目的对大连地区沙眼衣原体泌尿生殖道感染患者进行流行病学调查;比较观察不同药物不同疗程治疗沙眼衣原体泌尿生殖道感染的疗效;通过检测基因23S rRNA的突变情况探讨沙眼衣原体对大环内酯类药物的分子耐药机制。方法对2013年1月-2013年12月本院皮肤性病科门诊诊治的126例沙眼衣原体感染的尿道炎患者进行流行病学调查;统计分析不同方法的治疗结果;同时筛选出6例沙眼衣原体对大环内酯类药物耐药株,进行耐药基因23S rRNA突变的检测。结果男女患者沙眼衣原体阳性率差异无统计学意义(P>0.05);阿奇霉素长疗程治疗方案与其他三组治疗方案对沙眼衣原体感染患者的治愈率差异有统计学意义(P<0.05);其他三组治疗方案之间的治愈率差异无统计学意义(P>0.05);扩增23S rRNA的基因,PCR产物中耐药株测序结果中有1株A2059G突变,有3株A2057G突变,1株A2093T突变,5株有T2611C突变。结论男女沙眼衣原体感染的患病率无差别;阿奇霉素长疗程治疗方案对沙眼衣原体感染的患者治愈率较高;大连地区沙眼衣原体对大环内酯类药物的耐药分子基础是23S rRNA基因的点突变。 Objective To investigate the epidemiological investigation of genitourinary tract infections caused by Chlamydia trachomatis in Dalian and to compare the curative effects of different drugs on the treatment of genitourinary tract infections caused by Chlamydia trachomatis. To detect the changes of 23S rRNA gene in Chlamydia trachomatis Molecular drug resistance mechanism. Methods The epidemiological survey of 126 cases of urethritis infected with Chlamydia trachomatis in the department of dermatology outpatient department from January 2013 to December 2013 was conducted. The results of different methods were statistically analyzed. Six cases of Chlamydia trachomatis Macrolide drug-resistant strains, the resistance gene 23S rRNA mutation detection. Results The positive rates of Chlamydia trachomatis between men and women were not significantly different (P> 0.05). The long-term treatment with azithromycin and the other three groups had significant differences in the cure rate of Chlamydia trachomatis (P <0.05) There was no significant difference in the cure rate between the two groups (P> 0.05). The 23S rRNA gene was amplified, and one of the A2059G mutations, one of A2093T Mutant, 5 strains have T2611C ​​mutation. Conclusion There is no difference in the prevalence of Chlamydia trachomatis infection between men and women. The long-term treatment with azithromycin has a high cure rate in patients with Chlamydia trachomatis infection. The molecular basis of resistance to macrolides in Dalian is based on the point of 23S rRNA gene mutation.