【摘要】：[目的] 1、(1)檢測(cè)不孕患者及孕早期女性宮頸分泌物CT、UU、Mh,探討CT、UU、Mh與不孕的關(guān)系；(2)分析不孕患者及孕早期女性宮頸支原體培養(yǎng)結(jié)果和陰道分泌物檢測(cè)結(jié)果,探討支原體致病性與合并陰道感染的關(guān)系。 2、檢測(cè)輸卵管妊娠患者及孕早期女性宮頸分泌物CT、UU、Mh,探討CT、UU、Mh與輸卵管妊娠的關(guān)系。 3、檢測(cè)手術(shù)患者宮頸分泌物和盆腔液中的CT、UU、Mh,探討盆腔液中CT、UU、Mh的感染情況。 4、進(jìn)行支原體藥物敏感試驗(yàn),分析支原體的藥物敏感情況。 [方法] 所有研究對(duì)象均選取自2013年7月至2014年3月在昆明醫(yī)科大學(xué)第二附屬醫(yī)院婦科門診、婦科住院部和生殖醫(yī)學(xué)科就診的患者,均需滿足的納入標(biāo)準(zhǔn)：有性生活史,在兩周內(nèi)未使用過(guò)任何抗生素,取樣三天內(nèi)沒(méi)有陰道沖洗,沒(méi)有陰道用藥及性生活,排除經(jīng)期的女性。 1、選取生殖醫(yī)學(xué)科就診的不孕癥患者257例作為不孕組,不孕組患者均滿足無(wú)避孕性生活一年不孕,男方精液檢查正常；選取同時(shí)期婦科門診孕早期要求終止妊娠的患者106例作為對(duì)照組；取宮頸分泌物行支原體培養(yǎng)、沙眼衣原體檢測(cè),比較不孕組和對(duì)照組支原體、沙眼衣原體的陽(yáng)性率；取陰道分泌物行陰道分泌物檢查,比較不孕組和對(duì)照組支原體感染和陰道感染的情況。 2、選取婦科住院部收治的輸卵管妊娠患者81例作為輸卵管妊娠組,選取同時(shí)期婦科門診孕早期要求終止妊娠并排外既往有異位妊娠史的患者102例作為對(duì)照組；取宮頸分泌物行支原體培養(yǎng)、沙眼衣原體檢測(cè),比較輸卵管妊娠組和對(duì)照組支原體、沙眼衣原體的陽(yáng)性率。 3、選取婦科住院部因?yàn)椤白訉m肌瘤、子宮腺肌癥、卵巢囊腫、輸卵管妊娠”等疾病需手術(shù)治療的患者305例,術(shù)前取宮頸分泌物,術(shù)中取盆腔液,均行支原體培養(yǎng)、沙眼衣原體檢測(cè)。 4、將上述所取標(biāo)本在行支原體培養(yǎng)時(shí)用同一試劑盒行支原體藥物敏感試驗(yàn)。 [結(jié)果] 1、(1)不孕組和對(duì)照組宮頸分泌物均未檢出沙眼衣原體；(2)不孕組宮頸分泌物支原體陽(yáng)性率達(dá)59.14%,明顯高于對(duì)照組47.17%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；(3)不孕組單純支原體感染陽(yáng)性率為31.13%；對(duì)照組陽(yáng)性率為33.02%；兩組陽(yáng)性率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；不孕組支原體感染合并陰道感染陽(yáng)性率為28.02%,明顯高于對(duì)照組14.15%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；不孕組單純陰道感染陽(yáng)性率為15.95%；對(duì)照組陽(yáng)性率為17.92%,兩組陽(yáng)性率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 2、輸卵管妊娠組和對(duì)照組宮頸分泌物均未檢出沙眼衣原體；輸卵管妊娠組宮頸分泌物支原體陽(yáng)性率達(dá)62.96%,明顯高于對(duì)照組47.06%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 3、305例手術(shù)患者宮頸分泌物及盆腔液未檢出沙眼衣原體；305例手術(shù)患者宮頸分泌物支原體培養(yǎng)陽(yáng)性152例,陽(yáng)性率為49.84%,盆腔液支原體培養(yǎng)陽(yáng)性0例,宮頸分泌物陽(yáng)性率明顯高于盆腔液,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 4、單一UU感染時(shí),對(duì)四環(huán)素類、大環(huán)內(nèi)酯類敏感,對(duì)喹諾酮類耐藥。單一Mh感染時(shí),對(duì)四環(huán)素類敏感,對(duì)大環(huán)內(nèi)酯類、喹諾酮類耐藥。UU和Mh混合感染時(shí),對(duì)四環(huán)素類敏感,對(duì)大環(huán)內(nèi)酯類、喹諾酮類耐藥。 [結(jié)論] 宮頸支原體感染是導(dǎo)致不孕、輸卵管妊娠的原因之一；支原體可能合并其他病原微生物共同致病；盆腔液支原體檢出率低于宮頸分泌物；單一UU感染時(shí),對(duì)四環(huán)素類、大環(huán)內(nèi)酯類敏感,對(duì)喹諾酮類耐藥；單一Mh感染時(shí),對(duì)四環(huán)素類敏感,對(duì)大環(huán)內(nèi)酯類、喹諾酮類耐藥；UU和Mh混合感染時(shí),對(duì)四環(huán)素類敏感,對(duì)大環(huán)內(nèi)酯類、喹諾酮類耐藥。
[Abstract]:[Objective]
1. (1) To investigate the relationship between CT, UU, Mh and infertility by detecting the cervical secretions of infertility patients and early pregnant women; (2) To analyze the results of mycoplasma culture and vaginal secretions of infertility patients and early pregnant women, and to explore the relationship between Mycoplasma pathogenicity and vaginal infection.
