不孕、输卵管妊娠患者宫颈CT、UU、Mh检测结果及CT、UU、Mh盆腔液检测结果和UU、Mh药敏结果分析

发布时间：2018-08-21 14:17

【摘要】：[目的] 1、(1)检测不孕患者及孕早期女性宫颈分泌物CT、UU、Mh,探讨CT、UU、Mh与不孕的关系；(2)分析不孕患者及孕早期女性宫颈支原体培养结果和阴道分泌物检测结果,探讨支原体致病性与合并阴道感染的关系。 2、检测输卵管妊娠患者及孕早期女性宫颈分泌物CT、UU、Mh,探讨CT、UU、Mh与输卵管妊娠的关系。 3、检测手术患者宫颈分泌物和盆腔液中的CT、UU、Mh,探讨盆腔液中CT、UU、Mh的感染情况。 4、进行支原体药物敏感试验,分析支原体的药物敏感情况。 [方法] 所有研究对象均选取自2013年7月至2014年3月在昆明医科大学第二附属医院妇科门诊、妇科住院部和生殖医学科就诊的患者,均需满足的纳入标准：有性生活史,在两周内未使用过任何抗生素,取样三天内没有阴道冲洗,没有阴道用药及性生活,排除经期的女性。 1、选取生殖医学科就诊的不孕症患者257例作为不孕组,不孕组患者均满足无避孕性生活一年不孕,男方精液检查正常；选取同时期妇科门诊孕早期要求终止妊娠的患者106例作为对照组；取宫颈分泌物行支原体培养、沙眼衣原体检测,比较不孕组和对照组支原体、沙眼衣原体的阳性率；取阴道分泌物行阴道分泌物检查,比较不孕组和对照组支原体感染和阴道感染的情况。 2、选取妇科住院部收治的输卵管妊娠患者81例作为输卵管妊娠组,选取同时期妇科门诊孕早期要求终止妊娠并排外既往有异位妊娠史的患者102例作为对照组；取宫颈分泌物行支原体培养、沙眼衣原体检测,比较输卵管妊娠组和对照组支原体、沙眼衣原体的阳性率。 3、选取妇科住院部因为“子宫肌瘤、子宫腺肌症、卵巢囊肿、输卵管妊娠”等疾病需手术治疗的患者305例,术前取宫颈分泌物,术中取盆腔液,均行支原体培养、沙眼衣原体检测。 4、将上述所取标本在行支原体培养时用同一试剂盒行支原体药物敏感试验。 [结果] 1、(1)不孕组和对照组宫颈分泌物均未检出沙眼衣原体；(2)不孕组宫颈分泌物支原体阳性率达59.14%,明显高于对照组47.17%,差异有统计学意义(P0.05)；(3)不孕组单纯支原体感染阳性率为31.13%；对照组阳性率为33.02%；两组阳性率差异无统计学意义(P0.05)；不孕组支原体感染合并阴道感染阳性率为28.02%,明显高于对照组14.15%,差异有统计学意义(P0.05)；不孕组单纯阴道感染阳性率为15.95%；对照组阳性率为17.92%,两组阳性率差异无统计学意义(P0.05)。 2、输卵管妊娠组和对照组宫颈分泌物均未检出沙眼衣原体；输卵管妊娠组宫颈分泌物支原体阳性率达62.96%,明显高于对照组47.06%,差异有统计学意义(P0.05)。 3、305例手术患者宫颈分泌物及盆腔液未检出沙眼衣原体；305例手术患者宫颈分泌物支原体培养阳性152例,阳性率为49.84%,盆腔液支原体培养阳性0例,宫颈分泌物阳性率明显高于盆腔液,差异有统计学意义(P0.05)。 4、单一UU感染时,对四环素类、大环内酯类敏感,对喹诺酮类耐药。单一Mh感染时,对四环素类敏感,对大环内酯类、喹诺酮类耐药。UU和Mh混合感染时,对四环素类敏感,对大环内酯类、喹诺酮类耐药。 [结论] 宫颈支原体感染是导致不孕、输卵管妊娠的原因之一；支原体可能合并其他病原微生物共同致病；盆腔液支原体检出率低于宫颈分泌物；单一UU感染时,对四环素类、大环内酯类敏感,对喹诺酮类耐药；单一Mh感染时,对四环素类敏感,对大环内酯类、喹诺酮类耐药；UU和Mh混合感染时,对四环素类敏感,对大环内酯类、喹诺酮类耐药。
[Abstract]:[Objective]
1. (1) To investigate the relationship between CT, UU, Mh and infertility by detecting the cervical secretions of infertility patients and early pregnant women; (2) To analyze the results of mycoplasma culture and vaginal secretions of infertility patients and early pregnant women, and to explore the relationship between Mycoplasma pathogenicity and vaginal infection.
2. To investigate the relationship between CT, UU, Mh and tubal pregnancy.
3. To detect CT, UU and Mh in cervical secretion and pelvic fluid of patients undergoing operation, and to investigate the infection of CT, UU and Mh in pelvic fluid.
4, carry out Mycoplasma drug sensitivity test and analyze the drug sensitivity of Mycoplasma.
[method]
All participants were selected from the gynecological outpatient clinic of the Second Affiliated Hospital of Kunming Medical University from July 2013 to March 2014. All patients in the gynecological inpatient department and the reproductive medicine department met the inclusion criteria: having a history of sexual life, not using any antibiotics within two weeks, no vaginal flushing within three days, no vaginal medication and Sexual life excludes menstrual women.
1. Select 257 infertility patients in the Department of reproductive medicine as the infertility group, the infertility group were satisfied with one-year non-contraceptive life infertility, the male semen examination was normal; Select the same period of gynecological clinic early pregnancy termination of 106 patients as the control group; Take cervical secretion for Mycoplasma culture, Chlamydia trachomatis detection, The positive rates of Mycoplasma and Chlamydia trachomatis were compared between the infertility group and the control group.
