沙眼衣原体感染引起输卵管性不孕的机理

越来越多的研究表明，沙眼衣原体（ＣＴ）引起的输卵管性不孕与免疫损伤有关。综述由于ＣＴ感染引起输卵管损伤导致不孕的体液免疫、细胞免疫及其他可能的机制。     

沙眼衣原体感染引起输卵管性不孕的机理

越来越多的研究表明,沙眼衣原体(CT)引起的输卵管性不孕与免疫损伤有关。综述由于CT感染引起输卵管损伤导致不孕的体液免疫、细胞免疫及其他可能的机制。     

沙眼衣原体感染与输卵管性不孕的关系探讨

目的探讨沙眼衣原体(CT)感染与输卵管性不孕的关系。方法对198例不孕症患者进行通水或造影检查,其中72例双侧输卵管通畅患者作为对照组,126例输卵管阻塞患者作为观察组,对两组患者血液进行CT-DNA检测,分析CT感染与输卵管性不孕高危因素的关系。结果观察组CT的阳性率为51.58%(65/126),对照组为15.27%(11/72),(p<0.05),两组患者中流产早产、死胎死产、宫外孕、人流药流、不洁性生活史比较差异有统计学意义(p<0.05)。结论 CT感染与输卵管阻塞关系密切,是造成不孕不育的主要原因,流产早产、死胎死产、宫外孕、人流药流、不洁性生活史是CT感染的高危因素,对于有高危因素的患者,CT-DNA应该作为孕前的常规检查项目。     

生殖道衣原体感染输卵管性不孕女性生殖激素及氧化应激指标的变化

目的 探讨生殖道衣原体感染所致输卵管性不孕女性生殖激素及氧化应激指标的变化及意义。方法 选取2017年1月-2020年1月于医院妇科门诊收治的患者180例,按照沙眼衣原体检测结果将患者分为阳性不孕组、阳性可孕组及阴性可孕组,每组60例。检测患者宫颈分泌物和血清白细胞介素-2(IL-2)和白细胞介素-6(IL-6)水平、血清性激素六项水平和氧化应激指标水平。结果 阳性不孕组和阳性可孕组宫颈分泌物中的IL-2水平高于阴性可孕组;阳性不孕组患者促黄体生成素(LH)水平高于阳性可孕组和阴性可孕组;阳性不孕组患者丙二醛(MDA)和8-羟基脱氧鸟苷(8-OHDG)水平高于阳性可孕组和阴性可孕组,阳性不孕组患者超氧化物歧化酶(SOD)和过氧化氢酶(CAT)水平低于阳性可孕组和阴性可孕组;与阴性可孕组患者比较,阳性不孕组患者总抗氧化能力(TAC)水平下降,而LH和8-OHDG水平上升,与阳性可孕组患者比较,阳性不孕组患者LH和8-OHDG水平升高,差异具有统计学意义(P<0.05)。结论 生殖道衣原体感染后机体LH及8-OHDG水平上升和TAC水平下降可能在输卵管损伤中发挥了重要作用,引起女性不孕症发生。     

女性输卵管不孕症与盆腔沙眼衣原体感染关系状况分析

目的:了解不孕妇女盆腔沙眼衣原体(CT)感染的情况及其与输卵管性不孕症的关系。方法:对68例腹腔镜术中发现有输卵管炎症的不孕妇女盆腔积液行CT检测;对60例同期术中发现无输卵管炎症的手术患者盆腔积液行CT检测作为对照。结果:不孕组CT感染率(52.94%),极显著高于对照组CT感染率(13.33%),差异有统计学意义(P<0.01)。结论:CT感染是导致不孕症的重要原因之一。     

