胎盘解脲支原体感染与新生儿出生体重的关系

对１６６例足月分娩产妇的胎盘组织进行解脲支原体分离培养，其中９４例为自然分娩，２２例为剖宫产。结果：ＵＵ阳性者共有３３例，阳性率为２８．４５％。自然分娩者中，ＵＵ阳性者２８例，阳性率炎２９．７９％；剖宫产者中，ＵＵ阳性者５例，阳性率为２２．７３％，两者差异无显著性（Ｐ＞０．０５）。     

父母支原体感染与新生儿感染关系的研究

目的：探讨父母解脲支原体（ＵＵ）感染与新生儿ＵＵ感染的关系，以及新生儿ＵＵ感染与分娩方式的关系。方法：于１９９５年７～１２月应用聚合酶链反应（ＰＣＲ）技术对１５７例孕妇宫颈管分泌物拭子标本作ＵＵ检测，凡阳性者分别取其丈夫尿道分泌物和新生儿鼻咽部分泌物拭子作ＵＵ检测。结果：孕妇ＵＵ阳性率１７．２％；ＵＵ阳性孕妇之丈夫及其新生儿ＵＵ阳性率分别为６６．７％及５５．６％；其中仅母亲阳性的新生儿ＵＵ阳性２例（２／９），父母ＵＵ均阳性者新生儿ＵＵ阳性率为７２．２％（１３／１８）（Ｐ＜０．０５）。剖宫产与阴道分娩的新生儿ＵＵ阳性率分别为７０．０％及４７．１％，两者间差异无显著性（Ｐ＞０．０５）。结论：父母均存在ＵＵ感染时，其新生儿ＵＵ感染的机会增加；感染途径主要为宫内而不是产道。     

输卵管妊娠患者沙眼衣原体及解脲脲原体检测

目的：探讨生殖道沙眼衣原体（ＣＴ）和解脲脲原体（ＵＵ）感染与输卵管妊娠的关系。方法：采用聚合酶链反应方法，检测３４例输卵管妊娠患者（输卵管妊娠组）的宫颈分泌物、输卵管组织、盆腔液中ＣＴＤＮＡ及ＵＵＤＮＡ，同时选择２８例输卵管结扎妇女（输卵管结扎组）和４０例正常早孕妇女（正常早孕组）作为对照。结果：输卵管妊娠组宫颈分泌物ＣＴＤＮＡ和ＵＵＤＮＡ阳性检出率分别为４７．１％和５５．９％，高于输卵管结扎组和正常早孕组（Ｐ＜０．０５）；输卵管妊娠组患者的输卵管组织ＣＴＤＮＡ阳性检出率为２６．５％，高于输卵管结扎组（Ｐ＜０．０５）；输卵管妊娠组与输卵管结扎组输卵管组织ＵＵＤＮＡ及盆腔液ＣＴＤＮＡ和ＵＵＤＮＡ阳性检出率比较，差异无显著性（Ｐ＞０．０５）。结论：输卵管妊娠与生殖道ＣＴ和ＵＵ感染有关。     

不育夫妇支原体感染及相关因素分析

用间接血凝法对２６８例（１３４对）不育夫妇（其中不孕夫妇１０２对，有自然流产史的夫妇３２对）作解脲支原体（ＵＵ）和人型支原体（Ｍｈ）的感染率血清学调查，同时检查了１６５例正常人血清以资对照。结果表明，２６８例不育夫妇支原体抗体ＵＵ阳性率为１６．８％。Ｍｈ阳性率为１２．３％，总阳性率为２６．５％。正常对照组支原体抗体总阳性率为９．１％，二者相比差异非常显著，不育夫妇的支原体抗体滴度显著高于对照组。对不育男性作精液分析，表明支原体抗体阳性病人中４５％的人精子活力（率）异常，１５．０％的人精子形态异常；４３例有生殖系炎症的妇女支原体抗体阳性率为４８．８％，９１例无生殖系炎症的妇女支原体抗体阳性率为２２．０％，二者相比差异有显著意义。这些结果提示在不育人群中有相当一部分人存在着生殖道的支原体感染并成为不育病因之一，尤其当患者有精子活力（率）、形态异常或有生殖系炎症时，应把支原体感染检查作为一项重要的病因诊断参考依据。     

