236例盆腔炎、宫颈炎患者宫颈沙眼衣原体及解脲支原体感染结果分析

目的研究盆腔炎、宫颈炎与宫颈沙眼衣原体(CT)及解脲支原体(UU)感染的相关性.方法对236例盆腔炎、宫颈炎患者进行宫颈CT、UU检测,CT采用抗原免疫法,UU采用培养法.结果 236例盆腔炎、宫颈炎患者中,衣原体感染62例(26.3%),支原体感染99例(42.9%),两者感染的总阳性率68.2%,混合感染26例(11.0%).结论沙眼衣原体及解脲支原体为盆腔炎/宫颈炎重要致病因素,应重视宫颈沙眼衣原体及解脲支原体的检测.     

沙眼衣原体和解脲支原体感染与稽留流产的关系

目的探讨生殖道沙眼衣原体（CT）解脲支原体（UU）感染与稽留流产的关系。方法应用免疫金标法、培养法对148例稽留流产病人（观察组）进行CT、UU的检测,并以150例正常妊娠妇女作为对照（对照组）。结果观察组CT、UU以及CT＋UU混合感染阳性率分别为20.95%、33.11%、10.14%;对照组分别为5.33%、8.67%、2.67%,两组CT、UU以及CT＋UU混合感染阳性率比较差异均有显著性（P〈0.01）。结论生殖道沙眼衣原体（CT）和解脲支原体（UU）感染与稽留流产关系密切,是造成稽留流产病因之一。     

236例盆腔炎、宫颈炎患者宫颈沙眼衣原体及解脲支原体感染结果分析

目的　研究盆腔炎、宫颈炎与宫颈沙眼衣原体 (CT)及解脲支原体 (UU)感染的相关性 .方法　对 2 36例盆腔炎、宫颈炎患者进行宫颈CT、UU检测 ,CT采用抗原免疫法 ,UU采用培养法 .结果　 2 36例盆腔炎、宫颈炎患者中 ,衣原体感染 6 2例 (2 6 .3% ) ,支原体感染 99例 (42 .9% ) ,两者感染的总阳性率 6 8.2 % ,混合感染 2 6例 (11.0 % ) .结论　沙眼衣原体及解脲支原体为盆腔炎 /宫颈炎重要致病因素 ,应重视宫颈沙眼衣原体及解脲支原体的检测 .     

不孕不育夫妇CT、UU检测结果分析及临床意义

目的了解解脲支原体（UU）和沙眼衣原体（CT）感染与不孕不育的关系,同时了解不孕不育夫妇之间的交叉感染情况,为生殖医学提供相关的医学依据,以便采取相应的治疗和有效预防措施,提高受孕率。方法用荧光定量PCR方法检测200对夫妇（不孕不育组100对,正常对照组100对）女性宫颈分泌物、男性精液标本中的解脲支原体一DNA和沙眼衣原体一DNA含量,并对相关实验数据进行医学统计学处理。结果不孕不育组女性解脲支原体-DNA阳性率46%,沙眼衣原体-DNA阳性率25%,解脲支原体或沙眼衣原体的总感染率为55%,男性解脲支原体-DNA阳性率21%,沙眼衣原体-DNA阳性率20%,解脲支原体或沙眼衣原体的总感染率为36%,一对夫妇同时感染同一种病原体者32%;正常对照组女性则分别为15%、9%、20%,男性分别为12%、6%、15%,一对夫妇同时感染同一种病原体者11%,两组间有显著性差异。结论解脲支原体和沙眼衣原体是引起男女不孕不育的重要病原体之一,应引起生殖医学工作者的足够重视,同时积极加强不孕不育夫妇之间交叉感染的预防,也是提高不孕不育夫妇受孕率的方法之一。     

荧光定量PCR检测稽留流产患者沙眼衣原体和解脲支原体结果分析

目的探讨沙眼衣原体（CT）和解脲支原体（UU）感染与孕妇稽留流产的相关性,以及荧光定量PCR在稽留流产病因检测中的应用价值。方法采用荧光定量PCR检测稽留流产患者宫颈分泌物标本中的CT-DNA和UU-DNA的含量。结果 138例稽留流产患者中72例感染CT或UU,总检出率53.62%,其中CT阳性率21.74%,UU阳性率42.03%,混合感染10.14%。与正常人群对照差异均有统计学意义（P〈0.05）。结论泌尿生殖系统CT和UU的感染与稽留流产有密切相关性,荧光定量PCR对稽留流产患者CT和UU的检测简单、快速、准确。     