女性生殖道沙眼衣原体感染与输卵管性不孕的临床分析

目的:探讨女性生殖道沙眼衣原体感染与输卵管性不孕的关系。方法:从86例输卵管性不孕妇女(观察组)的宫颈及输卵管内取样,用聚合酶链反应(PCR)检测沙眼衣原体,并从50例正常妊娠妇女(对照组)的宫颈及输卵管提取样本作为对照。结果:宫颈沙眼衣原体感染率在两组间无明显差异,但观察组输卵管沙跟衣原体感染率为20.93％,明显高于对照组(4.00％),两组比较有显著性差异(P<0.05),输卵管不同病变间的沙眼衣原体阳性率无明显差异。结论:输卵管性不孕妇女的输卵管沙眼衣原体感染率高,生殖道沙眼衣原体感染是输卵管性不孕的重要因素。     

输卵管性不孕与女性生殖道解脲支原体及沙眼衣原体感染的关系

目的:探讨女性宫颈支原体和沙眼衣原体感染与输卵管性不孕的关系及其感染特点。方法:对2005年10月～2006年4月在我院妇科门诊检查的68例输卵管性不孕患者(不孕组)与45例门诊健康检查女性(对照组)分别进行了宫颈分泌物UU及CT检测。结果:两组宫颈分泌物感染UU阳性率分别为26.47%和6.67%,二者相比差异具有显著性(P<0.05);感染CT阳性率分别为30.88%和13.33%,差异具有显著性(P<0.05)。结论:女性生殖道感染UU及CT症状隐匿,应对不孕妇女常规进行宫颈分泌物培养,一旦发现感染,应及时治疗。     

解脲支原体和沙眼衣原体感染与输卵管阻塞性不孕的临床研究

目的研究支原体、衣原体感染患者与输卵管阻塞性不孕之间的关系。方法2005年10月至2008年10月笔者所在科室不孕不育患者150例，妇科门诊术前检查患者150例，分为不孕症患者组和门诊患者组。采用多聚酶链反应技术（PCR）和细菌培养法对两组患者宫颈分泌物沙眼衣原体（CT）和解脲支原体（UU）进行检测。发现有UU、CT感染后，给予针对性治疗，复查结果证实感染治愈后，行输卵管造影。结果（1）两组UU和CT感染率相比，不孕症患者组高于门诊患者组，有显著差异（P〈0．01）；（2）不孕症患者组未感染者和感染者输卵管阻塞发病率比较有显著差异（P〈0．01）。结论说明UU和CT感染与输卵管阻塞呈正相关。     

沙眼衣原体感染与不孕不育

沙眼衣原体(CT)是近年来主要的性传播疾病病原体之一，它可引起男女泌尿生殖道感染。其最严重的后果是导致宫外孕(EP)及输卵管性不孕症(TFI)。其发病机制可能为感染后的自身免疫因素造成输卵管阻塞及早孕丢失(early pregnancy loss)。筛查及预防性治疗对降低其发病率很关键。     

沙眼衣原体、解脲支原体感染引起输卵管性不孕的临床分析

[目的]探讨生殖道沙眼衣原体(CT)、解脲支原体(UU)感染对输卵管性不孕的影响.[方法]选取输卵管完全阻塞的不孕症患者66例、输卵管部分阻塞的不孕症患者116例、输卵管通畅的不孕症患者90例.应用聚合酶链反应(PER)技术对其宫颈分泌物进行CI、UU DNA片段的扩增检测.[结果]输卵管完全阻塞组、输卵管部分阻塞组的不孕症患者的CT、UU及2者合并感染率显著高于输卵管通畅组的不孕症患者,比较差异有统计学意义(P<0.05);输卵管完全阻塞组和输卵管部分阻塞组之间的比较差异无统计学意义(P>0.05).[结论]CT、UU感染可引起宫颈炎、子宫内膜炎、输卵管炎及积水等炎症,是造成输卵管性不孕的主要原因之一,与输卵管性不孕有密切的关系.     