抗精子抗体在早期反复自发流产方面的研究

对１７６例ＲＳＡ夫妇血清、精浆中ＡＳＡｂ检测，并与正常生育组对照研究，结果表明：ＲＳＡ患者血清、精浆中ＡＳＡｂ阳性率显著高于正常生育组（Ｐ＜０．０００５）；女方血清中ＡＳＡｂ阳性率随流产次数的增加而降低；男方血清、精浆中ＡＳＡｂ阳性率与流产次数无关；精浆中ＡＳＡｂ阳性率以流产时孕期＜５０天者为最高（Ｐ＜０．０５）；女方血清ＡＳＡｂ阳性率随流产时孕期的增加而增加；男方血清中ＡＳＡｂ阳性率与流产时孕期无关．提示，随早期流产次数的增加，抗精子免疫导致流产的可能性越小；精浆中ＡＳＡｂ对孕初期影响最大；女方血清ＡＳＡｂ主要作用在孕７１～８５天者。     

抗精子抗体,抗子宫内膜抗体及抗弓形虫抗体与反复自发性流产关…

应用ＥＬＩＳＡ方法检测了１８６例自发性流产患者血清中抗精子抗体（ＡｓＡｂ）抗子宫内膜抗体（ＥＭＡｂ）与抗弓形虫抗体（ＡＴＡｂ）并以５６例正常育龄妇女作为对照，结果表明，反复自发性流产患者血清中ＡｓＡｂ，ＥＭＡｂ，ＡＴＡｂ阳性率分别为２９．０３％，３８．７１％和１８．８２％，而正常对照组的阳性率分别为相应为１．７９％，３．５７％和１．７９％（Ｐ〈０．０１）。ＡＴＡｂ，阳性率随流产次数的增加而增加（Ｐ     

联合测定子宫内膜异位症患者血清中EMAb及CA125的临床评价

目的：对联合测定子宫内膜异位症（内异症）患者血清中ＥＭＡｂ及ＣＡ１２５进行临床评价。方法：采取内异症１０９例术前（内异症组）和健康妇女３０例（对照组）空腹静脉血，用酶联免疫吸附法（ＥＬＩＳＡ）测定两组血清中ＥＭＡｂ水平；用放射免疫法（ＲＩＡ）测定血清中ＣＡ１２５水平。结果：内异症组ＥＭＡｂ阳性率为６３．３０％，对照组为１０％，两组差异有显著性（Ｐ＜０．０５）。内异症各期及子宫腺肌病间ＥＭＡｂ阳性率差异无显著性（Ｐ＞０．０５）。内异症组血清ＣＡ１２５水平平均为７０．７０±１６．６２Ｕ／ｍｌ，对照组为１５．３８±５．３２Ｕ／ｍｌ，两组差异有显著性。如以ＣＡ１２５≥３５Ｕ／ｍｌ为阳性界值，则内异症组阳性率为８０．２３％，对照组为６．６６％。单独测定ＥＭＡｂ诊断内异症的敏感性为６３．３０％，特异性为９０％；单独测定ＣＡ１２５诊断内异症的敏感性为８０．２３％、特异性为９３．３３％。如以两者均阳性为诊断标准，则敏感性为５７．８０％，特异性为１００％；如以其中之一阳性为诊断标准，则敏感性为９１．７４％，特异性为８３．３３％。结论：测定内异症患者血清中ＥＭＡｂ及ＣＡ１２５水平对内异症有较好的辅助诊断价值，联合测定ＥＭＡｂ及?     

CA125与子宫内膜抗体测定用于诊断子宫内膜异位症

测定了４２例妇女血清和腹腔液ＣＡ＿（１２５）及子宫内膜抗体（ＥＭＡｂ）水平，其中经腹腔镜诊断为子宫内膜异位症者２８例（观察组），无子宫内膜异位症者１４例（对照组）。结果表明：观察组血清ＥＭＡｂ的吸光度为０．４４±０．１３，明显高于对照组的０．３４±０．０７，但两组间血清ＣＡ＿（１２５）差异无显著性；两含用于诊断的敏感性分别为７１．４３％和８２．１４％，特异性为５７．２１％和５７．１４％。两组腹腔液中ＥＭＡｂ差异无显著性；两组腹腔液ＣＡ＿（１２５）和ＥＭＡｂ水平均明显高于血清。     

沙眼衣原体和解脲支原体引起不育的临床观察

目的：探索沙眼衣原体（ＣＴ）和解脲支原体（ＵＵ）感染对生育的影响。方法：应用单克隆抗体免疫荧光法和分离培养法，对１１９８例不育患者（不育组）及１６７例正常生育者（对照组），进行ＣＴ和ＵＵ检测。结果：不育组和对照组ＣＴ阳性率分别为２５．５％和６．６％，ＵＵ阳性率分别为３５．９％和１５．６％。两组间差异均有极显著性（Ｐ＜０．０１）。经治疗后ＣＴ和ＵＵ转为阴性者的妊娠率明显高于未转为阴性者（Ｐ＜０．０１）。结论：ＣＴ和ＵＵ的生殖道感染是造成不育的因素之一。     

抗精子抗体与不育

抗精子抗体与不育王苏梅，邱毅综述王志新审校（山东省计划生育科学技术研究所，济南，２５０００２）精子作为一种独特抗原，与机体免疫系统接触后可引起自身或同种免疫反应，产生抗精子抗体（ＡｓＡｂ）。研究资料证实，体内存在ＡｓＡｂ可导致不育，这类情况占不育患者...     

