不孕症女性血清抗精子抗体、抗子宫内膜抗体及抗苗勒管激素的改变

目的 探讨不孕症女性血清抗精子抗体(ASAb)、抗子宫内膜抗体(EMAb)及抗苗勒管激素(AMH)的改变,为免疫性不孕不育的预测、诊断和治疗提供依据.方法 选择2010年5月至2011年5月来我院就诊的200例不孕女性为不孕症组；以同时期100名有正常生育史的女性为对照组,定性检测两组血清中ASAb、EMAb,定量检测AMH.结果 不孕症组女性血清ASAb总阳性率为27.5％( 55/200),IgG阳性率为11.5％ (23/200),IgM阳性率为22.5％ (45/200),IgA阳性率为9.5％ (19/200)；对照组阳性率分别为6.0％ (6/100)、1.0％ (1/100)、0、2.0％ (2/100)(x2值分别为5.33、5.37、5.41、4.05,P均＜0.05).不孕症组EMAb总阳性率为48.5％ (97/200),IgG阳性率为13.5％ (27/200),IgM阳性率为32.5％ (65/200),IgG和IgM同时阳性率为5.5％ (11/200),对照组分别为0、1.0％ (1/100)、3.0％(3/100)、0(x2值分别为5.01、5.24、5.16、5.33,P均＜0.01).不孕症组血清AMH为(5.39±1.42)μg/L,对照组为(2.55 ±1.27)μg/L,差异有统计学意义(=5.39,P＜0.01)；相关性分析发现女性不孕患者ASAb与EMAb具有一定的相关性(x2=6.27,P=0.03).结论 不孕妇女血清AMH显著高于正常人群,且ASAb、EMAb的阳性率高于对照人群；检测ASAb、EMAb及AMH对寻找不孕原因及采取相应对策具有重要意义.

Analysis of the changes of antisperm antibody, antiendometrial antibody and anti-mulerian hormone in serum of women with infertility

Objective To examine the level of antisperm antibody （ASAb）, antiendometrial antibody （EMAb） and anti-mulerian hormone（AMH） in serum of women with infertility and to provide a reliable basis for prediction, diagnosis and treatment of infertility. Methods Two hundred cases of women with infertility visiting our hospital between May. 2010 and May. 2011 were chosen as the infertility group and 100 cases of women with fertility experience visiting our hospital at the same period with the infertility group were chosen as the control group. We examined the presence of ASAb and EMAb and the levels of AMH of the participants. Results In the infertility group,the total positive rate of serum ASAb was 27.5% （55/200） and the positive rates of ASAb-IgG, ASAb-IgM and ASAb-IgA were 11.5 % （ 23/200）, 22. 5 % （ 45/200 ） and 9. 5 % （19/200） respectively. While in the control group,the rates were 6. 0% （6/100） ,1.0% （1/100） ,0 and 2.0% （2/100） respectively （ X2 = 5.33,5.37,5.41,4. 05 ; P 〈 0. 05 ）. The total positive rate of EMAb was 48. 5 % （97/200）, and the positive rates of EMAb-IgG and EMAb-lgM were 13.5% and 32. 5% respectively, and EMAb-IgG ＋ EMAb-IgM positive rate was 5.5% （11/20）. These parameters were significantly higher than those in the control group 0,1.0% （1/100） ,3.0% （3/100） ,0, X2 = 5.01,5.24,5.16,5.33 ;P 〈 0. 01 ]. There was significantly difference on the level of AMH between the experimental group and the control group （5.39 ＋ 1.42） Ixg/L vs. （2. 55 ＋ 1.27）Ixg/L,t =5.39,P 〈0. 01 ]. Significant correlation was found between ASAb and EMAb（ X2 = 6. 27 ,P = 0. 03） by correlation analysis . Conclusion The level of AMI-t and the positive rates of ASAb and EMAb are higher in women with infertility than in normal people. Detection of ASAb, EMAb and AMH are important in in finding cause for infertility and taking appropriate measures to treat infertility