解脲脲原体不同血清型别宫内感染与妊娠结局及其胎盘绒毛膜超微结构观察

Serotypes of Ureaplasma Urealyticum Intrauterine Infection with Pregnancy Outcome and Placental Villus Ultrastructural Observation.

目的探讨解脲脲原体(ureapla smaurealyticum,Uu)不同血清型别宫内感染与自然流产和高危妊娠及其胎盘绒毛膜改变的关系。方法试验组79例,包括45例自然流产组织,高危妊娠34例(6例早产、28例PROM)胎膜分别进行Uu分离培养,采用代谢抑制试验进行血清型别鉴定以及阳性病例胎盘组织电镜观察,并与51例对照组相比照。结果共计从79例不良妊娠组胎盘组织中分离检出50株Uu(50/79,63.3%),与51例对照人群分离检出15株Uu(15/51,29.4%)比较有显著性差异(P<0.001);经血清型别分析,从不良妊娠组中分离的50株Uu中44株为1、4、5和8型(88%,44/50),与正常妊娠组比较有显著性差异(26.7%,4/15,P<0.001)。电镜下证实,不良妊娠组1、4、5和8型Uu阳性的胎盘组织电镜下检出率(81.8%,36/44),较之非1、4、5和8型Uu(0%,0/6)比较有显著性差异(P<0.001)。提示1、4、5和8型Uu易穿过胎膜;1和4型Uu检出组易发生自然流产、早产、低体重、死胎以及新生儿围生期感染致死。结论1和4型Uu宫内感染与自然流产、早产、PROM等不良妊娠结局相关。

Objective To evaluate the relationships between serotypes of U. urealyticum intrauterine infection with outcome pregnancy and placental villus uhrastructural transform. Methods The placental tissues from 45 cases with spontaneous abortion,34 cases of high -risk pregnancy ,including 6 premature delivery and 28 PROM patients （ study group ） and 51 normal pregnant patients （control group） were isolated,cnltured and performed. Serotypes of U. urealyticum were identified by a metabolic inhibition test. The positive cases placental tissue of U. urealyticum were preformed ultrastructural observation by electron microscope. Results Total positive rate 63.3% （50/79） in the study group , showing significant difference from that of control group （47.1% , 24/51, P 〈 0. 001 ） ）. Serotypes distribution assay showed that positive rate for 1, 4,and 5 or 8 types were 80% （40/50） in the 50 strains. Serotypes 1 ,and 4 were the main serotype in spontaneous abortion, premature delivery , stillbirth ,low birth weight and early neonatal death. Conclusions U. urealyticum is an important pathogen intrauterine infection such as serotype land 4 is liable traverse plaeent membrane and leading to the occurrence of spontaneous abortion, premature delivery ahd PROM.