Mueller B A, Luz-Jimenez M, Daling J R, Moore D E, McKnight B, Weiss N S
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Sex Transm Dis. 1992 Jan-Feb;19(1):28-34. doi: 10.1097/00007435-199201000-00006.
In order to explore possible etiologic differences between tubal infertility in women who had been physician-diagnosed as having pelvic inflammatory disease ("overt" PID) and in women who had not ("silent" pelvic inflammatory disease), we made use of self-reported data from a large, population-based, case-control study of infertility in King County, Washington. Responses from 33 infertile women with no history of physician-reported PID and 129 infertile women with such a history were compared to those of 501 fertile women. No cultures or blood for antibody titers were obtained. Logistic regression was used to compute the relative risks for silent and overt PID-related tubal dysfunction associated with various lifestyle and contraceptive habits in an effort to identify practices that potentially affect these outcomes. In general, practices associated with an increased risk of overt tubal disease, such as use of Dalkon Shield and other types of intrauterine devices, were also associated with an increased risk of silent tubal disease, but to a lesser extent. Women who used oral contraceptives for longer than three years had a decreased risk for silent disease (relative risk = 0.5, 95% confidence interval = 0.3-0.8), but their risk for overt disease did not decrease to the same extent (relative risk = 0.9, 95% confidence interval = 0.3-2.5). These results suggest that silent and overt tubal disease share many common lifestyle risk factors.
为了探究经医生诊断患有盆腔炎（“显性”盆腔炎）的女性与未患盆腔炎（“隐性”盆腔炎）的女性在输卵管性不孕方面可能存在的病因差异，我们利用了华盛顿州金县一项基于人群的大型不孕症病例对照研究中的自我报告数据。将33名无医生报告盆腔炎病史的不孕女性和129名有盆腔炎病史的不孕女性的回答与501名有生育能力女性的回答进行了比较。未采集培养物或血液进行抗体滴度检测。采用逻辑回归计算与各种生活方式和避孕习惯相关的隐性和显性盆腔炎相关输卵管功能障碍的相对风险，以确定可能影响这些结果的行为。一般来说，与显性输卵管疾病风险增加相关的行为，如使用达康盾和其他类型的宫内节育器，也与隐性输卵管疾病风险增加相关，但程度较轻。使用口服避孕药超过三年的女性患隐性疾病的风险降低（相对风险 = 0.5，95%置信区间 = 0.3 - 0.8），但其患显性疾病的风险并未降低到相同程度（相对风险 = 0.9，95%置信区间 = 0.3 - 2.5）。这些结果表明，隐性和显性输卵管疾病有许多共同的生活方式风险因素。
