继发不孕与生殖道感染的临床相关性分析

Clinical analysis of the relationship between secondary infertility and reproductive tract infections

目的探讨继发不孕妇女生殖道感染的情况及与输卵管炎症的相关性。方法对985例继发不孕妇女的临床资料进行回顾性分析,采用碘海醇注射液进行子宫输卵管造影,根据输卵管通畅情况分为3组,即输卵管完全阻塞组(A组)、部分阻塞组(B组)和通畅组(C组),取宫颈分泌物进行生殖道病原体(解脲支原体、沙眼衣原体、人型支原体)检测,并进行临床分析。结果在继发不孕的985例患者中,感染率依次为解脲支原体25.48%(251/985)、沙眼衣原体5.89%(58/985)、人型支原体2.44%(24/985)。其中解脲支原体感染者输卵管通畅组与完全阻塞组及部分阻塞组均有统计学差异(Pearsonx^2=40.629,P<0.05;沙眼衣原体感染者输卵管通畅组与完全阻塞组有统计学差异(Pearsonx^2=6.898,P<0.05);人型支原体感染者输卵管通畅与否均无统计学意义(Pearsonx^2=2.897,P>0.05)。结论在继发不孕妇女中,应重视对解脲支原体、沙眼衣原体的检测,从而降低输卵管性不孕的发生率。

Objective To investigate the reproductive tract infections and their relationship with the inflammation of fallopian tubes in secondary infertility women. Methods Retrospective analysis was conducted on the clinical data of 985 cases of secondary infertility. Hysterosalpingography （HSG） was performed to understand the condition of fallopian tube. All of the secondary infertility women were divided into 3 groups according to the smoothness of fallopian tube, completely blocked group （ group A） , partially blocked group （ group B） and tubal fluent group （group C ）. Cervical secretions were taken for checking reproductive tract pathogens （including ureaplasma urealyticum, Chlamydia trachomatis and mycoplasma hominis ）. Results In 985 cases of secondary infertility, the infection rate of ureaplasma urealyticum, Chlamydia trachomatis and mycoplasma hominis was 25.48 % （251/985）, 5.89% （58/985） and 2.44% （24/ 985）, respectively. The differences in the infection rate of ureaplasma urealyticum among three groups was significant （ Pearson χ2 = 40. 629 ,P 〈 0.05 ）, and the difference in that of Chlamydia trachomatis infection was significant between group C and group A （Pearson χ2 = 6. 898 ,P 〈 0.05 ）. However, the infection rate of mycoplasma hominis among three groups showed no significant difference （Pearsonχ2 = 2. 897, P 〉 0.05）. Conclusion Attention should be paid to the detection of ureaplasma urealyticum and Chlamydia trachomatis in secondary infertility women, so as to reduce the incidence of tubal infertility.