摘要
子宫颈位于相对“有菌”的下生殖道和相对“无菌”的上生殖道之间,是上生殖道的“门户”。急性子宫颈炎较为明确的病原体为性传播病原体,即外源性病原体,包括沙眼衣原体、淋病奈瑟菌、生殖支原体等,但仍有50%的患者致病菌并不明确。阴道与子宫颈位置毗邻,阴道内源性病原体上行可导致子宫颈炎。近年来研究表明,细菌性阴道病相关病原体与子宫颈炎相关。急性子宫颈炎可进一步导致盆腔炎、不孕、早产、流产、新生儿感染等,正确诊断和治疗对预防子宫颈炎远期并发症至关重要。急性子宫颈炎的诊断分为临床诊断和病原学诊断。临床诊断依据特征性体征和子宫颈、阴道分泌物显微镜下白细胞计数。随着病原体分子诊断技术的长足发展,其在子宫颈炎诊断中也表现出越来越重要的作用。文章介绍了急性子宫颈炎的诊断方法,以及各种方法的优点及局限性,并对其需要鉴别的疾病进行讨论。
The cervix is the "gateway" between the relatively "insterile" lower genital tract and the relatively "sterile" upper genital tract. The pathogenic bacteria of acute cervicitis mainly are sexually transmitted pathogens.Namely,the exogenous pathogens,including Chlamydia trachomatis,Neisseria gonorrhoeae Mycoplasma genitalium,etc.,but the pathogenic bacteria are still unknown in 50% of patients. The vagina is adjacent to the cervix,and the ascending vaginal endogenous pathogens can lead to cervicitis.Recent studies have shown that the bacterial vaginosisassociated pathogens are asociated with cervicitis.Acute cervicitis can further lead to pelvic inflammatory disease,infertility,premature birth,miscarriage,neonatal infection,etc.,and correct diagnosis and treatment is essential to prevent the long-term sequelae of cervicitis. The diagnosis of acute cervicitis is divided into clinical and etiological diagnosis. Clinical diagnosis and treatment is based on characteristic signs and microscopic leukocytes of cervical and vaginal discharge. With the rapid development of molecular diagnostic technology and its wide application in clinical practice,their diagnostic performance in pathogens has also shown an increasingly important role. This article describes the diagnostic approach and their advantages and limitations of acute cervicitis,and discusses other disease that need to be differentiated.
作者
董梦婷
薛凤霞
DONG Meng-ting;XUE Feng-xia(Depart ment of Gynecology and Obstetrics,Tianjin Medica University General Hospital,Tianjin Key Laborator of Female Reproductive Health and Eugenics,Tianjin 300052,China)
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2024年第7期676-679,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
国家自然科学基金(81471419)
天津市重大疾病防治科技重大专项(18ZXDBSY00200)。
关键词
急性子宫颈炎
诊断
鉴别诊断
核酸扩增方法
acute cervicitis
diagnosis
differential diagnosis
nucleic acid amplification methods
