支原体、衣原体感染与自然流产的相关性探讨

Relationship between ureaplasma urealyticum (UU) or chlamydia trachomatis (CT) infections and spontaneous abortion

目的 探讨解脲支原体 (UU)、沙眼衣原体 (CT)感染与自然流产的相关性 ,为临床决策提供依据。对女性生殖道与宫内胚胎间UU ,CT感染的关系进行评价。方法 自然流产 (研究组 )和人工流产 (对照组 )妇女各 30例 ,留取宫颈管分泌物和绒毛组织 ,采用聚合酶链反应技术 (PCR)进行UU -DNA ,CT -DNA检测。随机抽取了其中的 8例绒毛标本进行光镜和电镜的组织学检查。结果 生殖道UU ,CT检出阳性者研究组分别为 10 0 % ,33 3 % ,对照组分别为 2 0 0 % ,43 3 % ,差异无显著性 (P >0 0 5 )。绒毛UU ,CT检出阳性者研究组分别为 16 7% ,2 6 7% ,对照组为 33 3 % ,30 0 % ,差异无显著性 (P >0 0 5 )。生殖道UU ,CT阳性者 37 9%绒毛中检出同种病原体 ,阴性者中 48 4%绒毛UU ,CT阳性。两者差异无显著性 (P >0 0 5 )。组织学检查未发现UU ,CT感染的绒毛标本具特异性改变。结论 生殖道及妊娠组织的UU ,CT感染并不增加早期妊娠丢失 ,宫颈管UU ,CT的存在不是导致宫内胚胎感染的决定因素。

Objective To study the relationship UU and CT infection in spontaneous abortion and the relationship between of UU and CT infection in female genital tract and embryos in utero. Methods Sixty early pregnant women were divided into study group (spontaneous abortion n =30) and control group (induced abortion n =30). Samples were taken from cervical canal and villus tissue. The polymerase chain reation technique was used to detect UU-DNA and CT-DNA. Eight villus specimens were examined under light and electron microscope. Results The positive rate UU and CT infections in genital tract was 10.0% and 33.3% respectively in the study group and was while 20.0% and 43.3% in control group respectively. There were not significant differences between the two groups ( P >0.05). The positive rate of villus UU and CT infections was 16.7% and 26.7% in study group and was 33.3% and 30.0% in control group respectively. There were not significant differences. 37.9% of genital tract UU and CT positive women and 48.4% of negative women were detected to have the same pathogen in villus, but there were not significant differences in two groups. Histological examination did not found specific change among the villus specimens infected by UU and CT. Conclusion Female genital tract and pregnant tissue infected by UU and CT dose not increase early pregnant lose. Detection of UU and CT in cervical canal is not the decisive factor causing embryo infection in utero.