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[血清中抗沙眼衣原体IgG抗体水平用于识别输卵管损伤所致不孕症]

[Anti-C. trachomatis IgG antibodies levels in serum to identify infertility caused by tubal damage].

作者信息

Hernández-Trejo María, López-Hurtado Marcela, Arteaga-Troncoso Gabriel, Guerra-Infante Fernando M

出版信息

Rev Invest Clin. 2009 Jan-Feb;61(1):87-9.

Abstract

OBJECTIVE

To identify the serologic titers of anti-Chlamydia trachomatis IgG (Ab) antibodies that could be used to differentiate tubal damage infertility from other causes of subfertility in a group of Mexican women.

MATERIAL AND METHODS

This was a prospective, longitudinal and analytical study of 147 women selected in a non-random way. The women were classified into three sub-groups: 1) infertile women with tubal occlusion detected by laparoscopy (n = 58); 2) infertile women with alternative causes of subfertility (n = 50), and 3) fertile women for the control group (n = 39). An assay of indirect immunofluorescence was performed on all infertile women (n = 108). The results obtained were compared with the laparoscopic and hormonal analyses carried out on the 108 infertile women. The statistical analysis included a model in ROC Curve and Logistical Regression.

RESULTS

The results showed that the titer 1:256 is able to differentiate fertile women from infertile women. Moreover, in the adjusted analysis, the titer 1:512 was able to identify infertile women with tubal occlusion (OR 2.6, CI 95% 1.24, 5.4), with a sensibility of 40% and a specificity of 90%. Positive and negative predictive values were 85% and 50%, respectively and the positive and negative likelihood ratios were 3.85 and 0.67, respectively. The pattern of the ROC curve confirmed a court value of 1:512, with an area under the curve of 62.2% (CI 95%: 53.4-72%).

CONCLUSION

A titer greater or equal to 1:512 of anti-C. trachomatis IgG antibodies is useful in the identification of tubal factor infertility.

摘要

目的

确定抗沙眼衣原体IgG(Ab)抗体的血清学滴度,以用于区分一组墨西哥女性中因输卵管损伤导致的不孕症与其他亚生育原因。

材料与方法

这是一项对147名非随机选择女性进行的前瞻性、纵向分析研究。这些女性被分为三个亚组:1)通过腹腔镜检查发现输卵管阻塞的不孕女性(n = 58);2)有其他亚生育原因的不孕女性(n = 50);3)作为对照组的有生育能力女性(n = 39)。对所有不孕女性(n = 108)进行间接免疫荧光检测。将所得结果与对这108名不孕女性进行的腹腔镜检查和激素分析结果进行比较。统计分析包括ROC曲线模型和逻辑回归。

结果

结果显示,滴度1:256能够区分有生育能力的女性和不孕女性。此外,在调整分析中,滴度1:512能够识别出输卵管阻塞的不孕女性(OR 2.6,95% CI 1.24,5.4),敏感性为40%,特异性为90%。阳性和阴性预测值分别为85%和50%,阳性和阴性似然比分别为3.85和0.67。ROC曲线模式证实临界值为1:512,曲线下面积为62.2%(95% CI:53.4 - 72%)。

结论

抗沙眼衣原体IgG抗体滴度大于或等于1:512有助于识别输卵管因素不孕症。

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