ELISA法检测不育男子精浆中抗精子IgG和IgA

将精子经Tritonx－100处理，冷冻高速离心后，经抗人全血清-SephadexG－75亲和柱层析分离，提取分子量为59KD人精子膜蛋白作为抗原，经ELISA间接法对20例生育男子和50例不育男子精浆中抗精子IgG和IgA进行了测定。结果显示：生育男子精浆中抗精子IgG为阴性；抗精子IgA阳性率为5％。不育男子精浆中抗精子IgG和IgA阳性率分别为10％、30％；抗精子IgG和IgA均为阳性者3例，均为阴性者33例；抗精子IgG阳性而IgA阴性者2例；抗精子IgA阳性而IgG阴性者12例。不育组与生育组间抗精子IgG阳性率无显著性差异（P＞0．05）；而IgA阳性率间则有显著性差异（P＜0．05）。不育组抗精子IgG和IgA阳性率间有极显著性差异（P＜0．01）。本文利用ELISA法对精浆中抗精子抗体的分类及可能来源进行了讨论。     

用ELISA法检测不孕夫妇抗精子抗体——附137对观察结果

本文应用ELISA检测不明原因不孕夫妇血清抗精子抗体,结果抗体阳性率为35%,其中不孕女方阳性21.9%,不育男方阳性13.1%。而FD法和SIT法抗精子抗体阳性率各为28.5%与21.9%,三法总符合率为90.2%。不孕组抗精子抗体阳性与对照组比较,有显著统计学意义(P<0.01)。显示不孕夫妇抗精子抗体的发生明显高于生育组。本文就抗精子抗体的发生与不孕症的关系、诊断及其临床意义进行了讨论。     

A reverse (antibody capture) enzyme-linked immunosorbent assay for detection of antisperm antibodies in sera and genital tract secretions

A reverse (antibody capture) enzyme-linked immunosorbent assay (ELISA) for detection of antisperm antibodies has been developed. The assay enables detection of immunoglobulin (Ig) M, IgG, IgA, or IgM, IgG, and IgA--antisperm antibodies in serum, cervical mucus, and seminal plasma samples. The reverse ELISA is more specific and sensitive than conventional ELISA in detecting human antisperm antibodies of different isotypes. Using this assay, statistically significant differences in levels of antibodies between infertile and fertile individuals were demonstrated in sera and in genital tract secretions. Studies with 143 infertile couples revealed that the presence of antibodies in sera was not necessarily reflected in individual's genital tract secretion and vice versa. These data emphasize the importance of detecting antisperm antibodies in sera as well as in genital tract secretions for correct evaluation of sperm immunity.     

Detection and titration of class-specific antisperm antibodies in serum using an enzyme-linked immunosorbent assay

An antisperm antibody enzyme-linked immunosorbent assay (ELISA) that uses whole unfixed sperm and detects immunoglobulin G (IgG) and IgA antibodies in serum was developed. Donor sperm were washed and plated on poly-L-lysine-treated microtiter plates. The patient's sera were diluted to concentrations of 1:4 to 1:256 and incubated with sperm. Positive and negative sera had been previously tested for IgG antisperm antibody activity with a radiolabeled antiglobulin assay. Samples were considered positive when the mean absorbance of triplicate wells was greater than 2 SD above the pooled negative mean. Intra-assay variation was 7.9 and 9.6% for pooled negative and positive controls, respectively. Identical titers of control positive serum were consistently detected. A correlation of 0.83 was observed between ELISA IgG serum titers and radiolabeled antiglobulin results (N = 12). All negative samples tested negative in both assays (N = 21). Some serum samples showed IgA antisperm antibodies. Determination and titration of class-specific antibodies in serum should facilitate initial screening and follow-up of patients at risk for antisperm antibodies.     

Comparison between immunobead test, indirect immunofluorescence and a quantitive ELISA for the diagnosis of antisperm antibodies

Immunobead Test, Indirect Immunofluorescence and ELISA, have been used to research antisperm antibodies in serum of 105 fertile male patients and in serum of 109 infertile male patients. Antisperm antibodies were present among 12.8% of infertile patients and 0.9% of infertile patients. The immunological factor is certainly an important factor in the aetiology of male hypofertility.     

