980例女性不孕患者唾液酸苷酶和抗精子抗体检测分析

目的探讨细菌性阴道病(BV)对女性不孕的影响及其与抗精子抗体(ASAb)的关系。方法对980例女性不孕患者和876例正常妊娠妇女的阴道分泌物进行唾液酸苷酶检测,并采用酶联免疫吸附(ELISA)法对女性不孕患者血清进行ASAb检测,并对结果进行分析。结果女性不孕患者的唾液酸苷酶和ASAb阳性率分别为24.5%和12.8%,其阳性率明显高于正常妊娠妇女组(P<0.05);唾液酸苷酶阳性组的As Ab阳性率为22.9%,显著高于唾液酸苷酶阴性组的9.5%,差异有统计学意义(P<0.05)。结论 BV和血清免疫不孕抗体ASAb可引起女性不孕,且BV与ASAb的产生有相关性,对女性不孕的诊断和治疗具有重要的指导意义。     

不孕妇女抗精子抗体和抗子宫内膜抗体检测分析

抗精子抗体 (ＡｓＡｂ)、抗子宫内膜抗体 (ＥｍＡｂ) ,在女性体内为同种异体和自身两种抗体 ,是引起女性免疫不孕的重要因素 ,我们通过对 2 17例不孕妇女ＡｓＡｂ和ＥｍＡｂ的检测 ,探讨其临床意义。1　材料与方法1 1　观察对象　本组 2 17例均为门诊病人 ,原发性不孕10 6例 (2 2～ 38岁 ) ,不孕 1年～ 12年。继发性不孕 11例 ,其中反复自然流产 32例 (2 2～ 30岁 ) ,流产次数 2～ 4次 ,人工流产 79例 (2 2～ 2 8岁 ) ,流产次数 1～ 2次。对照组 :30例为体检健康孕妇 (2 3～ 2 8岁 ) ,孕龄 (2 1～ 32周 )。1 2　检测方法　取孕妇静脉血 2ｍ…     

血清抗子宫内膜抗体在不孕症及自然流产患者的临床价值探讨

目的探讨检测抗子宫内膜抗体对不明原因不孕症和自然流产病因的临床价值。方法采用ELASA检测70例不明原因不孕者,35例自然流产者和30例正常对照者的血清EMAB。结果不明原因不孕组RMAB总阳性率为35.71%,其中原发性不孕组为27.08%,继发性不孕组54.55%,自然流产组EMAB阳性率为31.43%.以上均高于正常对照组6.6%。结论 ELASA检测抗子宫内膜抗体敏感性高,操作简单,易于推广,对不明原因不孕症,自然流产的病因探讨有重要参考价值。     

抗环瓜氨酸肽抗体在银屑病关节炎患者中的检测及意义

目的 研究抗环瓜氨酸肽(CCP)抗体在银屑病关节炎(PsA)患者中的临床意义,探讨抗CCP抗体与PsA患者伴发关节炎、骨侵蚀破坏的关系及判断预后的意义.方法 采用酶联免疫吸附法,分别检测56例PsA患者血清的抗CCP 抗体水平,分析比较抗CCP 抗体与患者临床特征的关系.结果 抗CCP抗体在PsA患者中的阳性率为12.5%(7/56).抗CCP抗体在PsA五种临床分型中的阳性率分别为7.1%、21.4%、0%、0%、0%,抗CCP抗体阳性率在对称性多关节炎型PsA中明显高于其他四种PsA(P＜0.05).抗CCP抗体阳性与阴性PsA患者临床及其他实验室指标比较结果显示:抗CCP抗体阳性组外周关节肿胀数、腕关节受累比例及红细胞沉降率(ESR)均高于抗CCP阴性组(P＜0.05);在发病年龄、关节炎病程、阳性家族史、肘关节受累、腊肠指(趾)、腰骶痛和C反应蛋白(CRP)之间比较,差异无统计学意义.结论 12.5%的PsA患者体内存在抗CCP抗体;抗CCP抗体的出现与PsA患者多发性关节炎和骨侵蚀密切相关,对判断PsA关节炎的预后具有重要的临床价值.     

乙型肝炎病毒聚合酶片段的表达及其在血清学检测中的应用

目的建立乙型肝炎患者血清HBV病毒聚合酶抗体(抗-HBp)的ELISA检测方法。方法构建HBV反转录酶/DNA聚合酶(HBV-Pol)基因原核表达载体pQE30-Pol,表达并纯化目的蛋白,用间接ELISA法检测274例乙型肝炎患者及50例正常人血清中的抗-HBp抗体,并与HBV-DNA实时荧光定量检测结果比较。结果成功将HBV-Pol基因插入原核表达载体pQE30,并在大肠埃希菌M15中获得了高效表达,表达产物以包涵体形式存在。以纯化的重组蛋白建立间接ELISA检测方法,在检测的274例乙型肝炎患者中,HBsAg+/HBeAg+/抗HBc+,HBsAg+/抗HBe+/抗HBc+,HBsAg+/抗HBc+患者血清中的抗-HBp抗体阳性率分别为97.8%、57.9%和13.2%,平均阳性率58.8%,而正常人血清抗-HBp均为阴性。运用此法测得的血清抗-HBp阳性率和实时定量PCR检测结果无统计学差异(P=0.359)。结论成功表达了HBV-Pol片段并且建立了血清抗-HBp抗体的检测方法,为进一步研究乙型肝炎患者血清HBV-Pol抗体的血清学意义奠定了基础。     

