沙眼衣原体/淋球菌感染与输卵管因素不孕症的关联。

Swasdio K, Rugpao S, Tansathit T, Uttavichai C, Jongusuk P, Vutayavanich T, Oranratanachai A, Pruthitada N, Peerakom S, Ittipunkul W, Rowe P J, Ward M E

Department of Obstetrics and Gynecology, Chiang Mai University, Thailand.

J Obstet Gynaecol Res. 1996 Aug;22(4):331-40. doi: 10.1111/j.1447-0756.1996.tb00985.x.

OBJECTIVE

To determine the association of past Chlamydia trachomatis and past Neisseria gonorrhoeae infection with tubal factor infertility.

METHODS

A cross-sectional study was conducted. Cases consisted of 55 primary infertile women with laparoscopy confirmed tubal damage (group A) and their husbands, consecutively attending the Infertility Unit at Maharaj Nakorn Chiang Mai Hospital between 1990 and 1992; and 58 primary infertile women with laparoscopy confirmed normal tubes (group B) and their husbands, consecutively attending the same hospital over the same period. Controls consisted of 59 postpartum women (group C) and their husbands omitted to the same hospital over the same period as cases. Past chlamydial and gonococcal infections were assessed by measuring serum IgG antibodies by enzyme immunoassay (EIA). The EIA antigens consisted of purified elementary bodies of C. trachomatis serovar L1, or purified alpha pili of N. gonorrhoeae strain P9.

RESULTS

The prevalence of positive IgG antibody to gonococcal pili in sera from group A was 29.1%, significantly higher than the prevalence of 5.2% in group B or 3.4% in group C (p = 0.000). The husbands of women in group A had a significantly higher prevalence of IgG antibody to gonococcal pili (36.4%) than the husbands of women in group B (8.6%) or group C (18.6%) (p = 0.002). There was no significant difference in positive IgA antibody between case and control groups. After controlling for age, group A showed significantly higher prevalences of past gonorrhea (OR = 32.4, 95% CI 4.3, 242.2) and past chlamydial infection (OR = 3.2, 95% CI 1.2, 8.5) than group C. The husbands of women in group A also had higher prevalences of both types of infection than the husbands of women in group C; the odds ratios for past gonorrhea or chlamydial infections were 2.8 (95% CI 1.1, 6.9) and 2.9 (95% CI 1.2, 7.1), respectively. Neither infertile women with normal tubes (group B) nor their husbands showed any difference when compared with controls.

CONCLUSION

These results suggest that in this region of northern Thailand there is an association between past gonorrhea and past chlamydial infection and tubal factor infertility.

目的

确定既往沙眼衣原体和淋病奈瑟菌感染与输卵管因素不孕症之间的关联。

方法

进行了一项横断面研究。病例包括1990年至1992年间连续就诊于清迈玛哈拉吉医院不孕症科的55名经腹腔镜检查证实有输卵管损伤的原发性不孕女性（A组）及其丈夫；以及同期连续就诊于同一医院的58名经腹腔镜检查证实输卵管正常的原发性不孕女性（B组）及其丈夫。对照组包括59名产后女性（C组）及其丈夫，他们与病例同期就诊于同一医院。通过酶免疫测定法（EIA）检测血清IgG抗体来评估既往衣原体和淋球菌感染情况。EIA抗原由沙眼衣原体血清型L1的纯化原体或淋病奈瑟菌菌株P9的纯化α菌毛组成。

结果

A组血清中淋病奈瑟菌菌毛IgG抗体阳性率为29.1%，显著高于B组的5.2%或C组的3.4%（p = 0.000）。A组女性的丈夫淋病奈瑟菌菌毛IgG抗体阳性率（36.4%）显著高于B组女性的丈夫（8.6%）或C组女性的丈夫（18.6%）（p = 0.002）。病例组和对照组之间IgA抗体阳性率无显著差异。在控制年龄后，A组既往淋病（OR = 32.4，95%CI 4.3，242.2）和既往衣原体感染（OR = 3.2，95%CI 1.2，8.5）的患病率显著高于C组。A组女性的丈夫这两种感染的患病率也高于C组女性的丈夫；既往淋病或衣原体感染的比值比分别为2.8（95%CI 1.1，6.9）和2.9（95%CI 1.2，7.1）。输卵管正常的不孕女性（B组）及其丈夫与对照组相比均无差异。