输卵管远端细微异常的临床意义：一项多中心前瞻性观察研究
The Clinical Significance of Subtle Distal Fallopian Tube Abnormalities: A Multicentre Prospective Observational Study.
作者信息
Zheng X, Yu X, Xie X, Lyu G, Niu J, Li X, Chen H, Watrelot A, Guan J
出版信息
Facts Views Vis Obgyn. 2024 Mar;16(1):67-73. doi: 10.52054/FVVO.16.1.007.
BACKGROUND
Subtle distal fallopian tube abnormalities are a group of diseases characterised by small variations in tubal anatomy. The clinical significance of these abnormalities need to be studied.
OBJECTIVES
The purpose of this multicentre prospective observational study was to investigate whether subtle distal fallopian tube abnormalities are related to infertility and endometriosis.
MATERIALS AND METHODS
The investigation was carried out in five medical centres in China and France from February to July 2021 and included reproductive-age patients who underwent gynaecological laparoscopy. Subtle abnormalities included Hydatid of Morgagni (HM) , fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis, and accessory fallopian tube.
RESULTS
642 patients were enrolled in the study and 257 (40.0%) were diagnosed with subtle tube abnormalities. Hydatid of Morgagni was the most common abnormality (22.7%; n=146), followed by fimbrial agglutination (19.8%; n=127), tubal diverticula (6.9%; n=44), accessory tube (2.0%; n=13), and tubal accessory ostium (1.9%; n=12). Fimbrial phimosis was the least common abnormality (0.3%; n=2). The prevalence of subtle fallopian tube abnormalities was significantly higher among infertile patients (188/375, 50.1%) than those without history of infertility (69/267, 25.8%, ᶍ2=38.332, P=0.000). 209 patients were diagnosed with endometriosis during surgery, and the prevalence of subtle abnormalities was significantly higher in the endometriosis group than in those without endometriosis (61.2%, [128/209] vs. 29.8% [129/433], ᶍ2=58.086, P=0.000).
CONCLUSIONS
Higher prevalence of subtle tubal abnormalities suggests that they may contribute to infertility. They are highly related to endometriosis and indicate fimbrial abnormalities of endometriosis.
WHAT IS NEW?: This is the largest multicentre study to investigate the subtle distal fallopian tube abnormalities in infertile women. Compared to previous studies, this study includes the main subtle distal abnormalities and the control group patients without a history of infertility.
背景
细微的输卵管远端异常是一组以输卵管解剖结构微小变异为特征的疾病。这些异常的临床意义有待研究。
目的
这项多中心前瞻性观察研究的目的是调查细微的输卵管远端异常是否与不孕症和子宫内膜异位症有关。
材料与方法
该调查于2021年2月至7月在中国和法国的五个医疗中心进行，纳入了接受妇科腹腔镜检查的育龄患者。细微异常包括 Morgagni 囊肿（HM）、伞端粘连、输卵管憩室、副开口、伞端狭窄和副输卵管。
结果
642例患者纳入研究，257例（40.0%）被诊断为细微输卵管异常。Morgagni 囊肿是最常见的异常（22.7%；n = 146），其次是伞端粘连（19.8%；n = 127）、输卵管憩室（6.9%；n = 44）、副输卵管（2.0%；n = 13）和输卵管副开口（1.9%；n = 12）。伞端狭窄是最不常见的异常（0.3%；n = 2）。不孕症患者中细微输卵管异常的患病率（188/375，50.1%）显著高于无不孕史的患者（69/267，25.8%，χ2 = 38.332，P = 0.000）。209例患者在手术中被诊断为子宫内膜异位症，子宫内膜异位症组细微异常的患病率显著高于无子宫内膜异位症的患者（61.2%，[128/209] 对 29.8% [129/433]，χ2 = 58.086，P = 0.000）。
结论
细微输卵管异常的患病率较高表明它们可能导致不孕。它们与子宫内膜异位症高度相关，并提示子宫内膜异位症的伞端异常。
新发现
这是调查不孕女性细微输卵管远端异常的最大规模多中心研究。与以往研究相比，本研究纳入了主要的细微远端异常以及无不孕史的对照组患者。
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