血清标志物对复发性流产的临床诊断价值

目的探讨血清抗心磷脂抗体(ACA)、抗β2-糖蛋白I抗体(AGA)联合检测对复发性流产(RSA)的临床诊断价值。方法选取63例RSA患者为实验组,60例正常经产妇为对照组,检测两组受检者血清ACA和AGA水平。结果实验组的ACA阳性率为25.06%,对照组为8.33%,差异有显著统计学意义(P<0.01);实验组的AGA阳性率为20.63%,对照组为5%,差异有显著统计学意义(P<0.01)。在确诊的50例抗磷脂抗体综合征(APS)患者中,ACA和AGA联合检测的阳性预测值为67.5%,明显高于其他组。结论 (1)ACA和AGA与RSA有关。(2)ACA和AGA联合检测可以提高RSA患者APS的检出率,对于临床诊断有重要意义。     

血清结核抗体检测对诊断女性盆腔结核的价值

目的　评价三种结核抗体检测试剂盒对女性盆腔结核的诊断价值。方法　用MycoDot、TB 快速卡和ICT TB卡检测了 6 3例女性盆腔结核患者血清 ,其中子宫内膜结核 18例 ,盆腔腹膜结核包裹性积液 2 4例 ,输卵管卵巢脓肿 11例 ,腹膜结核合并妇科肿瘤 10例 ,并与 84例妇科肿瘤患者、6 0例健康人血清结核抗体检测结果对比观察。结果　ICT TB、MycoDot、和TB 快速卡检测结核抗体的敏感性分别为 6 0 32 %、5 8 73%、79 36 % ,三者间差异无统计学意义 (P >0 0 5 )。三种方法测均为 (+)的占 2 6 99% ,任意两种方法 (+)的占 5 3 95 % ,两者相加总阳性率 80 95 %。与非结核组比较差异有统计学意义 (P <0 0 1)。结论　血清结核抗体检测 ,特别是上述 3种方法同时检测结核杆菌多种抗体是女性盆腔结核诊断和鉴别诊断的一项重要辅助手段 ,有较高的临床价值。     

抗双链 DNA 抗体与狼疮细胞检查的诊断价值比较

20 0 2年 ,我们对系统性红斑狼疮 (SLE) 7例 ,分别抽取双份血样进行血清抗双链DNA(ds DNA)抗体与狼疮细胞的检测。结果 :抗双链DNA抗体的阳性率明显高于狼疮细胞的阳性率 ,提示抗双链DNA抗体测定对SLE更具有诊断价值。1　对象和方法1 1　对　象　均为女性 ,年龄 2 7～ 4 8岁 ,平均 34 6岁。均为临床诊断明确的SLE。1 2　方　法　抽双份血送检 ,一份血用金标免疫斑点法测血清的抗双链DNA抗体 ,试剂盒由福建蓝波生物制品公司生产 ;另一份血行改良血块法做狼疮细胞检查 ,按全国临床检验操作规程 (第 2版 )操作。2　结　果7例中 ,抗双…     

抗中性粒细胞胞质抗体和抗酿酒酵母抗体表达在炎症性肠病诊断中的意义

目的 回顾性分析血清核周型抗中性粒细胞胞质抗体(pANCA)和抗酿酒酵母抗体(AScA)的表达在炎症性肠病(IBD)诊断中的意义.方法 间接免疫荧光生物薄片(IIFT)法检测97例IBD患者血清pANCA、ASCA表达,其中86例溃疡性结直肠炎(UC)列入UC组,11例克罗恩病(CD)列入CD组,另设36例结肠镜检查正常者为对照组.结果 pANCA在UC、CD和对照组的阳性率分别为27.9%、0%和0%,UC组显著高于其他两组(P<0.01);ASCA在CD、UC和对照组的阳性率分别为36.4%、4.7%和0%,CD组显著高于其他两组(P<0.01).86例UC患者中,重度UC 23例(26.7%),其中pANCA 6例(26.1%),ASCA 2例(8.7%),pANCA /ASCA 1例(4.4%),轻、中度UC 63例(73.3%),其中pANCA 18例(28.6%).重度与轻、中度UC患者pAN-CA表达情况无显著差异(P>0.05).11例CD患者中,重度CD 4例(36.4%),其中ASCA 3例(75.0%),轻、中度CD 7例(63.6%),其中ASCA 1例(14.3%).重度CD患者ASCA阳性率明显高于轻、中度CD患者(P<0.05).结论 ASCA、pANCA两种血清标志物对诊断UC和CD具有一定临床参考价值.     

