沙眼衣原体和解脲支原体感染对早期先兆流产的影响

目的 探讨沙眼衣原体和解脲支原体感染对早期先兆流产的预测价值.方法 选取深圳龙华新区人民医院2012年6月至2013年1月收治、因早期先兆流产主动要求人工流产的46例孕妇为观察组,并以同期入院行人工流产的47例健康孕妇为对照组.取两组患者的宫颈分泌物和蜕膜组织,分别进行沙眼衣原体及解脲支原体培养,并取流产后蜕膜组织做病理切片,显微镜下观察其形态学变化.结果 观察组患者宫颈分泌物的沙眼衣原体、解脲支原体及共感染阳性率分别为47.8%（22/46）、43.5%（20/46）、23.9%（11/46）,对照组相应阳性率分别为14.9%（7/47）、12.8%（6/47）、6.38%（3/47）,两组相比,差异有统计学意义（P〈0.05）;观察组患者蜕膜组织沙眼衣原体、解脲支原体及共感染阳性率分别为43.5%（20/46）、41.3%（19/46）、15.2%（7/46）,对照组相应阳性率分别为6.38%（3/47）、8.51%（4/47）、4.26%（2/47）,两组相比,差异有统计学意义（P〈0.05）;光镜观察可见,阳性患者蜕膜组织出现细胞肿胀、破裂,细胞核固缩和细胞液外溢,细胞间隙明显大于阴性患者.结论 生殖道沙眼衣原体和解脲支原体可逆行感染,损伤蜕膜组织,为早期先兆流产的重要原因之一.

Influence of Chlamydia Trachomatis and Mycoplasma Infection on Early Threatened Abortion

Objective To investigate the predictive value of chlamydia trachomatis and ureaplasma ure- alyticum infection for early threatened abortion. Methods Forty-six cases of gravida which asked for abortion because of the early threatened abortion from People＇s Hospital of Longhua District during Jun. 2012 and Jan. 2013 were selected as observation group; at the same time,47 cases of healthy gravida who asked for induced abortion during the same period were selected as control group. Cervical secretions and decidual tis- sue of each gravida were extracted respectively for chlamydia trachomatis and ureaplasma urealyticumcuhure ; and morphological changes were also observed under the microscope. Results The positive rate of chlamydia trachomatis, ureaplasma urealyticum, and mixed infection was respectively 47.8% （ 22/46 ）, 43.5% （ 20/ 46 ）, and 23.9% （ 11/46 ） in cervical secretions of the observation group, while that in the control group was respectivelyl4.9% （ 7/47 ）, 12.8% （ 6/47 ） and 6.38% （ 3/47 ） ; and there were significant differences betweenthe two groups （ P 〈 0.05 ）. The positive rate of chlamydia trachomatis, ureaplasma urealyticum, and mixed infection was respectively 43.8 % （20/46） ,41.3 % （ 19/46 ） and 15.2 % （7/46） in decidual tissues of the observation group, while that in the control group was respectively 6.38 % （3/47） , 8.51% （4/47） , and 4.26 % （ 2/47 ） ; and there were also significant differences between the two groups （ P 〈 0.05 ）. The fractog- raphic results presented that the ceils of infected decidual tissue played an apoptosis trend （ cell swelling, rup- ture,nuclear condensation and cell fluid leak ）with more and bigger intercellular space. Conclusion Chlamydia trachomatis and ureaplasma urealyticum infection may be retrograde, and injure the decidual tis- sues, which is one of the important reasons of early threatened abortion.