不同生物亚群解脲脲原体感染与异位妊娠相关性的研究

目的 探讨不同生物亚群解脲脲原体（Uu）感染与异位妊娠的关系。方法 采用PCR方法对33例住院手术的异位妊娠妇女（异位妊娠组）的宫颈分泌物及输卵管内膜组织进行uu生物亚群分型检测;以同期因良性肿瘤行一侧附件切除术的40例患者为对照组。电镜观察不同生物亚群感染后,输卵管黏膜上皮细胞纤毛的形态学变化。结果 （1）检出率：Uu生物1群的检出率对照组为52％（21／40）,异位妊娠组为52％（17／33）,两组比较,差异无统计学意义（P〉0．05）;Uu生物2群的检出率对照组为12％（5／40）,异位妊娠组为46％（15／33）,两组比较,差异有统计学意义（P〈0．05）。（2）阳性符合率：异位妊娠组生物1群uu在输卵管黏膜组织和宫颈黏液中同时表达为13例,阳性符合率为72．2％,生物2群Uu在输卵管黏膜组织和宫颈黏液中同时表达为11例,阳性符合率为71．4％;对照组生物1群Uu在输卵管黏膜组织和宫颈黏液中同时表达为18例,阳性符合率为81．8％,生物2群Uu在输卵管黏膜组织和宫颈黏液中同时表达为5例,阳性符合率为71．4％,分别比较,差异均无统计学意义（P〉0．05）。（3）形态学变化：扫描电镜下见生物2群Uu感染的输卵管黏膜上皮细胞发生纤毛粘连、倒伏,微绒毛稀少、脱落的发生率为90％,生物1群Uu感染后,微绒毛稀少、脱落的发生率仅为10％,两者比较,差异有统计学意义（P〈0．05）。结论 生物2群Uu感染可能与输卵管黏膜上皮细胞形态变化及功能损伤有关,是增加异位妊娠发生率的原因之一。

Relationship between ureaplasma urealyticum infection and ectopic pregnancy

OBJECTIVES: To explore the relationship between different subtypes of Ureaplasma Urealyticum infection and ectopic pregnancy. METHODS: Ectopic pregnancy group included 33 patients and another 40 patients undergoing salpingo-ovariectomy with ovarian cyst or uterine myoma were investigated as control group. Polymerase chain reaction technique was used to detect Uu DNA in the two groups samples from endosalpinx and secretion of cervix. At the same time, these samples were set to electron microscope for examination. RESULTS: (1) Uu was detected in 27 fallopian tubal epithelium tissues among 33 ectopic pregnancy samples (81.8%), in which biovar1 was positive in 17 samples (52%, 17/33), biovar 2 was positive in 15 (46%, 15/33) and both biovar 1 and 2 positive was 5 (15.2%). While in the control group, Uu was detected in 24 fallopian tubal epithelium tissues among 40 samples (60%), in which biovar1 was positive in 21 samples (52%, 21/40), biovar 2 was positive in 5 (12%, 5/40) and both biovar 1 and 2 positive was 2 (5%). There was no significant difference between the two groups in Uu of biovar 1 (P > 0.05). The positive rate of Uu in biovar 2 show a significant difference (P < 0.05). (2) Co-expression samples in both fallopian tubal epithelium and cervical mucus samples from ectopic pregnancy patients in biovar1 was 13 (72.2%), and in biovar 2 was 11 (71.4%). While in control group, co-expression samples in both fallopian tubal epithelium and cervical mucus samples in biovar 1 was 18 (81.8%), and in biovar 2 was 5 (71.4%). There was no significant difference between the two groups in co-expression in both fallopian tubal epithelium and cervical mucus samples (P > 0.05). (2) The fallopian tubes infected by biovar 2 have a high rate (90%) of ciliary adhesion and exuviation. While there is a low rate (10%) for biovar1 with ciliary adhesion and exuviation. There was significant difference between the two groups of Uu (P < 0.05). CONCLUSION: The infection of ureaplasma urealyticum may increase the occurrence of fallopian pregnancy. The infection of ureaplasma urealyticum may be concerned with the morphological changes and functional damage of uterine fallopian epithelium.