治疗效果的短期指标能否预测盆腔炎的长期后遗症？
Do short-term markers of treatment efficacy predict long-term sequelae of pelvic inflammatory disease?
作者信息
Trautmann Gail M, Kip Kevin E, Richter Holly E, Soper David E, Peipert Jeffrey F, Nelson Deborah B, Trout Wayne, Schubeck Dianne, Bass Debra C, Ness Roberta B
机构信息
University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA.
出版信息
Am J Obstet Gynecol. 2008 Jan;198(1):30.e1-7. doi: 10.1016/j.ajog.2007.05.021.
OBJECTIVE
This study was undertaken to assess whether short-term markers, often used to measure clinical cure after treatment for pelvic inflammatory disease, predict sequelae of lack of pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain.
STUDY DESIGN
Women with mild-to-moderate pelvic inflammatory disease were assessed after treatment initiation at 5 days for tenderness (n = 713) and at 30 days for tenderness, cervical infections and endometritis (n = 298). Pregnancy, recurrent pelvic inflammatory disease, and chronic pelvic pain were evaluated after 84 months, on average.
RESULTS
Pelvic tenderness at 5 and at 30 days significantly elevated the risk for developing chronic pelvic pain; tenderness at 30 days was also significantly associated with recurrent pelvic inflammatory disease. However, pelvic tenderness at 5 and at 30 days was only modestly clinically predictive of chronic pelvic pain or recurrent pelvic inflammatory disease (positive predictive values 22.1-66.9%). No short-term marker significantly influenced the likelihood of achieving a pregnancy.
CONCLUSION
Tenderness at 5 or 30 days did not accurately predict the occurrence of pelvic inflammatory disease-related reproductive morbidities.
目的
本研究旨在评估常用于衡量盆腔炎治疗后临床治愈情况的短期指标，是否能预测不孕、复发性盆腔炎和慢性盆腔疼痛等后遗症。
研究设计
对轻度至中度盆腔炎患者在治疗开始后第5天评估压痛情况（n = 713），在第30天评估压痛、宫颈感染和子宫内膜炎情况（n = 298）。平均84个月后评估妊娠、复发性盆腔炎和慢性盆腔疼痛情况。
结果
第5天和第30天的盆腔压痛显著增加了发生慢性盆腔疼痛的风险；第30天的压痛也与复发性盆腔炎显著相关。然而，第5天和第30天的盆腔压痛对慢性盆腔疼痛或复发性盆腔炎的临床预测作用仅为中等程度（阳性预测值为22.1 - 66.9%）。没有短期指标对妊娠可能性有显著影响。
结论
第5天或第30天的压痛不能准确预测盆腔炎相关生殖系统疾病的发生。
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