女性生殖道衣原体、支原体感染不同治疗方案的综合评估

摘要

Objective To seek a better treatment protocol for female urogenital Chlamydia trachomatis ( CT ) and Urealplasma urea-lyticum ( UU ) infection. Methods A total of 327 cases of nongonococcal vaginitis, cervicitis and pelvic inflammations caused by CT and UU were assigned into three groups according to the different ways of administration. All patients were treated dependently on antibiotic susceptibility tests. The patients in Group A received oral administration of azithromycin or gatifloxacin, while intravaginal administration of roxithromyc and metronidazole were additionally given in Group B. The patients in Group C were intravenously infused with azithromycin or gatifloxacin. The male partners of all the cases received oral administration of the same antibiotics. Results The curative rates were 82. 61%( 76/92 ),96. 60%( 142/147 ),and 90. 91%( 80/88 ) in Groups A,B and C,respectively. There was significant difference between Groups A and B ( P < 0. 001 ), but not between Groups A and C, Groups B and C( P > 0. 05 ). The average costs were ￥292.76, ￥486.20 and ￥766. 50 in Groups A,B and C,respectively. The cost for treatment was lowest in group A, and the curative rate was the highest in group B. The pharmacoeconomic analysis demonstrated that Group B protocol was the best. Conclusion The best treatment for female CT and UU infections is oral administration of azithromycin or gatifloxacin combined with intravaginal administration of roxithromycin and metronidazole.%目的 对治疗女性生殖道衣原体、支原体感染的三种不同给药方案进行治愈率、药物经济学分析等方面的综合评估,旨在探讨一种最佳的女性生殖道衣原体、支原体感染治疗方案.方法 将临床和实验室确诊为由沙眼衣原体(CT)和/或解脲支原体(UU)引起的女性生殖道感染患者(包括非淋菌性阴道炎、宫颈炎、盆腔炎)共327例,根据不同的给药方式分为三组,每组依据药敏培养的结果 选择敏感药物治疗.A组:口服给药组,共92例,采用阿奇霉素或加替沙星口服给药.B组:口服+阴道上药组,共147例,在A组方案的基础上加用罗红霉素片和甲硝唑片混合研磨成的粉末经阴道上药.C组:静脉给药组:共88例,阿奇霉素或加替沙星静脉点滴.以上三组研究对象的性伴侣均采用口服治疗方案,选择与女性相同的敏感药物同时治疗.结果 三组治愈率分别为A组82.61%(76/92)、B组96.60%(142/147)、C组90.91%(80/88),A组与B组比较差异有统计学意义(P<0.001),B组与C组、A组与C组间比较,差异无统计学意义(P>0.05).三组的平均治疗成本分别为292.76元、486.20元、766.50元.A组治疗成本最低,B组治愈率最高,从药物经济学的角度分析B组为最佳方案.结论 女性生殖道衣原体支原体感染口服+阴道上药为最佳治疗方案.