1719例城镇职工乙肝表面抗体阳性率调查分析

目的调查城镇职工乙肝表面抗体(抗-HBS)阳性率的分布情况。方法对1719名健康体检的城镇职工进行肝功及乙肝5项检查,肝功正常及乙肝5项中仅抗-HBS呈(或±或-,按性别、民族、年龄分别统计抗-HBS阳性率并进行相互对比。结果 1719例城镇职工中抗-HBS阳性率46.7%,36~45岁抗-HBS阳性率最高为69.8%,其后依次为46~55岁为50.8%,26~35岁为44.7%,≤25岁为35.6%,>55岁为16.4%。汉族男性抗体阳性率明显高于女性(P<0.01),哈萨克族女性抗-HBS阳性率明显高于同族男性(P<0.01),汉族男性抗-HBS阳性率明显高于哈萨克族男性(P<0.01),哈萨克族女性抗-HBS阳性率明显高于汉族女性(P<0.01)。结论城镇职工抗-HBS阳性率存在年龄、性别及民族差异。     

Imaging in male-factor obstructive infertility

The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a "detailed map" for guiding corrective operative interventions.     

Hysterosalpingography in the evaluation of infertility

Hysterosalpinography (HSG) was performed in 220 women for evaluation of infertility. Laparoscopy or laparotomy for final assessment of tubal patency were carried out in 110. HSG revealed a normal tubal patency in 66.8 per cent, whereas abnormal patency was found in 24.1 per cent. At operation, 85.7 per cent of the HSG diagnoses were confirmed. A clear correlation existed between previous lesions in the genital tract and pathologic findings at HSG and operation. The pregnancy rate following HSG was 15.4 per cent. It is concluded that HSG is of great value in the initial evaluation of infertility. The findings facilitate the decision regarding the final operative procedure: laparoscopy or laparotomy.     

Salpingitis isthmica nodosa in female infertility

A retrospective study was undertaken to evaluate the radiologic appearance of salpingitis isthmica nodosa (SIN) in the fallopian tubes of 150 consecutive patients having hysterosalpingograms performed almost exclusively for primary and secondary infertility. SIN was observed in 13 of these 150 patients. The characteristic radiologic features of this condition are minute loculations of contrast medium adjacent to the tubal lumen which range in size up to 2 mm in diameter and are clustered together over a tubal length of 1 to 2 cm. Although the most frequent site of occurrence is in the proximal isthmic portion of the tube, there is occasional involvement of the distal isthmus and even the interstitial portion of the adjacent uterine cornu. Associated tubal abnormalities in this condition such as hydrosalpinx and tubal occlusion help explain the increased incidence of tubal pregnancy and infertility in patients with SIN.     

Diagnosis of subclinical varicocele in infertility

The clinically obvious varicocele is perhaps the most common identifiable and correctable cause of male infertility. However, less is known about the subclinical (not palpable) varicocele and its relationship to infertility. We undertook this study to compare the ability of high-resolution sonography and radionuclide scrotal scanning to detect subclinical varicocele. Fifty patients who were referred to our department with a diagnosis of infertility, an abnormal semen analysis, and a normal physical examination of the scrotum underwent both sonography and nuclear scanning. The final study group included 20 men who agreed to surgical ligation of the spermatic vein(s) after a positive sonographic and/or radionuclide study. Sonography was considered positive for subclinical varicocele in 95% of patients, while nuclear scanning was considered positive in only 55%. Postoperatively, all patients showed improvement in their semen and 40% (eight patients) became fertile. Subclinical varicocele seems to be an important causal factor in infertility and, in our experience, high-resolution sonography is superior to radionuclide scanning in its diagnosis.     

Imaging of female infertility

Normal reproduction requires healthy female anatomy. Cervical, uterine, tubal, ovarian, and peritoneal factors can coexist and cause female infertility. Ultrasound, hysterosalpingography, MR imaging, and fallopian tube catheterization are the radiologists' armamentarium for diagnosis. This article illustrates important findings in the infertile woman. An understanding of these entities helps i n accurateand sympathetic treatment.     

经阴道声像学造影在不孕症中的应用

经阴道声像造影术用于输卵管阻塞必不孕症的诊断和治疗．是近年来医学工作者采用的一种先进方法．我们采用此方法规察患者50例，取得良好效果，现报道如下。     

The role of imaging in infertility management

In a retrospective review of 211 female infertility patients receiving ovulation induction agents, the role of sonography in infertility management is defined. Sonography is used to determine imminence of ovulation for timing of insemination and in vitro fertilization. It is also used to diagnose ovarian hyperstimulation syndrome. To identify characteristics of the ovarian follicles of women able to conceive that might differentiate them from those unable to become pregnant, patients were assigned to "pregnant" (30.8%) or "nonpregnant" subgroups. In 259 sonographically monitored cycles reviewed, follicular size and configuration were not different for the two groups. The cumulus oophorus was seen in 28% of pregnant patients (8/28) and in only two nonpregnant patients. Low-level echoes were seen in the mature follicles of 11 patients but not in the large follicles of nonpregnant patients. Low-level intrafollicular echogenicity may be a prognostic indicator of fertility and may represent a periovulatory state, optimal, in the appropriate clinical setting, for artificial insemination or in vitro fertilization.