PCR检测解脲支原体和沙眼衣原体感染与女性不孕关系分析

目的探讨解脲支原体和沙眼衣原体感染与女性不孕关系。方法PCR荧光检测法,严格按试剂盒操作程序操作。结果试验组沙眼衣原体(CT)和解脲支原体(UU)阳性率分别为34.5%和40.3%,对照组阳性率为12.3%和18.5%,两组间有极显著性;CT:χ2=18.89P0.005;UU:χ2=15.97P0.005;CT+UU(混合)χ2=7.03P0.01。结论生殖道沙眼衣原体和解脲支原体感染是引起女性不孕的因素之一。     

FQ-PCR检测不孕不育患者解脲支原体和沙眼衣原体

目的观察解脲支原体和沙眼衣原体的感染与不孕不育的关系。探讨实时荧光定量PCR技术在不孕不育患者的诊断和治疗中的作用。方法采用实时荧光定量PCR技术检测45对不孕不育夫妇女性宫颈分泌物、男性精液或前列腺标本中的解脲支原体-DNA和沙眼衣原体-DNA含量。结果不孕不育患者解脲支原体-DNA阳性率37.78%,沙眼衣原体-DNA阳性率28.89%,解脲支原体或沙眼衣原体的总感染率为52.22%,正常对照组则分别为15.00%、8.33%、20.00%,两组间有显著性差异。不孕不育组中解脲支原体的感染率明显高于沙眼衣原体（P〈0.05）。女性患者解脲支原体DNA载量和沙眼衣原体-DNA载量均高于男性患者（P〈0.05）。结论解脲支原体和沙眼衣原体是引起男女不孕不育的重要原因之一。荧光定量PCR技术用于诊断引起不孕不育的解脲支原体或沙眼衣原体泌尿生殖道感染是完全可靠的。     

不良妊娠-稽留流产的病因探讨

目的探讨孕妇沙眼衣原体(CT)和解脲支原体(UU)感染与不良妊娠-稽留流产的关系及其发病机制,并试图寻找预防和降低稽留流产发生的方法和途径。方法分别采用荧光定量聚合酶链反应(FQ-PCR)的方法和细胞培养的方法对稽留流产患者340例和人工流产的孕妇176例的宫颈分泌物和妊娠产物同时进行了CT、UU的检测,并进行与稽留流产的相关分析。结果稽留流产组和人工流产组比较,宫颈分泌物标本:采用培养法,稽留流产与CT、UU感染及CT+UU混合感染有关(P<0.05)。采用PCR法,稽留流产组与CT+UU混合感染有关(P<0.05),与单纯CT及UU感染无关(P>0.05);妊娠产物标本:采用培养法,稽留流产与CT、UU感染有关(P<0.05),与CT+UU混合感染无关,但差异接近显著性水平(P=0.053)。采用PCR法,稽留流产与CT+UU混合感染有关(P<0.05),与单独CT、UU感染无关(P>0.05)。结论孕妇沙眼衣原体和解脲支原体感染与稽留流产有着密切关系。     

沙眼衣原体和解脲支原体在晚期先兆流产中的意义

目的探讨沙眼衣原体和解脲支原体判断晚期先兆流产预后的价值。方法选择85例患者,按妊娠结局分为2组：晚期难免流产组15例,晚期先兆流产组70例。另选正常中孕者50例作为中孕组。应用免疫金标法、培养法进行CT、UU的检测。结果晚期难免流产组CT、UU以及CT＋UU混合感染阳性率分别为26.66%、33.33%、13.33%;晚期先兆流产组分别为8.57%、11.42%、5.71%;正常中孕者分别为6.00%、8.00%、2.00%;晚期难免流产组沙眼衣原体（CT）和解脲支原体（UU）感染率与中孕组、先兆流产组比较有显著性差异（P〈0.001）。结论生殖道沙眼衣原体（CT）和解脲支原体（UU）感染与难免流产关系密切,是造成难免流产病因之一。早期治疗可改善晚期先兆流产预后。     

