.70％ (46/57),91.23％ (52/57),84.21％ (48/57) and 14.04％ (8/57) respectively in the females,19.30％ (11/57),8.77％ (5/57),87.71％ (50/57),12.28％ (7/57)respectively in the males,with significant differences in the positivity rate of anti-HSV1 and-HSV2 IgM antibodies (both P ＜ 0.01),but not in that of anti-HSV 1 or-HSV2 IgG antibodies (both P ＞ 0.05).The sensitivity,specificity,PPV and NPV were 13.24％ (9/68),86.67％ (104/120),36.00％ (9/25) and 63.80％ (104/163) respectively for anti-HSV2 IgM antibody in the diagnosis of GH,91.18％ (62/68),100.00％ (120/120),100.00％ (62/62),and 95.24％ (120/126) respectively for anti-HSV2 IgG antibody.Conclusions HSV2 prevails in the patients with GH in this region,while HSV1 only amounts to 5.18％.The type-specific anti-HSV2 IgG antibody shows a higher specificity,sensitivity,PPV and NPV in the diagnosis of GH than anti-HSV2 IgM antibody,hence,the type-specific anti-HSV2 IgG antibody is superior to anti-HSV2 IgM antibody in diagnosing GH before assisted reproduction.
