目的:由于对宫颈炎的诊断标准不同,因此对宫颈炎病因和患病率的研究缺乏可比性。我们旨在概述宫颈炎的关联,并提出最佳病例定义。
方法:一项针对悉尼三个性传播感染诊所的558名女性的横断面研究,澳大利亚,2006年至2010年,使用三种宫颈炎定义检查了宫颈炎的病原体和行为关联:\'显微镜\'(>30pmnl/hpf(宫颈革兰氏染色上每个高功率视野的多形核白细胞)),“宫颈分泌物”(黄色和/或粘液脓性宫颈分泌物)或“微+宫颈分泌物”(“显微镜”和“宫颈分泌物”)。
结果:沙眼衣原体(CT),生殖支原体(MG),阴道毛滴虫(TV)和淋病奈瑟菌(NG)与宫颈炎定义\'微宫颈排泄物\'的关联最强:CT调整后的患病率(APR)=2.13(95%CI1.38至3.30)p=0.0006,MGAPR=2.21(1.33至3.69)p=0.002,TVAPR=2.37(1.44至3.90)p=1.PR=1.23.使用避孕套进行阴道性交\“总是/有时”降低了宫颈炎的风险:(\'微宫颈分泌物\')APR=0.69(0.51至0.93)p=0.016。这四种病原体的合并人群归因风险百分比(PAR%)仅为18.0%,避孕套的保护性PAR%为25.7%。与宫颈炎无关的暴露包括细菌性阴道病,人型支原体,解脲脲原体,单纯疱疹病毒1和2,巨细胞病毒,念珠菌,年龄,吸烟和荷尔蒙避孕。
结论:宫颈炎与CT相关,MG,在这种情况下,TV和NG与这些病原体的总PAR百分比只有18%,这表明涉及其他因素。避孕套显著降低了宫颈炎的风险。具有最佳临床效用和病原体预测的宫颈炎定义为“宫颈放电”和“微宫颈放电”。
OBJECTIVE: Studies examining cervicitis aetiology and prevalence lack comparability due to varying criteria for cervicitis. We aimed to outline cervicitis associations and suggest a best
case definition.
METHODS: A cross-sectional study of 558 women at three sexually transmitted infection clinics in Sydney, Australia, 2006-2010, examined pathogen and behavioural associations of cervicitis using three cervicitis definitions: \'microscopy\' (>30 pmnl/hpf (polymorphonuclear leucocytes per high-powered field on cervical Gram stain)), \'cervical discharge\' (yellow and/or mucopurulent cervical discharge) or \'micro+cervical discharge\' (combined \'microscopy\' and \'cervical discharge\').
RESULTS: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Trichomonas vaginalis (TV) and Neisseria gonorrhoeae (NG) had the strongest associations with cervicitis definitions \'micro+cervical discharge\': CT adjusted prevalence ratio (APR)=2.13 (95% CI 1.38 to 3.30) p=0.0006, MG APR=2.21 (1.33 to 3.69) p=0.002, TV APR=2.37 (1.44 to 3.90) p=0.0007 NG PR=4.42 (3.79 to 5.15) p<0.0001 and \'cervical discharge\': CT APR=1.90 (1.25 to 2.89) p=0.003, MG APR=1.93 (1.17 to 3.19) p=0.011, TV APR=2.02 (1.24 to 3.31) p=0.005 NG PR=3.88 (3.36 to 4.48) p<0.0001. Condom use for vaginal sex \'always/sometimes\' reduced cervicitis risk: (\'micro+cervical discharge\') APR=0.69 (0.51 to 0.93) p=0.016. Combined population attributable risk % (PAR%) of these four pathogens was only 18.0% with a protective PAR% of condoms of 25.7%. Exposures not associated with cervicitis included bacterial vaginosis, Mycoplasma hominis, Ureaplasma urealyticum, herpes simplex virus 1&2, cytomegalovirus, Candida, age, smoking and hormonal contraception.
CONCLUSIONS: Cervicitis was associated with CT, MG, TV and NG with combined PAR% of these pathogens only 18% in this setting, suggesting other factors are involved. Condoms significantly reduced cervicitis risk. Cervicitis definitions with best clinical utility and pathogen prediction were \'cervical discharge\' and \'micro+cervical discharge\'.