1Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage淋病与非淋菌性尿道炎淋病与非淋菌性尿道炎GonorrhoeaeandNongonococcalurethritisGonorrhoeaeandNongonococcalurethritis广州医学院第二附属医院皮肤科黄新宇2Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage淋病—定义淋病是由淋病奈瑟菌(Neisseriagonorrhoeae,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,亦是我国重点监测及报疫的八种性传播疾病之一3Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage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疫的八种性传播疾病之一4Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage病因淋病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5Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage病因非淋菌性尿道炎沙眼衣原体其血清型D~K型引起泌尿生殖器系统感染支原体解脲支原体(UU)、人型支原体(MH)、生殖支原体(MG)可引起泌尿生殖道感染6Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage病因非淋菌性尿道炎少数由阴道毛滴虫、单纯疱疹病毒、类杆菌等微生物引起7Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage病因淋球菌喜潮湿,怕干燥淋球菌、衣原体及支原体对热和一般消毒剂均很敏感8Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage发病机制淋病淋球菌通过侵袭生殖泌尿系统黏膜的柱状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表现为充血、水肿,并有脓液9Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage发病机制非淋菌性尿道炎沙眼衣原体在宿主细胞内复制的组织损害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尿素酶等,损害细胞炎症较轻,其分泌物以浆液性为主10Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床流行经过—传染源淋病感染淋球菌的患者和携带者非淋菌性尿道炎感染沙眼衣原体和支原体、阴道毛滴虫、单纯疱疹病毒、类杆菌等微生物的患者和携带者11Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床流行经过—传播途径主要通过性接触传染极少数可通过污染的衣裤、床上用品、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染12Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床表现根据我国诊断标准淋病无合并症淋病、有合并症淋病和其他部位淋病非淋菌性尿道炎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13Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床表现均有较明显的潜伏期淋病1~10天,平均为3~5天非淋性尿道炎1~3周14Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床表现—淋病无合并症淋病男性淋菌性尿道炎尿道口红肿排出黏稠的深黄色脓液有尿频、尿急、尿痛体查见尿道口红肿,充血及脓性分泌物15Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage16Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage17Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage18Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage19Dermatology&VenereologyThe2ndAff.HospitalofGuangzhouMedicalCollage临床表现-淋病无合并症淋病女性泌尿生殖系统淋病淋菌性尿道炎有尿频、尿急、尿...