沙眼衣原体感染与异位妊娠关系的临床观察

目的探讨血清沙眼衣原体(CT)及其热休克蛋白60(C-HSP60)抗体反应与异位妊娠(EP)的关系.方法检测了47例EP患者(EP组)和46例宫内妊娠妇女(对照组)血清CT抗体.用基因工程的方法重组C-HSP60,以纯化后的C-HSP60蛋白为抗原,采用酶联免疫吸附法,检测了两组妇女血清C-HSP60抗体水平.结果 EP组和对照组血清沙眼衣原体IgG抗体阳性率分别为68.1%和34.8%,两组有显著性差异(P<0.05);EP妇女C-HSP60 IgG抗体阳性率为25.5%,高于对照组阳性率4.3%,两者有显著性差异(P<0.05).在沙眼衣原体血清学阳性妇女中,EP组C-HSP60 IgG抗体阳性率为34.4%,与宫内妊娠组0%(0/16)相比,有显著性差异 (P<0.05).两组在血清沙眼衣原体IgM、C- hsp60IgM抗体水平上皆无显著性差异(P>0.05).结论女性生殖道沙眼衣原体感染是导致EP的重要原因,C-HSP60与其发病机理有非常密切的关系.

Clinical observation on the relationship between chlamydia trachomatis infection and ectopic pregnancy

Objective To investigate the prevalence of antibody to chlamydia trachomatis and chlamydial heat shock protein 60(C HSP60) in women with ectopic pregnancy(EP).Methods Fourty seven women with ectopic pregnancy (EP group),46 women with intrauterine pregnancy (control group) were investigated as a case control study.An ELISA using purified recombinant C HSP60 was developed to detect antidobies to C.trachomatis and C HSP60 in serologic samples.Results IgG antibody to C.trachomatis was present in 32(68.1%) of 47 women with ectopic pregnancy compared with 16(34.8%) of 46 women with intrauterine pregnancy ( P <0.05);C HSP60 IgG positive rate was signficantly higher in EP group than in the control group(25.5% versus 4.3 %, P < 0.05 ).Among the C.trachomatis seropositive women,antibody to C HSP60 was present in 11(34.4%) of women with ectopic pregnancy compared with 0(0%) of 16 with introurine pregnancy ( P <0.05).There were no signficant differences in the positive rate of C.trachomatis IgM and C hsp IgM between two groups.Conclusions There is a strong association between antibody response to C HSP60 and the development of C.trachomatis associated ectopic pregnancy.So C HSP60 plays an important role in the pathogenesis of ectopic pregnancy.