解脲支原体感染与妊娠结局的关系探讨

目的探讨解脲支原体（UU）感染与妊娠结局的关系,了解妊娠期UU感染对围产儿及孕产妇的影响。方法采用培养法对369例孕产妇的宫颈分泌物进行检测。结果369例孕妇中UU阳性者210例,占56.9%,UU阳性组与阴性组比较,其胎膜早破、早产、低出生体重儿、新生儿肺炎、胎儿宫内窘迫、剖宫产的发生率高,差异有显著性（P〈0.05）。结论解脲支原体感染可引起不良的妊娠结局。     

解脲支原体、沙眼衣原体和弓形虫感染与自然流产的关系

目的探讨解脲支原体(UU)、沙眼衣原体(CT)和弓形虫(TOX)感染与自然流产的关系。方法对310例自然流产患者,UU采用培养法检测,CT、TOX采用酶联免疫吸附试验(ELISA)法检测。同样对75例自愿人工流产者进行检测。结果310例自然流产患者中UU、CT和TOX阳性检出率分别为36.13%、29.25%、11.12%,对照组其UU、CT和TOX感染率分别为6.67%、5.13%、2.67%。两组间有显著性差异(P<0.01或P<0.05)。结论UU、CT和TOX感染与自然流产有相关性。     

FQ-PCR检测不孕妇女沙眼衣原体和解脲支原体研究

目的研究不孕妇女宫颈分泌物中沙眼衣原体(C t)和解脲支原体(Uu)的感染状况。方法应用荧光定量PCR(FQ-PCR)法检测286例不孕妇女和162例对照组妇女宫颈分泌物中C t和Uu。结果不孕妇女C t和Uu阳性检出率分别为51(17.8%)和115(40.2%),对照组分别为12(7.4%)和37(22.8%),不孕不育妇女C t和Uu阳性检出率明显高于对照组妇女(P<0.005)。结论女性不孕症可能与C t和Uu感染有关。     

1049例育龄妇女下生殖道感染情况调查

目的了解育龄妇女下生殖道感染情况,为育龄女性生殖健康提供进一步的数据资料。方法对1049例来自健康体检中心的21~40岁育龄妇女的阴道后穹窿及宫颈分泌物标本进行检测,阴道清洁度、滴虫采用显微镜镜检法,淋球菌、解脲支原体、人型支原体、真菌采用培养法,沙眼衣原体则采用免疫层析法。检测结果进行统计学分析。结果女性生殖道感染的感染率为53.3%,其中混合感染率为9.8%,而清洁度异常率仅为28.4%;前三位病原体感染依次为解脲支原体(35.9%)、衣原体(18.1%)、真菌(6.7%)。结论女性生殖道感染情况严重,具有隐匿性,应加强对无症状感染的育龄妇女的监测。     

实时荧光定量PCR检测沙眼衣原体的研究

目的采用TaqMan探针建立检测沙眼衣原体的实时荧光定量PCR（real-time PCR）方法。方法根据沙眼衣原体外膜蛋白A的基因（ompA）序列设计引物和探针,以克隆的ompA部分基因片段作DNA模板,建立实时荧光定量检测方法。结果建立的荧光定量PCR检测方法的最低检出限为5 copies/反应,检测线性范围100～107线性关系良好（r2=0.997）,比巢式PCR敏感100倍;且与鹦鹉热衣原体、淋球菌、解脲脲原体、大肠杆菌等病原菌DNA以及人基因组DNA均无交叉反应,表明该方法具有良好的特异性。以巢式PCR作参比,建立的荧光定量PCR法检测沙眼衣原体的阳性符合率为100.00%,阴性符合率为95.09%,总符合率为96.81%。结论建立的检测沙眼衣原体实时荧光定量PCR具有特异性强和敏感性高的特点,可快速检测样本中微量沙眼衣原体DNA,适用于对沙眼衣原体进行大规模筛选。     

