输卵管妊娠与潜伏结核感染的相关性研究

Correlation between tubal pregnancy and latent tuberculosis infection

目的探讨输卵管妊娠与潜伏结核感染(latent tuberculosis infection,LTBI)的相关性以及LTBT对再次妊娠的影响。方法选择2019年1月至2020年12月因首次输卵管妊娠行患侧输卵管切除的患者153例为研究组,选取同期因妇科疾病行输卵管切除患者145例为对照组,对比2组输卵管LTBT的发生率。再将研究组根据是否为潜伏结核感染分为A、B组:A组为LTBT组;B组为非LTBT组。随访A、B组患者术后月经、输卵管造影情况以及再次妊娠结局。结果与对照组比较,研究组输卵管LTBT的发生率略高,但差异无统计学意义(P>0.05);与B组比较,A组的月经及输卵管造影中子宫异常差异无统计学意义(P>0.05),输卵管造影中输卵管异常差异有统计学意义(P<0.05),A组再次妊娠率低且再次输卵管妊娠的发生率较高,差异有统计学意义(P<0.05)。结论本文未得出输卵管妊娠与结核杆菌呈正相关,可能与研究的样本量小,结核菌检出率低有关,但LTBI可造成患者输卵管异常,再次妊娠率低,再次异位妊娠率高,对LTBI患者需积极抗结核治疗,更好的保护女性生育力。

Objective To investigate the correlation between tubal pregnancy and latent tuberculosis infection(LTBI),and the effect of LTBI on second pregnancy.Methods From January 2019 to December 2020,153 patients who underwent salpingectomy due to their first tubal pregnancy were taken as the study group,and 145 patients who underwent salpingectomy due to benign gynecological diseases in our hospital during the same period were taken as the control group.The incidence of LTBI in fallopian tubes in the two groups was compared.The study group was divided into group A(LTBI group)and group B(non-LTBI group)according to LTBI.Postoperative menstruation,salpingography and second pregnancy outcome in group A and B were followed up.Results Compared with the control group,the incidence of LTBI in fallopian tubes in the study group was higher,but the difference was not statistically significant(P>0.05).There was no significant difference in uterine abnormalities in menstruation and salpingography between group A and B(P>0.05),but there was a significant difference in salpingography between group A and B(P<0.05).A significantly lower rate of second pregnancy and a higher rate of second tubal pregnancy were detected in group A than those in group B(P<0.05).Conclusion We do not identify a positive correlation between tubal pregnancy and LTBI due to a small sample size and low detection rate of Mycobacterium tuberculosis.LTBI can cause tubal abnormality,low re-pregnancy rate and high ectopic pregnancy rate.An active anti-tuberculosis treatment is needed for LTBI to better protect women’s fertility.