未产妇人工流产致输卵管性不孕的临床分析

目的　分析未产妇人流术后继发不孕的主要原因。方法　将同期原发不孕症 2 93例及继发不孕症 178例 ,均行子宫输卵管碘油造影 ,造影剂为 40 %碘化油。结果　原发不孕症组 46例 15 .7% ,继发不孕症组 93例 5 2 .2 % ,有不同程度的输卵管梗阻 ,两组因输卵管阻塞引起的不孕有显著性差异 (P <0 .0 1)。结论　输卵管梗阻是继发不孕症的主要原因 ;并分析了未产妇因人流术引起继发不孕的原因及预防措施     

Prior cesarean delivery in women with secondary tubal infertility.

The history of cesarean delivery was evaluated in a population-based case-control study of secondary infertility in King County, Washington. Sixty-one married women diagnosed with secondary infertility due to tubal problems who had a previous viable pregnancy were compared to 343 married women who had a previous viable pregnancy and then had a live birth that was conceived at the same time the infertile women began trying to conceive. The risk of tubal infertility was not substantially elevated in women who had a previous cesarean delivery in the most recent viable pregnancy compared to women with vaginal delivery (odds ratio = 1.2; 95% confidence interval = 0.4, 3.7).     

Chlamydial antibodies and tubal infertility

Prevalence of Chlamydia trachomatis antibodies was studied in infertile women with and without tubal obstruction, and in a control group of pregnant women in a Central-African country with a high infertility rate. In comparison with the control group, tubal infertility patients were significantly more likely to have serum antibodies of 1:64 or greater with an age-adjusted odds ratio of 7.8 (95% confidence interval (CI) 3.2-19.1). Infertile women without tubal obstruction had antibody titres similar to the control group with an odds ratio of 1.1 (95% CI: 0.6-1.9). In the tubal infertility group there was a kind of dose-response relationship between chlamydial antibodies and the severity of tubal damage and pelvic adhesions on laparoscopy, with odds ratios of 3.2 (95% CI: 0.7-14.8), 6.2 (95% CI: 1.9-21.6) and 18.1 (95% CI: 6.0-68.5) in the group with mild, moderate and severe pelvic adhesions respectively. This survey adds more evidence to the hypothesis that C. trachomatis is a major agent responsible for tubal infertility in Central Africa.     

罗哌卡因-帕瑞昔布钠多模式镇痛在输卵管性不孕患者宫腹腔镜术后镇痛中的应用

目的:分析罗哌卡因联合帕瑞昔布钠多模式镇痛在输卵管性不孕患者宫腹腔镜术后镇痛效果。方法:选取2018年1月-2019年1月在本院妇产科行宫腹腔镜手术的输卵管性不孕患者112例,按照随机数字表法将患者分为观察组(56例)和对照组(56例),两组均在腹腔镜各切口周围注射0.5%的罗哌卡因10ml,观察组给予帕瑞昔布钠40mg静注,对照组给予相同容量的0.9%氯化钠。采用视觉模拟评分法(VAS)评估患者术后1、4、12、24、48h疼痛程度;比较拔管即刻和拔管后5min躁动评分和拉姆齐镇静评分(Ramsay),术中瑞芬太尼用量及术后静脉自控镇痛泵(PCA)按压次数;不良反应。结果:观察组术后各时间点VAS评分均低于对照组,拔管即刻和拔管后5min躁动评分(1.38±0.71分、0.74±0.48分)低于对照组(1.94±0.77分、1.43±0.45分)、镇静评分(1.86±0.55分、2.65±0.72分)高于对照组(1.55±0.58分、2.14±0.64分)。术后PCA按压次数(2.75±1.48次)低于对照组(5.39±1.58次)(均P<0.05),两组术中瑞芬太尼用量及术后恶心呕吐、呼吸抑制及切口水肿、感染等不良反应总发生率(14.3%、21.4%)无差异(P>0.05)。结论:罗哌卡因联合帕瑞昔布钠多模式镇痛可有效减轻宫腹腔术后患者的疼痛状态,减少术后不良反应的发生,值得临床使用。     

输卵管因素不孕的诊断及治疗策略

在不孕症的诊疗中,通常要进行输卵管疾病的诊治.目前腹腔镜检查已作为输卵管疾病诊断的金标准.子宫输卵管碘油造影术广泛应用于临床诊断,而超声波下子宫输卵管造影术在诊断输卵管阻塞方面优于子宫输卵管碘油造影术,并可与腹腔镜检查相媲美.血清学衣原体检查是一个效价比较高的非侵入性检查.要根据患者的年龄、卵巢的储备功能以及输卵管病变的程度和类型,综合考虑制定治疗方案.     

