输卵管性不孕患者支原体感染药物敏感性和H_(2)O_(2)与b-FGF检测意义

Drug susceptibility of mycoplasma infection in patients with tubal infertility and significance of H_(2)O_(2)and b-FGF

目的输卵管性不孕患者支原体感染药敏分析和过氧化氢(H_(2)O_(2))与重组人碱性成纤维细胞生长因子(b-FGF)对其预测价值。方法选取2018年1月-2021年3月海南西部中心医院收治的50例输卵管性不孕患者设为研究组,另选取同期健康育龄女性体检者50名作为对照组,采用液体培养法检测人型支原体(Mh)和解脲支原体(Uu),分析两组支原体检出情况以及输卵管性不孕患者支原体药敏试验结果;采用酶联免疫吸附法检测两组人输卵管上皮细胞上清液中H_(2)O_(2)、b-FGF含量,并采用受试者工作特征(ROC)曲线分析人输卵管上皮细胞上清液中H_(2)O_(2)、b-FGF含量对支原体感染导致输卵管性不孕的诊断效能,分析H_(2)O_(2)与b-FGF的相关性。结果研究组Uu、Mh、Uu+Mh感染率高于对照组(P<0.05);20~30岁输卵管性不孕患者Uu感染率高于31~40岁患者(P<0.05);Uu对四环素、交沙霉素、克拉霉素及强力霉素较敏感(敏感率>80%);Mh对交沙霉素、四环素、强力霉素敏感性较高(敏感率>85%);Uu+Mh对四环素、强力霉素、交沙霉素敏感性较高(敏感率≥75%);研究组人输卵管上皮细胞上清液中H_(2)O_(2)、b-FGF高于对照组(P<0.001);ROC曲线分析显示,人输卵管上皮细胞上清液中H_(2)O_(2)、b-FGF含量联合预测支原体感染导致输卵管性不孕的曲线下面积(AUC)为0.925,敏感度为96.00%高于单独检测(P<0.05);Spearman相关分析显示,H_(2)O_(2)与b-FGF呈正相关(r=0.379,P=0.015);研究组OD值低于对照组,细胞抑制率高于对照组(P<0.001)。结论支原体感染引起的输卵管性不孕患者输卵管上皮细胞上清液中H_(2)O_(2)、b-FGF含量较高,对输卵管性不孕预测价值较高,临床应对其水平进行监测;同时进行支原体感染的常规检查和药敏试验,以减少输卵管性不孕发生。

OBJECTIVE To analyze the drug susceptibility of mycoplasma infection in patients with tubal infertility,and the predictive value of hydrogen peroxide(H_(2)O_(2))and recombinant human basic fibroblast growth factor(b-FGF).METHODS Fifty patients with tubal infertility admitted to Western Hainan Central Hospital from Jan.2018 to Mar.2021 were selected as the study group,and 50 healthy women of childbearing age who underwent physical examination during the same period were selected as the control group.Mycoplasma hominis(Mh)and Ureaplasma urealyticum(Uu)were detected by liquid culture method.The detection of mycoplasma in the two groups and drug sensitivity test results of mycoplasma in patients with tubal infertility were analyzed.The contents of H_(2)O_(2)and b-FGF in supernatant of human fallopian tube epithelial cells in two groups were detected by ELISA method,and their diagnostic performance for tubal infertility caused by mycoplasma infection was analyzed using the receiver operating characteristic(ROC)curve.The correlation between H_(2)O_(2)and b-FGF was analyzed.RESULTS The infection rates of Uu,Mh and Uu+Mh in the study group were higher than those in the control group(P<0.05).The Uu infection rate in patients with tubal infertility aged 20-30 was higher than that in patients aged 31-40(P<0.05).Uu was relatively sensitive to tetracycline,josamycin,clarithromycin and doxycycline(sensitivity rates>80%).Mh was relatively sensitive to josamycin,tetracycline and doxycycline(sensitivity rates>85%).Uu+Mh was relatively sensitive to tetracycline,doxycycline,and josamycin(sensitivity rates≥75%).The content of H_(2)O_(2)and b-FGF in the supernatant of human fallopian tube epithelial cells in the study group was higher than that in the control group(P<0.001).The ROC curve analysis showed that the area under the curve(AUC)of H_(2)O_(2)and b-FGF in the supernatant of human fallopian tube epithelial cells combined to predict tubal infertility caused by mycoplasma infection was 0.925,and the sensitivity was 96.00%,which were higher than those of single detection(P<0.05).Spearman correlation analysis showed that H_(2)O_(2)was positively correlated with b-FGF(r=0.379,P=0.015).The OD value of the study group was lower than that of the control group,and the cell inhibition rate was higher than that of the control group(P<0.001).CONCLUSION The content of H_(2)O_(2)and b-FGF in supernatant of human fallopian tube epithelial cells in patients with tubal infertility caused by mycoplasma infection was relative higher,indicating their high predictive value for tubal infertility.Clinically,the levels of H_(2)O_(2)and b-FGF should be monitored,and routine inspections for mycoplasma infection as well as drug sensitivity test should be performed at the same time to reduce the occurrence of tubal infertility.