2. 81 cases of tubal pregnancy in gynecological inpatient department were selected as the tubal pregnancy group, 102 cases of patients with a history of ectopic pregnancy were selected as the control group. The positive rate of Mycoplasma and Chlamydia trachomatis was positive.
3. Choose 305 gynecologic inpatients who need surgery because of "uterine fibroids, adenomyosis, ovarian cysts, tubal pregnancy" and other diseases. Take cervical secretion before operation, pelvic fluid during operation, Mycoplasma culture, Chlamydia trachomatis detection.
4, use the same kit to test the Mycoplasma drug sensitivity test.
[results]
1. (1) Chlamydia trachomatis was not detected in cervical secretion of infertility group and control group; (2) The positive rate of Mycoplasma trachomatis in cervical secretion of infertility group was 59.14%, significantly higher than that of control group (47.17%, P 0.05); (3) The positive rate of mycoplasma infection in infertility group was 31.13%; the positive rate of control group was 33.02%; there was no significant difference between the two groups. The positive rate of mycoplasma infection with vaginal infection in infertility group was 28.02%, which was significantly higher than that in control group (14.15%, P 0.05). The positive rate of simple vaginal infection in infertility group was 15.95%, and that in control group was 17.92%. There was no significant difference between the two groups (P 0.05).
2. Chlamydia trachomatis was not detected in cervical secretion of tubal pregnancy group and control group, and the positive rate of Mycoplasma in cervical secretion of tubal pregnancy group was 62.96%, which was significantly higher than that of control group (47.06%, P 0.05).
Chlamydia trachomatis was not detected in cervical secretion and pelvic fluid of 3,305 patients, and mycoplasma culture in cervical secretion of 305 patients was positive in 152 cases (49.84%). Mycoplasma culture in pelvic fluid was positive in 0 cases, and the positive rate of cervical secretion was significantly higher than that in pelvic fluid (P 0.05).
4. Single UU infection is sensitive to tetracyclines, macrolides and quinolones. Single Mh infection is sensitive to tetracyclines, macrolides and quinolones. UU and Mh infection are sensitive to tetracyclines, macrolides and quinolones.
[Conclusion]
Mycoplasma infection is one of the causes of infertility and tubal pregnancy; Mycoplasma may be associated with other pathogenic microorganisms; Mycoplasma detection rate in pelvic fluid is lower than cervical secretions; when a single UU infection, it is sensitive to tetracyclines, macrolides and quinolones; when a single Mh infection, it is sensitive to tetracyclines. Resistance to macrolides and quinolones, susceptibility to tetracyclines and resistance to macrolides and quinolones in UU and Mh co-infection.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.6

【参考文献】