女性生殖道支原体及其他病原体在急性盆腔炎中的检出率

Detection rates of genital mycoplasma and other pathogens in women with acute pelvic inflammatory disease

目的:根据急性盆腔炎妇女与正常妇女的解脲支原体(Ureaplasma Urealylium,Uu)、人型支原体(Mycoplas-ma Hominis,Mh)、生殖支原体(Mycoplasmag enitalium,Mg)检出情况,结合急性盆腔炎妇女衣原体(Chlamydi trachomatis,Ct)及需氧菌的检出率,探讨支原体与急性盆腔炎的相关性。方法:取30例患急性盆腔炎的育龄期妇女的阴道后穹窿分泌物与子宫内膜分别进行解脲支原体(Uu)、人型支原体(Mh)的培养,生殖支原体(Mg)的PCR方法检测并以30例正常妇女为对照组,以及盆腔炎组取子宫内膜作衣原体(Ct)的PCR检测、细菌培养、内膜病理检验。结果:急性盆腔炎妇女阴道后穹窿分泌物解脲支原体(60%)、生殖支原体(33.3%)检出率明显高于正常妇女(30%、6.7%),两者差异有统计学意义(P<0.05);急性盆腔炎妇女子宫内膜解脲支原体(40%)、生殖支原体(33.3%)检出率明显高于正常妇女(6.7%、6.7%),两者差异有统计学意义(P<0.05);急性盆腔炎妇女阴道后穹窿、子宫内膜人型支原体(23.3%、23.3%)检出率与正常妇女(10%、6.7%)两者差异无统计学意义(P>0.05),可能与例数较少有关;盆腔炎组阴道后穹窿分泌物与子宫内膜Uu(60%vs40%)、Mh(23.3%vs23.3%)、Mg(33.3%vs33.3%)的检出率差异无统计学意义(P>0.05),正常对照组阴道后穹窿分泌物与子宫内膜Uu的检出率(30%vs6.7%)差异具有统计学意义,Mh(10%vs6.7%)、Mg(6.7%vs6.7%)的检出率差异无统计学意义(P>0.05);30例送检标本中子宫内膜的5种病原体的检测结果显示,盆腔炎组子宫内膜Uu检测出12例阳性(40%),Mh检测出7例阳性(23.3%),Mg检测出10例阳性(33.3%),Ct检测出9例阳性(30%),需氧菌检测出9例阳性(30%),两种混合感染检测出17例阳性(56.6%),三种混合感染检测出3例阳性(10%)。结论:①解脲支原体、生殖支原体与盆腔炎关系密切;②盆腔炎中解脲支原体的检出率最高,衣原体与细菌也是盆腔炎的重要病原体;③Uu的检测推荐首选子宫内膜检测;④盆腔炎为多种病原体混合感染。

Objective： To explore the correlation between mycoplasma and acute pelvic inflammatory disease according to the detection status of ureaplasma urealyticum （Uu）, mycoplasma hominis （Mh） , mycoplasma genitalium （Mg） in women with acute pelvic inflammatory disease and healthy women and detection rates of chlamydia trachomatis （ Ct）, aerobic bacteria in women with acute pelvic in- flammatory disease. Methods： Uu and Mh in vaginal secretions and endometrium from 30 women of child - bearing age with acute pelvic inflammatory disease （study group） were cultured, Mg in vaginal secretions and endometrium were detected by PCR, and Ct in endometrium was detected by PCR, then bacteria examination and pathologic examination of endometrium were carried out. 30 healthy women were selected as control group. Results： The detection rates of Uu （60%） and Mg （33.3%） in vaginal secretions in study group were significantly higher than those in control group （ 30% , 6. 7% ） （ P 〈 0. 05 ） ; The detection rates of Uu （40%） and Mg （ 33.3% ） in endometrium in study group were significantly higher than those in control group （6. 7%, 6. 7% ） （P 〈0. 05）; there was no significant difference in detection rates of Mh in vaginal secretions and endometrium between study group （23.3%, 23.3% ） and control group （ 10% , 6. 7% ） （P 〉0.05）, which was related to few cases ; there was no significant difference in detection rates of Uu, Mh and Mg in study group between vaginal secretions （60%, 23.3%, 33.3% ） and endometrium （40%, 23.3%, 33.3% ） （P 〉0. 05） ; there was significant difference in detection rate of Uu in control group between vaginal secretions （30%） and endometrium （6. 7% ）, but there was no significant difference in detection rates of Mh and Mg between vaginal secretions （ 10%, 6. 7% ） and endometrium （6. 7%, 6. 7% ） （P 〉0. 05） ; the detection rates of Uu, Mh, Mg, Ct and aerobic bacteria in study group were 40% （12 cases）, 23.3% （7 cases）, 33. 3% （10 cases）, 30% （9 cases） and 30% （9 cases）, respectively. Mixed infections of two pathogens and three pathogens were detected in 17 cases （56. 6% ） and 3 cases （ 10 cases） . Conclusion： Uu and Mg are closely relaled to PID. The detection rate of Uu is the highest, chlamydia and bacteria are important pathogens of acute pelvic inflammatory disease. To detect Uu, endometrial samples are more accurate. Mixed infections cause acute pelvic inflammatory disease.