血清抗精子抗体检测对输卵管病变诊断的意义

目的 :研究血清抗精子抗体 (AsAb)与输卵管病变之间的关系及对输卵管病变的诊断价值 ,为输卵管性不孕的诊断和治疗提供依据。方法 :分别将 2 80 6例不孕妇女分为沙眼衣原体 (CT)及解脲支原体 (UU)感染组和非感染组 ,阴道炎组、宫颈炎组、盆腔炎组和正常对照组 ,输卵管病变组和正常组三个对照系。用酶联免疫吸附法检测各组内血清AsAb阳性率差异 ;另对 2 12 4例不孕妇女检测血清AsAb ,用J检验和似然比来评估检验结果与临床诊断结果的符合率和准确性。结果 :①UU、CT生殖道感染组血清AsAb阳性率明显高于非感染组 (P <0 0 5 ) ;②宫颈炎、输卵管炎和盆腔炎组血清AsAb阳性率明显高于正常对照组 (P <0 0 1) ,而阴道炎组与正常对照组无显著性差异 (P >0 10 ) ;③血清AsAb阳性组中宫颈炎和输卵管炎发病率明显高于阴性组 ,而阴道炎发病率和生殖道正常者明显低于阴性组 (P <0 0 0 5 ) ;④血清AsAb检测结果与子宫输卵管临床检查诊断结果经统计学比较评估 ,有较高的符合率 (87 2 % )和准确性 (LR + 7 44 ,LR 0 18)。结论 :①在不孕妇女中 ,血清AsAb的产生与生殖道CT、UU感染有密切的关系 ;②血清AsAb的产生与上生殖道炎症尤其是输卵管病变之间的关系更为密切 ;③血清AsAb检测结合常规妇科检查可作为不孕妇女进?

Study of the value of detecting serum antisperm antibodies in infertile women for fallopian tubal disease diagnosis

Objective: To study the relationship between fallopian tubal disease and antisperm (AsAb) in infertile women,and evaluate the value of detecting serum AsAb for fallopian tubal disease diagnosis Methods: 2 806 infertile women were divide into the groups:CT?UU infection and no infection,vaginitis,cervicitis,pelvic inflammatory disease and normal contrast,fallopian tubal disease and normal contrast Serum AsAb were measured by an enzyme linked immunosorbent assay from above groups,and the difference of AsAb positive rate were examined by χ 2 The difference of the different position of genital tract inflammation dispersion between AsAb positive and negative groups were examined by χ 2 from another 2 124 infertile women,and the conform rate and accuracy were evaluated by J and likelibood ratios between the results of AsAb detection and clinical diagnosis Results: AsAb positive rate in CT?UU infection groups (39 2%,25 8%) were obviously higher than in no infection groups (15%,5%) and cervicitis (71 5%),pelvic inflammatory disease (76 6%),fallopian tubal disease (77 2%) groups were obviously higher than in normal contrast group (7 7%),but no marked difference between vaginitis (10 05%) and normal contrast groups The incidence of cervicitis (41 6%) and fallopian tubal disease (36 2%) in AsAb positive group were obviously higher than in AsAb negative group (8 55%,5 49%),but vaginitis (15 26%) and normal contrast (6 93) in AsAb positive group were obviously lower than in AsAb negative group (42 77%,43 19%) There were higher conform rate (87 2%) and accuracy (LR+7 44,LR 0 18) between the results of AsAb detection and the results of clinical diagnosis,indicating a good clinical test Conclusion: There are closer relations between AsAb and CT?UU genital tract infection;The relation of AsAb with upper genital tract infections,especially with fallopian tubal disease are closer than with lower genital tract infections;AsAb detection combining with gynaecology routine examination can be used as a primary screen test for infertile women before intrusive examination of uterus and tubal