Demonstration of Chlamydia trachomatis IgG antibodies in the male partner of the infertile couple is correlated with a reduced likelihood of achieving pregnancy

BACKGROUND: The objective of this study was to determine the prevalence of Chlamydia trachomatis among both men and women seeking help at an infertility clinic, and to prospectively follow the effect of previous infection on pregnancy rates and pregnancy outcome after a long follow-up period (mean 37 months). METHODS: A total of 244 infertile couples was tested for C. trachomatis IgG antibodies, and IgG(+) couples were also tested for C. trachomatis DNA by PCR in a first-void urine sample. Study parameters were serology, PCR results, clinical diagnoses, treatments, pregnancy rates and pregnancy outcome. As controls, age-matched and spontaneously pregnant women were also tested with serology. RESULTS: The prevalence of IgG antibodies was 24.2, 20.1 and 15.6% among infertile women, infertile men and control women respectively. The prevalence of C. trachomatis DNA was 6.8 and 7.1% among tested women and men respectively. The presence of C. trachomatis IgG antibodies in women was related to tubal factor infertility (TFI) (P = 0.002). Decreased pregnancy rates were seen in couples where the man was IgG(+) (P = 0.005) with no relationship to TFI. Among women who achieved pregnancy, there was no difference in pregnancy outcome between IgG(+) or negative couples. CONCLUSIONS: C. trachomatis IgG antibodies in the man of the infertile couple was related to decreased pregnancy rates and to the presence of IgG antibodies in the woman. There was a high prevalence of asymptomatic persistent infections among infertile couples.     

两种方法检测分娩期孕妇解脲支原体、沙眼衣原体宫内感染的分析

目的了解分娩期孕妇解脲支原体(Uu)、沙眼衣原体(CT)感染的发病率及其对不良妊娠结局的影响.方法采用PCR方法检测宫颈分泌物、羊水配对标本Uu、CT-DNA,及蛋白芯片方法检测孕妇空腹血清、脐动脉血血清配对标本Uu、CT-IgG抗体.结果 116例分娩期孕妇宫颈分泌物Uu、CT的阳性率分别是37.93%,5.17%,而羊水中Uu、CT的检出率为0%.孕妇血清Uu、CT感染率分别是38.14%,14.66%,脐动脉血血清Uu、CT阳性率19.83%,6.90%,血行性宫内感染垂直传播率约为50%.Uu或CT阳性组孕妇胎膜早破、胎儿宫内窘迫、相对性脐带过短发生率显著高于Uu和CT阴性组孕妇(P＜0.05).结论分娩期孕妇Uu和CT感染与胎膜早破、胎儿宫内窘迫、脐带缠绕有关.Uu、CT蛋白芯片方法是一种检测Uu、CT感染的新方法,值得临床推广应用.     

液态芯片技术在致早产病原体诊断中的应用

目的建立快速高通量的病原体检测方法多靶点液相芯片（multi analyte suspension array，MASA）法，分析早产孕妇病原微生物的分布情况。方法利用多靶点液相芯片技术平台，结合细胞培养技术对350例早产孕妇的羊水及胎盘组织标本进行感染病原学分析，主要针对人类巨细胞病毒（human cytomegalovirus，HCVM）、单纯疱疹病毒（herpes simplex virus）Ⅰ＋Ⅱ型、风疹病毒（rubella virus）、沙眼衣原体（Chlamydia trachomatis，Ct）和解脲支原体（Ureaplas maurealyticum，Uu）、淋球菌（Neisseria gonorrhoea，NG）、梅毒螺旋体（Treponema pallidum,TP）、弓形虫（Toxoplasma gondii）等常见微生物进行病原学研究。结果在350例标本中至少被前述的一种病原体感染的标本有161例，阳性率为46％。其中HSVⅠ＋Ⅱ感染率为4.3％、HCMV感染率为3．71％、TOX感染率为4．86％、RV感染率为4．57％、TP感染率为5．43％、Uu感染率为8％、Ct感染率为7．71％、NG感染率为7．43％．被两种以上病原体混合感染的早产孕妇有17例。MASA技术在致早产病原体分析中与培养法比较其特异性达到94％以上，敏感度达到95％以上。结论致早产的病原微生物感染机率均等，都值得重视。基于MASA技术平台建立的多重液相基因芯片法具有快速、高通量、敏感、特异性高等诸多优点值得推广。     

