Cates W, Joesoef M R, Goldman M B
Division of Training, Centers for Disease Control and Prevention (CO8), Atlanta, GA 30333.
Am J Obstet Gynecol. 1993 Aug;169(2 Pt 1):341-6. doi: 10.1016/0002-9378(93)90085-w.
We used data from a large multicenter case-control study of tubal infertility to analyze further the relationship among demographic variables, behavioral measures, history of previous sexually transmitted diseases, and past contraceptive practices, for women with and without a history of pelvic inflammatory disease.
We identified 283 white women with tubal infertility who requested care at seven participating institutions. Of these women, 238 (84%) did not have a history of pelvic inflammatory disease ("atypical pelvic inflammatory disease") whereas 45 reported a history of pelvic inflammatory disease ("overt pelvic inflammatory disease"). We compared these groups with 1629 white women without a history of either infertility or pelvic inflammatory disease who were delivered of their first live-born child at the same institutions as the infertile cases.
Women with atypical pelvic inflammatory disease were demographically more like fertile control subjects and had behavioral characteristics midway between those of the overt pelvic inflammatory disease group and the fertile group. Both oral contraceptive and diaphragm use protected against tubal infertility for women with either atypical or overt pelvic inflammatory disease. Atypical pelvic inflammatory disease was related to a history of Trichomonas infection but not to a reported history of gonorrhea, genital herpes, or other vaginitis.
Atypical pelvic inflammatory disease is probably more common than its symptomatic counterpart. Whereas this condition is associated with some characteristics of a sexually transmitted infection, clinical predictors remain elusive.
我们利用一项关于输卵管性不孕的大型多中心病例对照研究的数据，进一步分析有和没有盆腔炎病史的女性在人口统计学变量、行为指标、既往性传播疾病史以及过去避孕方式之间的关系。
我们确定了283名因输卵管性不孕而在7家参与机构寻求治疗的白人女性。在这些女性中，238名（84%）没有盆腔炎病史（“非典型盆腔炎”），而45名报告有盆腔炎病史（“显性盆腔炎”）。我们将这些组与1629名没有不孕或盆腔炎病史、在与不孕病例相同机构分娩第一胎活产儿的白人女性进行了比较。
非典型盆腔炎女性在人口统计学上更类似于生育对照组，其行为特征介于显性盆腔炎组和生育组之间。口服避孕药和使用子宫托对患有非典型或显性盆腔炎的女性预防输卵管性不孕均有保护作用。非典型盆腔炎与滴虫感染史有关，但与报告的淋病、生殖器疱疹或其他阴道炎病史无关。
非典型盆腔炎可能比有症状的盆腔炎更常见。虽然这种情况与性传播感染的某些特征有关，但临床预测因素仍然难以捉摸。
