宫腔镜联合CD138及子宫内膜微生态检测对慢性子宫内膜炎的诊断价值

Diagnostic value to endometritis with hysteroscopy combined with CD138 and endometrial microbiota detection

目的探讨宫腔镜联合白细胞分化抗原138(CD138)及子宫内膜微生态检测对慢性子宫内膜炎(CE)的诊断价值。方法纳入2020-06—2023-05郑州大学第二附属医院生殖医学部收治的行体外受精-胚胎移植(IVF-ET)失败的541例患者,A组(101例)行宫腔镜联合CD138及子宫内膜微生物组群检查,B组(240例)行宫腔镜联合CD138,C组(200例)行宫腔镜检查。分析三种检查方法对CE的诊断价值。结果A组、B组、C组CE的检出率分别为74.26%、62.50%、51.50%,差异有统计学意义(P<0.05)。C组宫腔镜的漏诊率为16.67%,B组的漏诊率为9.90%。三联诊断的准确率高于三者单独诊断与二联诊断(P<0.05)。结论宫腔镜联合CD138与子宫内膜微生物组群检测,能提高IVF-ET失败患者的CE检出率,降低漏诊率,并指导临床精准治疗。

Objective To explore the diagnostic value of hysteroscopy combined with leukocyte differentiation antigen 138(CD138)and endometrial microecological detection for endometritis.Methods A total of 541 patients(IVF-ET)admitted to Department of Reproductive Medicine from June 2020 to May 2023 were included in the study,among which 101 patients were sent except hysteroscopy and pathological examination for group A;240 patients underwent hysteroscopy and pathological examination CD138 in group B;another 200 patients only underwent hysteroscopy for group C to analyze the diagnostic effect of three examination methods on the diagnosis of chronic endometritis(CE).Results The detection rate of CE in groups A,B and C was 74.26%,62.50%and 51.50%,respectively(P<0.05).The missed diagnosis rate of hysteroscopy in group C was 16.67%,and that of hysteroscopy combined with pathological CE in group B was 9.90%.The accuracy of triple diagnosis was higher than that of the three separate diagnosis and double diagnosis(P<0.05).Conclusion Hysteroscopy combined with CD138 and endometrial microbiota detection can improve the CE detection rate and reduce the omission for IVF failure patients and guide precision therapy.