原发不孕与继发不孕妇女生殖道感染的临床分析

目的了解原发不孕与继发不孕妇女生殖道感染的情况及其病原体分布。方法对1462例不孕患者的临床资料进行回顾性分析，分为原发不孕组和继发不孕组，分别对其阴道分泌物、宫颈分泌物及血清进行生殖道感染相关病原体的检测。结果1462例不孕妇女中，原发不孕477例，继发不孕985例。共检出生殖道感染者655例，总体感染率为44．80％。原发不孕组中共检出生殖道感染者186例，感染率为3899％；继发不孕组中共检出生殖道感染者469例，感染率为47．61％。总体病原体检出率：依次为解脲支原体（25．72％）、阴道加德纳氏菌（15．87％）、假丝酵母菌（11．08％）、沙眼衣原体（506％）、人型支原体（2．33％）、阴道毛滴虫（075％）、梅毒螺旋体（055％）、淋球菌（0．34％）、人类免疫缺陷病毒（0．07％）。两组中衣原体感染率继发不孕组明显高于原发不孕组。其余病原体感染率差异无统计学意义。结论在不孕妇女中常规进行阴道分泌物病原体检测及血清梅毒螺旋体、HIV的检测非常重要。继发不孕妇女尤其要重视衣原体的检测。

Reproductive tract infections in women with primary infertilities and secondary infertilities

Objective To assess reproductive tract infections（RTI） and pathogens distribution in women with primary in- fertilities and secondary infertilities. Methods The clinical data of 1462 women with infertilities, including 477 cases of primary infertilities and 985 cases with secondary infertilities, were retrospectively analyzed. The samples of vaginal secretion, cervical secretion and serum were collected and pathogens of reproductive tract infection were detected. Results Among 1462 cases, reproductive tract infections were detected in 655 （44.80%）; the infection rate in primary infertility group was 38.99%（186/477） and that in secondary infertility group was 47.61% （469/985）. Ureaplasma urealyticum（25.72%） was the most common pathogen of RTI, followed by Gardnerella vaginalis （15.87%）, Candida Albicans （11.08%）, Chlamydia trachomatis （5.06%）, Mycoplasma hominis（2.33%）, vaginal hair trichomoniasis （0.75%）, syphilis（0.55%）, gonococcal（0.34%） and HIV（0.07%）. The chlamydia tra- chomatis infection in secondary infertility group was significantly higher than in primary infertility group, while for other pathogens there were no statistical differences in infection rates. Conclusion The detection of RTI pathogens in vaginal secre- tions and syphilis, HIV in serum detection is of importance for infertility women; and detection of Chlamydia trachomatis is im- portant for those with secondary infertilities.