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1、我国重点防治的8种性病,梅毒Syphilis淋病 Gonorrhea艾滋病 AIDS生殖道衣原体感染 Genital chlamydial infection尖锐湿疣 Condyloma acuminatum生殖器疱疹 Genital Herpes软下疳 Chancroid性病性淋巴肉芽肿 Lymphogranuloma venereum,其他STD,念珠菌病阴道毛滴虫病细菌性阴道病阴虱疥疮传染性软疣乙型肝炎阿米巴病股癣,Gonorrhea淋病Non-gonococcal urethritis(NGU)非淋菌性尿道炎Syphilis梅毒,Gonorrhea 淋病,Etio-pathogenes
2、is 病因与发病机理Neisseria gonorrhoeae,奈瑟淋球菌Intracellular Gram-negative diplococci胞内革兰阴性双球菌,传播途径Mode of transmission,sexual exposure 性接触contaminated objects 污染物birth 母婴产道传播,Gonorrhea 淋病,临床症状 Clinical features潜伏期 Incubation 2-6d(2-10 d)症状 SymptomsUrethral irritation symptoms:dysuria,etc尿路刺激症状Urethral discha
3、rge:pus&gonococci尿道分泌物男 Male:尿道炎 urethritis-symptoms 女 Female:宫颈炎 cervicitis-symptoms,临床症状 Clinical features,男性：潜伏期 Incubation 2-6d(2-10 d)症状 SymptomsUrethral irritation symptoms:dysuria,etc尿路刺激症状Urethral discharge:pus&gonococci尿道分泌物90%症状明显；10%无明显症状（重要传染源）,Gonorrhea 淋病,合并症Epididymitis附睾炎Prostatitis前
4、列腺炎,临床症状 Clinical features,女性：潜伏期 Incubation 2-6d(2-10 d)症状 Symptoms宫颈炎 cervicitis-分泌物尿道炎尿路刺激症状:dysuria,etc尿道分泌物50%无明显症状（重要传染源）,Gonorrhea 淋病,合并症输卵管炎Salpigitis或盆腔炎Pelvic inflammatory disease，PID不孕，异位妊娠肝周炎 peri-hepatitis,其他感染部位 Other sites,Proctitis直肠炎Pharyngitis咽炎Conjunctivitis结膜炎,播散性淋球菌感染 DGI,菌血症：发热
5、关节炎：关节、肌腱疼痛肿胀皮炎：四肢末端：丘疹、淤点、脓疱,Gonorrhea 淋病,Laboratory studies 实验室检查Identification of gonococcismear 涂片culture 培养-金标准 gold standard,Gonorrhea 淋病,治疗 Treatment1.Azithromycin阿齐霉素,1.0g,po,single dose2.Ceftriaxone头孢曲松,250mg,iv,single dose3.Spectinomycin壮观霉素,2.0g,im,single dose4.Guinolones 喹诺酮5.Others,其他治疗
6、,淋病性眼炎妊娠期淋病前列腺炎、附睾炎等合并症盆腔炎播散性淋球菌感染,NGU,Non-gonococcal urethritis非淋菌性尿道炎,病因 Etiology:Chlamydia trachomatis沙眼衣原体?Ureaplasma urealyticum解脲支原体,NGU非淋菌性尿道炎,临床症状 Clinical featuresMild urethral irritation symptoms 尿道刺激症状较轻mild urethral discharge稀薄的尿道分泌物,NGU非淋菌性尿道炎,并发症 ComplicationsProstatitis前列腺炎Pain and di
7、scomfort of the pelvic floor,may compromise the patients quality of lifePelvic inflammatory disease盆腔炎Ectopic pregnancy 异位妊娠Infertility 不孕,NGU非淋菌性尿道炎,诊断 Diagnosis尿液分析Urinalysis:WBC 10-15/400X尿道涂片Urethral smear:WBC 5/1000X病原体检查(Optional)Detection of C.Trachomatis or?U.Urealyticum,Treatment of NGU,1.D
8、oxicycline多西环素,0.1,po,bid,7-10d2.Azithromycin阿齐霉素,1.0,po,single dose3.Erythromycin红霉素,0.5,po,qid,7 d4.Erythromycin ethylsuccinate琥乙红霉素,0.8,po,qid,7d5.Roxithromycin罗红霉素,0.15,po,bid,10d6.Ofloxacin氧氟沙星,0.3,po,bid,7d7.Minocycline米诺环素,0.1,po,bid,10d8.Tetracycline四环素,0.5,po,qid,7-10d,Gonorrhea-小结,革兰-奈瑟淋球菌
9、Neisseria gonorrhoeae传播:性、污物、生产临床表现:尿痛+分泌物实验室:涂片+培养治疗:Azithromycin or Ceftriaxone or Spectinomycin,非淋菌性尿道炎NGU,病因:沙眼衣原体Chlamydia trachomatis?解脲支原体 Ureaplasma urealyticum临床表现:轻度刺激症状+分泌物诊断:WBC 10-15/400X or 5/1000X治疗:DoxicyclineAzithromycinErythromycinOfloxacinMinocycline,尖锐湿疣,Human Papillomavirus,Genital herpes,Human Herpesviruses,
