孕期病原微生物感染与自然流产相关性研究

STUDY ON THE CORRELATION BETWEEN INFECTION OF PATHOGENIC MICROORGANISM AND SPONTANEOUS ABORTION OF GESTATION

目的探讨孕期病原微生物感染与自然流产的相关性。方法对两所医院2008年1月～2010年12月收治的360例稽留流产妇女(观察组)和360例正常足月分娩孕妇(对照组)进行15种病原微生物感染指标检测。包括阴道分泌物假丝酵母菌、加德纳菌、滴虫、衣原体、支原体、淋病奈瑟菌,血清中特异性抗体检测包括TORCH4项、乙肝两对半定量、丙肝、HIV、梅毒和微小病毒抗体,对两组检测结果进行比较。结果观察组阴道分泌物假丝酵母菌阳性119例(33.06%),对照组阳性61例(16.94%);观察组细菌性阴道病阳性125例(34.72%),对照组阳性74例(20.56%);两组比较差异有统计学意义(p<0.05)。观察组两种病原体总检出率为53.62%,对照组为37.50%,两组比较差异有统计学意义(p<0.05)。观察组阴道感染控制后,有74例(20.56%)在随访的3年中再次妊娠并顺利分娩。结论容易被忽视的阴道假丝酵母菌持续感染和细菌性阴道病可能是东莞地区育龄妇女自然流产的主要感染性原因。有效治疗上述感染可能改善这些孕妇的妊娠结局。

Objective To explore the correlation between infection of pathogens and spontaneous abortion due to the embryonic death. Methods 360 patients with spontaneous abortion （ observation group ） and 360 cases with normal delivery （control group） were recruited by 2 hospitals from Jan 2008 to Dec 2010. Blood serum and endocervical swabs from vagina secretion or cervical secretions were taken for detection of 15 kinds pathogens such as candida species, bacterial vaginosis （ BV）, triehomonas, gonococci, ureaplasma urealyticum, mycoplasma hominis, TORCH, syphilis spirochaeta pallida, HBsAg, tiny virus, HIV and HcV antibodies and so on, and the results were compared between the two groups. Results 119 patients （33.06%） were candida species positive in the observation group, while 61 cases （ 16.94% ） were positive in the control group. The difference between two groups was significant （p 〈 0.05）. In the observation group, 125 cases （34.72%） had BV active infection, while in the control group, only 74 cases （20.56%） had active infection. The difference between the two groups showed statistical significance （p 〈 0.05 ）. In the observation group, 74 cases （20.56%） had normal pregnancy and delivery after infection cured in following 3 years. There was no significant difference in the other infection between observa- tion group and control group （p ~ 0.05）. Conclusion The lower reproductive tract infection was associated with spontaneous abortion. The saccharomycetes and bacterial vaginitis may be the main infectious factors leading to the spontaneous abortion in Dongguan area. Pre - pregnancy examination should pay attention to screening bacterial viginitis and saccharomycetes. Detec- tion of these pathogens and active treatment can play important roles in improving the pregnancy outcomes of these gravidas.