联合检测血清CT-IgG60及CHSP60在筛查输卵管不孕中的价值

Clinical value of joint detection of serum CT-IgG60 and CHSP60 in the screening for tubal infertility

目的探讨联合检测血清沙眼衣原体免疫球蛋白(CTIgG)及衣原体热休克蛋白60,(CHSP60)在初步筛查输卵管不孕中的临床价值。方法收集2011年10至2012年5月在中南大学湘雅二医院和湖南省职业病防治院妇科经腹腔镜诊断的33例输卵管不孕患者(研究组)和15例正常盆腔非输卵管因素不孕患者(对照组)的血清,用酶联免疫法检测CTIgG及CHSP60,分析单个CTIgG、CHSP60指标及联合指标筛查输卵管不孕的灵敏度、特异度、阳性似然比、阴性似然比及约登指数。结果研究组和对照组中CTIgG、CHSP60的阳性率分别为57.58%(19/33)、6.67%(1/15)和54.55%(18/33)、6.67%(1/15),研究组CTIgG和CHSP60阳性率均高于对照组,经比较差异均有统计学意义(x^2值分别为10.996、9.885,均P<0.05)。研究组中CTIgG、CHSP60的灵敏度和特异度分别为57.58%、93.3%和54.55%、93.3%;两者联合后检测的灵敏度为80.72%,特异度为87.04%,阳性似然比为6.23,阴性似然比为0.07,约登指数为0.68。结论联合检测血清CTIgG及CHSP60在初步筛查输卵管不孕中是一个较好的无创血清学指标,特别是排除非输卵管不孕是一个较好地选择。

Objective To investigate the clinical value of joint detection of serum Chlamydia trachomatis IgG （CTIgG） and Chlamydia heat shock protein 60 （CHSP60） in the preliminary screening for tubal infertility. Methods Serums were collected from 33 cases of patients with tubal infertility （study group） and 15 cases of infertile patients with normal pelvic cavity and non-tubal factors （control group）. All those patients were diagnosed at the Second Xiangya Hospital of Central South University or gynecology department of Hunan Prevention and Treatment Center for Occupational Diseases by laparoscope from October 2011 to May 2012. Enzyme-linked Immunosorbent Assay was used to detect CTIgG and CHSP60. Single or joint detection of CTIgG and CHSP60 were carried out to explore the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and Youden index of the screening for tubal infertility. Results The positive rate of CTIgG in the study group and control group was 57.58% （19/33） and 6.67% （ 1/15）, respectively. In addition, the positive rate of CHSP60 in the study group and control group was 54.55% （18/33） and 6.67% （ 1/15）, respectively. Thus, the positive rate of CTIgG and CHSP60 in the study group was higher than that of the control group, and the difference was statistically significant （X2 value was 10. 996 and 9. 885, respectively, both P 〈 0.05）. The sensitivity and specificity of CTIgG in the study group was 57.58% and 93.3%, respectively. Besides, the sensitivity and specificity of CHSP60 in the study group was 54.55% and 93.3%, respectively. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and Youden index of joint detection was 80~ 72%, 87.04%, 6.23, 0.07 and 0.68, respectively. Conclusion Joint detection of serum CTIgG and CHSP60 is a relatively good and non-invasive serological indicator in the preliminary screening for tubal infertility, especially for the exclusion of infertility of non-tubal factors.