输卵管性不孕危险因素的病例对照研究

Risk factors for tubal infertility in child-bearing aged women: a hospital-based case-control study

目的 寻找育龄妇女输卵管性不孕的危险因素。方法 将连续收集的 6 0例住院育龄输卵管性不孕妇女作为病人组 ,以同期入院的 6 0名育龄妊娠妇女作为对照组。使用统一问卷对所有研究对象的一般状况、性生活史、生育史、避孕史、个人卫生习惯及以往疾病史等进行调查。应用单因素和多因素分析方法对有关因素进行分析。结果 与对照组比较 ,病人组第一次性交年龄早、结婚年龄早、第一次妊娠年龄早、有婚前性行为、有婚前妊娠、有 1个以上的性伴侣、以往有阴道炎、不明原因的慢性腹部疼痛而未进行治疗及有结核病历史的比例高 ;使用避孕套的比例低。在校正了婚前性交和多个性伴侣等因素后 ,既往有不明原因的慢性腹痛而未进行诊治 (OR =9 88,95 %CI =2 6 6～36 72 ) ;第一次性交年龄 (OR =0 6 4,95 %CI =0 5 0～ 0 81)和既往结核病史 (OR =2 1 80 ,95 %CI =3 36～ 141 5 6 )仍与输卵管性不孕有关。结论 慢性腹痛和既往结核病史是输卵管性不孕的危险因素 。

Objective To identify the risk factors for tubal infertility in child bearing aged women in Chengdu, China and by so doing, prevent its occur . Methods Sixty consecutively hospitalized female patients suffering from tubal infertility were recruited as cases, and 60 pregnant women hospitalized in the same hospital were selected as controls. A structured questionnaire was used to identify the general characteristics, sexual activity, reproductive and contraceptive history, hygiene habit, and previous history of disease. Univariate and multivariate analyses were used to analyze the data thus collected. Results In comparison with the controls, the members of the case group had their first coitus, got married, and had their first pregnancy at earlier age; they trended to have more than one sexual partner, and have sex and be pregnant before marriage; a higher proportion of them had history of natural or induced abortion during their first pregnancy, and history of vaginitis, previous chronic abdominal pain without treatment and tuberculosis etc; and they use condom less regularly. logistic regression after adjusted for other variables, the variables significantly associated with tubal infertility were previous history of untreated chronic lower abdominal pain of unknown cause ( OR =9.88, 95% CI =2.66～36.72), age of first coitus ( OR =0.64, 95% CI =0.50～0.81), and history of tuberculosis ( OR =21.80, 95% CI = 3.36～ 141.56). Conclusion Unexplained abdominal pain and tuberculosis are the risk factors for tubal infertility while increased age at first coitus is protect protective factor for tubal infertility.