沙眼衣原体、支原体感染的不孕症抗生素治疗后临床观察

Clinical study of antimicrobial therapy in infertile couples with Chlamydia trachomatis and Mycoplasma infections

目的 :探讨沙眼衣原体 (CT)、支原体感染不孕症夫妇系统抗生素治疗后的临床效果。方法 :对CT ,溶脲脲原体 (Uu)和人型支原体 (Mh)感染的原发不孕和继发不孕症 112例进行系统的夫妻双方抗生素治疗及临床随访。结果 :抗生素治疗后CT、Uu和Mh感染转阴率为 77.7% (87/ 112 ) ,不育丈夫的精液常规明显好转 (P <0 .0 1) ,87例治疗后感染转阴的不孕症患者 1年内有 39例妊娠 ,妊娠率为 4 4 .8% (39/ 87) ,妊娠成功率为 84 .6 % (33/ 39)。 4例患者再次感染CT、Uu和Mh而妊娠失败 ,2例发生宫外孕 ,妊娠失败率为 15 .4 % (6 / 39)。结论 :CT、Uu和Mh感染的不育不孕症抗生素系统治疗是有效的 ,对妊娠妇女有必要进行妊娠早期的CT、Uu和Mh感染监测和再次感染治疗。

Objective: To evaluate the efficacy of antimicrobial therapy in infertile couples with Chlamydia trachomatis (CT) and Mycoplasma infections. Methods: One hundred and twelve primary and secondary sterile couples with CT, Ureaplasm urealyticum (Uu), and Mycoplasma hominis (Mh) infections were treated by systemic antibiotics. Results: The eradication rates of CT , Uu and Mh was 77.7% (87 /112). Their husbands' spermatozoa routine test improved after treatment ( P < 0.01). Among the pathogen eradicated 87 patients, 39 patients (44.8%) got pregnant within one year after treatment, and at last 33 of them were (84.6%) pregnant successfully. Among them 27 were successfully pregnant naturally, 12 had threatened miscarriage. 6 of the 12 were pregnant successfully by measures prevent miscarriage and antibiotics therapy, 4 patients treated by measures prevent miscarriage without given antibiotics, failed of pregancy, and ectopic pregnancy occurred in 2, the failure rate being 15.4% (6 /39). Conclusions: Antimicrobial therapy is effective in infertile couples with CT, Uu and Mh infections. It is essential to monitor CT, Uu and Mh infection in early pregnancy and treat infections to prevent the failure of pregnancy and ectopic pregnancy.