Effects of incubation time in serum and capacitation on spermatozoal reactivity with antisperm antibodies

Sperm reside within the female reproductive tract before the occurrence of fertilization. During this time they undergo surface modifications associated with changes in their functional state. To study their antigenic expression, capacitated and acrosome-reacted sperm were incubated with sera that had previously been tested for antisperm antibodies against fresh washed sperm, as detected by indirect immunobead binding. Forty-eight percent of previously positive and 20% of previously negative sera reacted differently with sperm after an extended time (18 hours) of incubation in serum or after sperm capacitation. These results suggest that current techniques of antisperm antibodies detection be modified to include testing sera after prolonged incubation times with both capacitated as well as fresh sperm.     

Detection of autoimmunity to sperm: mixed antiglobulin reaction (MAR) test or sperm agglutination? A study on 537 men from infertile couples

Two different ways of testing for antisperm antibodies were compared: the mixed antiglobulin reaction (MAR) test for demonstration of antibodies of the IgG and IgA classes bound in vivo to the sperm membrane antigens and the gelatin agglutination test for detection of nonbound antisperm antibodies in serum and seminal plasma. Samples from 537 men from infertile couples were investigated. Antibodies bound to the sperm membrane were detected in 49 men (9.1%), IgG in 44 (8.2%), and IgA in 38 cases (7.1%). Sperm agglutinins were recorded in seminal plasma from 30 men (5.6%) and in serum (titer greater than or equal to 16) from 43 men (8.0%). The investigation revealed a very close correlation between the results of MAR testing and the occurrence of sperm agglutinins in serum and seminal plasma. However, if one focuses on antisperm antibodies of the IgA class, which seem to play the major role in male immune infertility, the MAR test offered the advantage that a minor group of patients with pure IgG responses could be distinguished, and rare cases with mainly or exclusively locally produced IgA antibodies could be detected.     

溶脲脲原体与人精子膜蛋白交叉反应抗原的研究

目的 :研究溶脲脲原体 ( Ureaplasma urealyticum,UU)与人精子膜之间的交叉反应抗原。方法 :将从不育患者精液中分离、纯化等获取的 UU蛋白质与人精子膜蛋白进行十二烷基硫酸钠 -聚丙烯酰胺凝胶电泳 ( SDS- PAGE) ,再将电泳条带转移到硝酸纤维素膜上 ,用兔抗人精子膜抗血清及羊抗兔 Ig G- HRP进行 Western blot反应。结果 :Western blot证实 UU中 61 k D、5 0 k D和 2 7k D蛋白质组份与精子膜蛋白具有相似抗原性。结论 :UU与人精子膜之间存在交叉反应抗原 ,这可能与临床上 UU感染不育患者血清和 /或精液中抗精子抗体 ( As Ab)阳性率明显升高相关     

Antisperm antibodies in infertile and homosexual men: relationship to serologic and clinical findings

The incidence and significance of antisperm antibodies in different groups of men were evaluated by a modified enzyme-linked immunosorbent assay. In serum, 4.0% of dermatologic patients (n = 223), 9.6% of andrologic patients (n = 178), and 28.6% of homosexual men (n = 42) were positive for IgG and/or IgM antibodies. In seminal fluids, 7.3% of the andrologic patients had IgA (and IgG) antibodies to spermatozoa. Only 1 of 29 positive men had antibodies both in serum and in seminal fluid. No correlation between antisperm antibodies and IgG/IgM concentrations was found in serum, whereas in seminal plasma men with antisperm antibodies showed higher IgG/IgA concentrations than men without (IgA, 3.2 versus 1.7 mg/dl; IgG, 9.8 versus 6.3 mg/dl). It is concluded that there is a high incidence of antisperm antibodies among homosexual men, probably because of contact of spermatozoa with the immune system by passive anal intercourse. There is little correlation between antisperm antibodies in serum and seminal plasma of infertile men because of a lack of relevant antibody transfer from the serum and the formation of local antibodies in seminal plasma. Antisperm antibodies in seminal fluid are associated with elevated local IgG and IgA concentrations.     

精浆内抗精子抗体和免疫复合物的研究——对男性不育患者及输精管粘堵术者的观察

本文用ELISA法研究了174名男性不育患者及43名输精管粘堵术后精浆中的抗精子抗体及其种类。结果表明,精浆中抗精子抗体的检出率,在男性不育患者中为24.1%,输精管粘堵术后者为48.8%。在这些患者的精浆中可检出IgA、IgG和IgM型抗精子抗体,其中主要是IgA。同组人群血清和精浆中的抗精子抗体缺乏相关性。精浆中抗精子抗体的存在与精子活动率的下降有一定的关系。应用PEG法测定精浆中免疫复合物,在66例精子抗体阳性的患者中,阳性率为56.1%,表明局部抗精子的自身免疫反应,在一定条件下可导致免疫复合物的形成。