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肺结核合并不孕症女性的临床特征、实验室检查结果与盆腔超声检查的相关性

Correlation of Clinical Features, Laboratory Finding, and Pelvic Ultrasonography of Pulmonary Tuberculosis Women with Infertility.

作者信息

Madjid Tita Husnitawati, Ardhi Iqbal, Permadi Wiryawan, Susiarno Hadi, Krisnadi Sofie Rifayani, Wirakusumah Firman Fuad, Parwati Ida

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia.

Department of Clinical Pathology and Laboratory Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia.

出版信息

Int J Gen Med. 2019 Dec 31;12:485-489. doi: 10.2147/IJGM.S228464. eCollection 2019.

Abstract

BACKGROUND AND PURPOSE

The prevalence of tuberculosis (TB) in Indonesia is still high, whereas the prevalence of extra pulmonary tuberculosis such as female genital tuberculosis (FGTB) affecting infertility is unknown. FGTB caused irreversible severe damaged of tubes and endometrium, resulting in tubal occlusion and partial or total obliteration of the uterine cavity. Diagnosis of FGTB is difficult. Therefore, a prompt diagnosis and treatment of pulmonary TB in women can prevent fertility complications. This study aims to analyze the correlation of clinical features taken from the history, physical examination, investigation of blood laboratory and gynecological ultrasound of pulmonary tuberculosis women with infertility.

PATIENTS AND METHODS

This was an observational analytic study with cross-sectional method. Subjects were women with pulmonary TB treated in TB-DOTS (tuberculosis-directly observed treatment, short-course) services at Dr Hasan Sadikin Hospital Bandung during December 2016 until March 2017. Subjects were divided into two groups consist of 32 TB patients with infertility, and 35 TB patients without infertility.

RESULTS

The results showed that clinical features such as intermenstrual bleeding, endometrial synechiae, hydrosalpinx and endometritis appearance were the difference between two groups (p <0.001), those clinical features had a moderate correlation with the incidence of pulmonary tuberculosis women.

CONCLUSION

Clinical features like endometrial synechia and ultrasound imaging such as hydrosalpinx and endometritis encountered in pulmonary and extra pulmonary tuberculosis patients with infertility can be used as a basis for the diagnosis of alleged genital TB.

摘要

背景与目的

印度尼西亚的结核病患病率仍然很高,而诸如影响不孕症的女性生殖器结核(FGTB)等肺外结核病的患病率尚不清楚。FGTB会导致输卵管和子宫内膜发生不可逆转的严重损伤,从而导致输卵管阻塞以及子宫腔部分或完全闭塞。FGTB的诊断很困难。因此,及时诊断和治疗女性肺结核可预防生育并发症。本研究旨在分析肺结核不孕女性的病史、体格检查、血液实验室检查和妇科超声检查的临床特征之间的相关性。

患者与方法

这是一项采用横断面方法的观察性分析研究。研究对象为2016年12月至2017年3月期间在万隆哈桑·萨迪金医院接受结核病直接督导短程治疗(TB-DOTS)服务的肺结核女性。研究对象分为两组,32例患有不孕症的结核病患者和35例未患不孕症的结核病患者。

结果

结果显示,两组之间的临床特征如月经间期出血、子宫内膜粘连、输卵管积水和子宫内膜炎表现存在差异(p<0.001),这些临床特征与肺结核女性的发病率具有中等相关性。

结论

在患有不孕症的肺结核和肺外结核患者中遇到的子宫内膜粘连等临床特征以及输卵管积水和子宫内膜炎等超声成像特征可作为疑似生殖器结核诊断的依据。

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