淋病与非淋菌性尿道炎

淋菌性宫颈炎
白带增多，阴道口有黏液脓性分泌物
Dermatology & Venereology 体查见阴道口充血、水肿，子宫颈口充血
、糜烂，有黏液脓性分泌物
外阴瘙痒，阴道内轻微疼痛和烧灼感
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The 2nd Aff. Hospital of Guangzhou Medical Collage
The 2nd Aff. Hospital of 淋病与非淋菌性尿道炎 Guangzhou Medical Collage Gonorrhoeae and Nongonococcal urethritis
广州医学院第二附属医院皮肤科 Dermatology & Venereology 黄新宇
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淋病—定义
淋
病 The 是 由 淋Aff. 病 奈 瑟 菌 of (Neisseria 2nd Hospital Guangzhou Medical Collage gonorrhoeae ，简称淋球菌 )感染泌尿生 殖系统所致的一种常见的性传播疾病
淋病是我国法定报疫的传染病，亦是我
Dermatology & Venereology 国重点监测及报疫的八种性传播疾病之
淋病
非淋菌性尿道炎
Dermatology & Venereology 男性非淋菌性尿道炎、女性非淋菌性泌尿
生殖道炎和新生儿感染
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临床表现
The 2nd Aff. Hospital 均有较明显的潜伏期
1~10天，平均为3~5天
of Guangzhou Medical Collage 淋病
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
体查见尿道口红肿，充血及脓性分泌物
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－淋病
无合并症淋病 The 2nd
Aff. Hospital of Guangzhou Medical Collage 女性泌尿生殖系统淋病
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病因
The 2nd Aff. Hospital of 淋病 Guangzhou Medical Collage
病原菌为淋病奈瑟菌,属革兰阴性双球菌 淋球菌呈卵圆形或肾形，常成对排列
Dermatology & Vຫໍສະໝຸດ Baidunereology
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病因
非淋菌性尿道炎 The 2nd Aff.
Hospital of 沙眼衣原体 Guangzhou Medical Collage
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
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临床表现－淋病
The 2nd 无合并症淋病
女性泌尿生殖系统淋病
淋菌性尿道炎
Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
尿道口充血，有脓性分泌物
有尿频、尿急、尿痛、尿血及烧灼感
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The 2nd Aff. Hospital of Guangzhou Medical Collage
The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－淋病
有合并症淋病 The 2nd
Aff. Hospital of Guangzhou Medical Collage 播散性淋病
一
2
非淋菌性尿道炎—定义
非淋菌性尿道炎是指通过性接触传染的 The 2nd Aff. Hospital of
Guangzhou Medical Collage 一种尿道炎，尿道炎症明显，但尿道分 泌物中查不到淋球菌
非淋菌性尿道炎亦是我国重点监测及报
Dermatology & Venereology 疫的八种性传播疾病之一
Dermatology & Venereology
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临床表现－淋病
The 2nd Aff. Hospital of 有合并症淋病 Guangzhou Medical Collage
女性淋病合并症
淋菌性盆腔炎
Dermatology & Venereology
淋菌性前庭大腺炎
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淋 菌 性 前 庭 大 腺 炎
非淋菌性尿道炎
Dermatology & Venereology 单纯疱疹病毒、类杆菌等微生物的患者和
携带者
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临床流行经过 —传播途径
主要通过性接触传染 The 2nd Aff. Hospital of
Guangzhou Medical Collage 极少数可通过污染的衣裤、床上用品、
非淋性尿道炎
1~3周
Dermatology & Venereology
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临床表现—淋病
无合并症淋病 The 2nd
Aff. Hospital of Guangzhou Medical Collage 男性淋菌性尿道炎
尿道口红肿 排出黏稠的深黄色脓液
Dermatology & Venereology 有尿频、尿急 、尿痛
男性淋病合并症
淋菌性附睾炎、睾丸炎
Dermatology & Venereology 淋菌性前列腺炎
其他合并症
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Dermatology & Venereology
淋 菌 性 附 睾 睾 丸 炎
The 2nd Aff. Hospital of Guangzhou Medical Collage