Simultaneous Chlamydia trachomatis and HPV infection in pregnant women

Pregnancy is associated with HPV infection and with Chlamydia trachomatis (CT) infection mostly due to the natural immunosuppression. In addition, pregnancy associated to CT infection can lead to adverse conditions to the woman and fetus, and CT is also believed to be a co‐factor in human immunodeficiency virus infection and HPV‐induced cervical cancer. The aim of this study was to establish the odds ratios (OR) of CT infection in to HPV‐infected pregnant women and vice versa of women stratified by age (<25 years) and marital status. This work is part of a national multicentric transversal study carried out in six Brazilian cities supported by the Ministry of Health of Federal Government of Brazil in 2003. Cervical scrapes of 371 pregnant women were sampled. We performed a hybrid capture‐2 technique to diagnose these samples on HPV and CT infection, and the women responded a questionnaire. Significant association was observed between nonstable marital status and hr‐HPV infection [OR = 2.61 (1.38–4.97) P = 0.003)], and age <25 years old [OR = 2.26 (1.09–4.71) P = 0.029]. Nonstable marital status was also associated with lr‐HPV infection [OR = 2.67 (1.59–4.50) P < 0.001), and age <25 years old [OR = 2.55 (1.51–4.32) P < 0.001). Fifty of the 371 pregnant women were infected with hr‐HPV (13.5%) and 111 (30.0%) were infected with lr‐HPV. The coinfections of HPV and CT were found in 31 women, that is, 8.36% of the pregnant women (P < 0.001). The high rate of simultaneous CT and HPV infection in pregnant women favors the recommendation to screen pregnant women for both CT and HPV. Diagn. Cytopathol. 2010. © 2009 Wiley‐Liss, Inc.     

Chlamydia trachomatis infection in pregnancy: risk factor for an adverse outcome

A cohort of 122 pregnant women attending the hospital antenatal clinic in northern India were studied to determine the prevalence of genital chlamydial infection, and any adverse effect on the pregnancy. Endocervical swabs were taken at > 12 weeks of pregnancy and cultured for Chlamydia trachomatis. Twenty-six (21.3%) pregnant women were found to be infected with C. trachomatis. The mean age, gravidity and parity were significantly higher (25.03 vs 23.6 years, 1.88 vs 1.72 and 0.92 vs 0.68 respectively [P < 0.005]) in women from whom C. trachomatis was isolated. Follow-up was possible in 87 women who delivered in the hospital. There was increased incidence of still-birth, prematurity and low birth-weight in the C. trachomatis-positive women (16.6% vs 5.7%, 26.6% vs 18.4% and 26.6% vs 23.0%), and these differences were statistically significant (P < 0.5, P < 0.5 and P < 0.05 respectively). The results suggest a definite need for C. trachomatis screening on a wider scale, both in different risk groups of asymptomatic antenatal women and in neonates, to confirm these findings.     

Association between Chlamydia trachomatis and abnormal uterine bleeding

PROBLEM: The purpose was to identify distinct inflammatory markers in endometrial tissues of women with abnormal uterine bleeding (AUB) and Chlamydia trachomatis infection. METHOD OF STUDY: Archived endometrial specimens from 92 randomly selected premenopausal women with AUB were examined for C. trachomatis using the species-specific monoclonal antibody against major outer membrane protein (MOMP) and for histopathology associated with inflammation. Statistical analyses included single and multiple logistic regression. Diagnostic accuracy was summarized using receiver operating characteristic (ROC) curves. RESULTS: Chlamydia trachomatis was detected in 44 (48%) of 92 AUB specimens. There were statistically significant correlations of positive MOMP with higher counts of plasma cells (P < 0.01), macrophages (P < 0.0001), and lymphocytic foci (P = 0.01). The ROC curve for macrophages was the strongest predictor (area under the curve = 0.82) for C. trachomatis. CONCLUSION: The prevalence of C. trachomatis in women with AUB is under-estimated. Macrophages appear to be a strong marker for the presence of C. trachomatis in the endometrium.