Decreasing oxidative stress with choline and carnitine in women

OBJECTIVE: Fatty acid oxidation is predominantly a mitochondrial event, which is enhanced by dietary choline and carnitine supplementation resulting in extra reactive oxygen species (ROS) load. The objective was to assess oxidative stress level by thiobarbituric acid reactive substances [TBARS] in choline and carnitine supplemented healthy women before and after mild exercise. METHODS: Nineteen free-living women completed the placebo control study in which choline and/or L-carnitine was orally taken for 21 days. Anthropometric measurements, dietary recall, exercise routine and blood samples were analyzed to determine body composition, nutrients intake, distance walked and biochemical markers related to oxidative stress. RESULTS: TBARS were significantly lower in the groups supplemented with choline, carnitine or both and the mild exercise (walking) was not a deterrent in this effect of the supplements. Serum vitamin A and E concentrations were higher in the supplemented groups even though the consumption of these nutrients was not different among the groups. CONCLUSION: Choline and carnitine supplementation lowers lipid peroxidation, and promotes conservation of retinol and alpha-tocopherol in free-living women.     

3种方式治疗输卵管性不孕的临床效果及影响因素分析

目的:探讨不同治疗方法对输卵管性不孕的疗效影响。方法:2006年1月～2008年12月,在3家医疗机构选择输卵管性不孕患者310例,分别接受输卵管通液、宫腔镜输卵管插管疏通、宫腹腔镜联合输卵管疏通手术3种治疗方式,随访1年,记录其妊娠情况。统计分析采用χ2检验和多项logistic模型。结果:共283例得到1年后随访。输卵管通液治疗方式对任何部位阻塞的输卵管疏通效果差,妊娠率较低;近端阻塞患者采用宫腔镜输卵管插管疏通[OR=3.370,95%CI(1.456,7.798)]与宫腹腔镜联合输卵管疏通[OR=3.095,95%CI(1.112,8.614)]疗法宫内妊娠率相当;而远端阻塞患者采用宫腹腔镜联合输卵管疏通[OR=5.962,95%CI(1.497,23.749)]易宫内妊娠。沙眼衣原体阳性、解脲支原体阳性、阻塞程度是影响输卵管性不孕治疗效果的因素。结论:输卵管通液治疗输卵管性不孕效果较差,宫腔镜输卵管插管疏通操作相对简单安全且妊娠率高,宫腹腔镜联合输卵管疏通方式治疗合并有盆腔粘连不孕症的效果更好,且不增加发生异位妊娠的风险。     

Effect of ubiquinone and other scavengers on alterations caused by oxidative stress

In the development of several diseases the oxidative stress is a significant aetiological or important pathogenetic factor. Its significance has been proved in the pathogenesis of several diseases, among them in arteriosclerosis and reperfusion, in inflammation and immunological disorders, as well as in toxic alterations and in carcinogenesis. The increased incidence of malignant tumors may be attributed to smoking, intemperate alcohol abuse, as well as inappropriate nutrition. Inappropriate nutrition is thought to be responsible for the development of about 30-50% of malignancies. In this paper the authors review the processes of the development of free radicals based on oxygen and nitrogen. They discuss the modalities which are able to decrease the oxidative stress, like the low oxygen tension in the tissues, the enzymatic and antioxidant protections, and the different repair mechanisms. In details the roles of ubiquinone, with other name of coenzyme Q, as well as of the selenium are discussed in the antioxidant defence processes. As a conclusion they suppose that oxidative stress in the organism and the alterations caused by them can be decreased by adequate nutrition or nutriceuticals.