SexuallyTransmittedDiseaseWomen’sHospital,SchoolofMedicineZhejiangUniversityProf.LinJun性傳播疾病STD雙語(yǔ)教學(xué)第1頁(yè)Sexuallytransmitteddisease,STDSTD

isusedtodenotedisordersspreadprincipallybysexualintercourseorbehaviorsimilartothat.Formsoftransmission:SexualtransmissionIndirectcontacttransmission

bloodtouchiatrogenic(醫(yī)源性)

transmission性傳播疾病STD雙語(yǔ)教學(xué)第2頁(yè)

STDsurveillanceinChinaSyphilisGonorrheaAIDSNongonococcalurethritis(NGU,非淋菌性尿道炎)Condylomaacuminata(尖銳濕疣)Chancroid(軟下疳)Lymphogranulomavenereum(性病性淋巴肉芽腫)Genitalherpes(生殖器皰疹)Sexuallytransmitteddisease,STD性傳播疾病STD雙語(yǔ)教學(xué)第3頁(yè)Sexuallytransmitteddisease,STD

Pathogens：BacteriaVirusSpirochete(螺旋體)MycoplasmaChlamydiaProtozoa(原蟲(chóng))Fungi(真菌)Ectoparasite(寄生蟲(chóng))性傳播疾病STD雙語(yǔ)教學(xué)第4頁(yè)Sexuallytransmitteddisease,STD

Gonorrhea

Pathogen：

NeisseriagonorrhoeaeTransmission：

primarilybysexualcontactInvasion：

columnar

epithelium

andtransitionalepitheliumcervix,urethra→upperreproductivetract性傳播疾病STD雙語(yǔ)教學(xué)第5頁(yè)

Gonorrhea

Clinicalfindings：Incubationperiod：1-10days50%~70%patientsareasymptomatic.1.Lowergenitaltractinfection:endocervicitisurethritisbartholinitis(前庭大腺炎)2.Uppergenitaltractinfection:pelvicinflammatorydisease(PID)3.Disseminatedgonococcalinfection(DGI)passbybloodcirculation性傳播疾病STD雙語(yǔ)教學(xué)第6頁(yè)Gonorrhea性傳播疾病STD雙語(yǔ)教學(xué)第7頁(yè)Diagnosis：Accordingtobadsexualencounter,clinicalfindingsandlaboratoryfindingsGram-negativediplococci(雙球菌)canbeseenmicroscopicallyinsecretions.Cultureisthebeststandard.PCR

Gonorrhea

性傳播疾病STD雙語(yǔ)教學(xué)第8頁(yè)Treatment：

Principles:promptly、fulldose、antibioticsavailablethirdgenerationcephalosporinsquinolonesCriterionofcure：Underthesituationofnosexuallifeand2weeksafterthewholetherapy,theclinicalsymptomsandsignshavegone.The4-7daftercure,thesmeartestingandcultureofsecretionincervicalcanalsarenegative.

Gonorrhea

性傳播疾病STD雙語(yǔ)教學(xué)第9頁(yè)Sexuallytransmitteddisease,STDSyphilisPathogen：

Treponemapallidum

Transmission：sexuallytransmissionindirectcontacttransmission

bloodtouchfrominfectedmothertofetus性傳播疾病STD雙語(yǔ)教學(xué)第10頁(yè)SyphilisClinicalfindings：1.Primarysyphilis

：chancre(硬下疳)indurated,firm,painlesspapuleorulcerwithraisedbordersonlabia,vulva,vagina,cervix,anus,lips,ornipples2.Secondarysyphilis

：diffusebilaterallysymmetricextragenitalpapulosquamouseruption(丘疹鱗屑性皮疹),condylomalatum(扁平濕疣)3.Tertiarysyphilis：cardiac，neurologic(神經(jīng)),ophthalmic(眼),andauditory(耳)

lesions性傳播疾病STD雙語(yǔ)教學(xué)第11頁(yè)Syphilissecondarysyphiliscondylomalatum(扁平濕疣)secondarysyphilis:papulosquamous(丘疹疹鱗屑性皮疹)性傳播疾病STD雙語(yǔ)教學(xué)第12頁(yè)SyphilisTertiarysyphilis性傳播疾病STD雙語(yǔ)教學(xué)第13頁(yè)SyphilisLaboratoryfindings:

1.IdentificationoftheorganismDarkfieldmicroscopyexamination(暗視野顯微鏡檢驗(yàn))→Treponemapallidum

(梅毒螺旋體)2.Serologicexaminationa.Nontreponemaltests(非梅毒螺旋體抗原試驗(yàn))

VDRL,RPR——syphilisscreening(篩查)

b.Treponemaltests(梅毒螺旋體抗原試驗(yàn))

TPPA,TPHA——syphilisconfirmation(確診)3.Examinationofcerebrospinalfluid(腦脊液)性傳播疾病STD雙語(yǔ)教學(xué)第14頁(yè)SyphilisTreatment：penicillinCriterionofcure：ClinicalcureSerologiccure性傳播疾病STD雙語(yǔ)教學(xué)第15頁(yè)Sexuallytransmitteddisease,STDCondylomaacuminata（尖銳濕疣）Pathogen:

humanpapillomavirus(HPV)

mainlyTypes6and11——low-riskHPVTransmission：

sexuallytransmission性傳播疾病STD雙語(yǔ)教學(xué)第16頁(yè)CondylomaacuminataClinicalFindingsSymptomsneoplasm：vulvae,cervix,vagina,perianalarea(肛周)vulvarpruritusvulvarburningsensationpostcoitalbleedingSigns：Tiny,isolatedorclusteringpinkpapules(丘疹)arepresentatfirst,thengettogetherjustlikecombshape(雞冠狀).性傳播疾病STD雙語(yǔ)教學(xué)第17頁(yè)Condylomaacuminata性傳播疾病STD雙語(yǔ)教學(xué)第18頁(yè)CondylomaacuminataLaboratoryFindingsCytology：koilocytosis(挖空細(xì)胞)dyskeratosis(角化不良細(xì)胞)

parakeratosis(角化不全細(xì)胞)

Aceticacidtest(醋酸試驗(yàn))

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white（+）Colposcope(陰道鏡)Pathology：hyperplasiaofsquamousepitheliumPCR:HPVdetect性傳播疾病STD雙語(yǔ)教學(xué)第19頁(yè)CondylomaacuminataTreatmentThereisnocureforHPValthoughlesionscanber