解脲支原体感染引起稽留流产的危险性研究

Ureaplasma urealyticum infection increases the risk of missed abortion

目的探讨解脲支原体感染引起稽留流产的危险性,为稽留流产患者的防治提供参考。方法选取2018年1~6月,丽水市妇幼保健院收治的稽留流产患者100例为观察组,行人工流产孕妇100例为对照组。采用荧光定量PCR法检测有无解脲支原体感染,采用酶联免疫吸附法检测血清白细胞介素-6(interleukin 6,IL-6);肿瘤坏死因子-α(tumor necrosis factor alpha,TNF-α);血管内皮生长因子(vascular endothelial growth factor,VEGF);低氧诱导因子-1α(hypoxia-inducible factor-1 alpha,HIF-1α)。结果观察组解脲支原体阳性率43.00%(43/100),对照组解脲支原体阳性率12.00%(12/100),差异有统计学意义(χ~2=24.100,P=0.000)。观察组血清IL-6、VEGF、HIF-1α水平低于对照组,TNF-α高于对照组,差异有统计学意义(t=14.703、14.894、7.013、16.148,P均=0.000)。年龄≥35岁、流产史≥1次患者解脲支原体感染率分别为56.25%(9/16)、51.35%(38/74),高于年龄<35岁、流产史<1次时感染率40.48%(34/84)、19.23%(5/26),差异有统计学意义(χ~2=4.341、8.099,P均<0.05)。结论解脲支原体感染可增加稽留流产发生风险性,随着年龄和流产次数的增加,解脲支原体感染风险性随之增加。血清IL-6、TNF-α、VEGF、HIF-1α水平可作为监测稽留流产的潜在标志。

Objective To discuss the risk of missed abortion caused by ureaplasma urealyticum infection,in order to provide a reference for prevention of missed abortion.Methods 100women with missed abortion(observation group)and 100pregnant women undergoing induced abortion(control group)in Lishui Matermal and Child Healthcare Hospital from January to June 2018were included in the study.Ureaplasma urealyticum infection was determined by fluorescence quantitative PCR.Enzyme-linked immunosorbent assay was used to determine the serum levels of interleukin-6(IL-6),tumor necrosis factor alpha(TNF-a),vascular endothelial growth factor(VEGF)and hypoxia induced factor-1(HIF-1a).Results The positive rate of ureaplasma urealyticum infection was significantly higher in the observation group than that in control group(43.00%vs 12.00%;χ2=24.100,P=0.000).The serum levels of IL-6,VEGF and HIF-1αin the observation group were significantly lower than those in the control group,while the serum level of TNF-αwas significantly higher(t=14.703,14.894,7.013,16.148,P=0.000).The positive rates of ureaplasma urealyticum infection were significantly higher among women of≥35years old and women with≥1times of abortion compared to those younger than 35years old and women with no abortion history(56.25%vs 40.48%;51.35%vs 19.23%;χ2=4.341,8.099,P<0.05).Conclusions Ureaplasma urealyticum infection increases the risk of missed abortion,especially among women of older age and with abortion history.Serum levels of IL-6,TNF-alpha,VEGF,HIF-1can be potential markers for missed abortion monitoring.