宫颈及盆腔解脲支原体感染与输卵管性不孕(英文)

Tubal infertility and infections of Ureaplasma Urealyticum in cervix and pelvis

目的探讨女性宫颈与盆腔解脲支原体(UU)感染与输卵管性不孕的关系及其感染特点,探讨腹腔镜手术在输卵管性不孕的诊断中的作用。方法应用聚合酶链反应(PCR)方法对经腹腔镜检查确诊的输卵管性不孕患者(不孕组36例)和因卵巢肿瘤等原因而行腹腔镜手术、有正常生育史的患者(对照组23例)进行宫颈分泌物和盆腔液体的UU检测,并通过腹腔镜观察盆腔粘连情况,在腹腔镜下行美兰通液观察输卵管通畅程度。结果1.不孕组与对照组宫颈分泌物的UU阳性率分别为30.6%(11/36)和8.7%(2/23),两者相比有显著性差异(P<0.05);两组患者盆腔液体UU阳性率分别为5.6%(2/36)和0%(0/23),二者无显著性差异(P>0.05);2.不孕组中UU阳性患者输卵管阻塞率为87.5%,明显高于同组UU阴性患者输卵管阻塞率64.6%(P<0.05);在两组共59例患者中,UU阳性患者中仅14.3%有盆腔炎症状,与无UU感染的患者相比无显著性差异(P>0.05);3.不孕组中UU阳性者输卵管粘连以无粘连或轻度粘连为主,占50%(12/24条输卵管);UU阴性者则以中、重度粘连为主,占79.2%(38/48条输卵管),两者比较有显著性差异(P<0.05)。结论1.女性生殖道UU感染与输卵管性不孕相关;2.UU感染症状隐匿,多数患者无明显临床症状,但输卵管腔损害明显;3.早期腹腔镜检查对怀疑感染所致的不孕症患者有必要;4.

Objective: To explore the effects of Ureaplasma Urealyticum (UU) infections on tubal infertility. Methods: Samples from cervical canal and pelvic fluid of 36 tubal infertile women who underwent laparoscopy (study group) and 23 normal fertile women (contrast group). The polymerase chain reaction (PCR) technique was employed for UU-DNA assays. Results: The UU positive rate of samples from cervical canal infertile group and contrast group were 30.6% and 8.7%, respectively. There was significant difference between the two groups (P <0.05). UU positive rates of samples from pelvic fluid between the two groups showed no significant difference. The obstructive rate of tubes in UU positive infertile patients was 87.5%,but there was no pelvic adhesion or only mild pelvic adhesion in these patients. Conclusions: UU infection in cervix is a principal pathogenic factor of tubal infertility. Most patients with genital infection of UU are asymptomatic, but there are severe damages in tubal cavity.