尿道炎
of Guangzhou Medical Collage
有尿道灼热或尿频症状
Dermatology & Venereology 尿道口充血，微红或正常
挤压有分泌物溢出
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临床表现－淋病
The 2nd 有合并症淋病 Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－非淋菌性尿道炎
女性非淋菌性泌尿生殖道炎 The 2nd Aff. Hospital
主要感染部位
宫颈
of 宫颈炎 Guangzhou Medical Collage
白带增多
Dermatology & Venereology
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Hospital of 沙眼衣原体在宿主细胞内复制的组织损害 Guangzhou Medical Collage
临床流行经过 —传染源
淋病
The 2nd Aff. Hospital of Guangzhou Medical Collage 感染淋球菌的患者和携带者
感染沙眼衣原体和支原体、阴道毛滴虫、
其血清型 D ～ K 型引起泌尿生殖器系统
感染 支原体 Dermatology & Venereology 解脲支原体 (UU) 、人型支原体 (MH)、 生殖支原体 (MG) 可引起泌尿生殖道感 染
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病因
The 2nd Aff. Hospital of 非淋菌性尿道炎 Guangzhou Medical Collage
阴道有脓性分泌物，排尿困难
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－非淋菌性尿道炎
The 2nd Aff. Hospital 男性非淋菌性尿道炎
和排尿困难，少数有尿频
毒剂均很敏感
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发病机制
淋病
上皮细胞及移形上皮细胞 在细胞内繁殖，通过内毒素、脂寡糖与补 体、 IgM 的协同作用，引起化脓性炎症反 应 Dermatology & Venereology 表现为充血、水肿，并有脓液
The 2nd Aff. Hospital of 淋球菌通过侵袭生殖泌尿系统黏膜的柱状 Guangzhou Medical Collage
淋球菌通过血行传播至全身，出现全身
非特异性的临床表现。
有高热、寒战、关节疼痛、皮损等临床 Dermatology & Venereology
宫颈内黏液脓性分泌物 可有异常阴道出血
子宫颈水肿或糜烂
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－非淋菌性尿道炎
The 2nd Aff. Hospital 女性非淋菌性泌尿生殖道炎
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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The 2nd Aff. Hospital of Guangzhou Medical Collage
少数由阴道毛滴虫、单纯疱疹病毒、类杆
Dermatology & Venereology
菌等微生物引起
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病因
The 2nd Aff. Hospital of 淋球菌喜潮湿，怕干燥 Guangzhou Medical Collage
淋球菌、衣原体及支原体对热和一般消
Dermatology & Venereology
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淋 菌 性 龟 头 包 皮 炎
The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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淋 菌 性 尿 道 周 围 脓 肿
The 2nd Aff. Hospital of Guangzhou Medical Collage
尿道口红肿，少量浆液性或脓性分泌物
of Guangzhou Medical Collage 较淋菌性尿道炎轻，有尿道刺痒、烧灼感
Dermatology & Venereology 晨起尿道口有少量黏液性分泌物或仅有痂
膜封口
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The 2nd Aff. Hospital of Guangzhou Medical Collage
Dermatology & Venereology
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临床表现－淋病
The 2nd 无合并症淋病
女童淋病
Aff. Hospital of Guangzhou Medical Collage 女性泌尿生殖系统淋病
可见阴道口、尿道口、会阴部红肿，可出
现糜烂、溃疡和疼痛 Dermatology & Venereology
毛巾、浴盆、马桶和手等间接传播 幼女常通过间接接触感染 新生儿的感染主要通过母体产道时被传 Dermatology & Venereology 染
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临床表现
根据我国诊断标准 The 2nd Aff.
Hospital of 淋病 Guangzhou Medical Collage
无合并症淋病、有合并症淋病和其他部位
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发病机制
非淋菌性尿道炎 The 2nd Aff.
和其引起的炎症反应及宿主细胞破坏的坏 死物质等产生的综合影响 支原体只能黏附在上皮细胞表面，通过吸 收宿主细胞的养料，释放有毒代谢产物及 Dermatology & Venereology 尿素酶等，损害细胞 炎症较轻，其分泌物以浆液性为主