2. To investigate the relationship between CT, UU, Mh and tubal pregnancy.
3. To detect CT, UU and Mh in cervical secretion and pelvic fluid of patients undergoing operation, and to investigate the infection of CT, UU and Mh in pelvic fluid.
4, carry out Mycoplasma drug sensitivity test and analyze the drug sensitivity of Mycoplasma.
[method]
All participants were selected from the gynecological outpatient clinic of the Second Affiliated Hospital of Kunming Medical University from July 2013 to March 2014. All patients in the gynecological inpatient department and the reproductive medicine department met the inclusion criteria: having a history of sexual life, not using any antibiotics within two weeks, no vaginal flushing within three days, no vaginal medication and Sexual life excludes menstrual women.
1. Select 257 infertility patients in the Department of reproductive medicine as the infertility group, the infertility group were satisfied with one-year non-contraceptive life infertility, the male semen examination was normal; Select the same period of gynecological clinic early pregnancy termination of 106 patients as the control group; Take cervical secretion for Mycoplasma culture, Chlamydia trachomatis detection, The positive rates of Mycoplasma and Chlamydia trachomatis were compared between the infertility group and the control group.
2. 81 cases of tubal pregnancy in gynecological inpatient department were selected as the tubal pregnancy group, 102 cases of patients with a history of ectopic pregnancy were selected as the control group. The positive rate of Mycoplasma and Chlamydia trachomatis was positive.
3. Choose 305 gynecologic inpatients who need surgery because of "uterine fibroids, adenomyosis, ovarian cysts, tubal pregnancy" and other diseases. Take cervical secretion before operation, pelvic fluid during operation, Mycoplasma culture, Chlamydia trachomatis detection.
4, use the same kit to test the Mycoplasma drug sensitivity test.
[results]
1. (1) Chlamydia trachomatis was not detected in cervical secretion of infertility group and control group; (2) The positive rate of Mycoplasma trachomatis in cervical secretion of infertility group was 59.14%, significantly higher than that of control group (47.17%, P 0.05); (3) The positive rate of mycoplasma infection in infertility group was 31.13%; the positive rate of control group was 33.02%; there was no significant difference between the two groups. The positive rate of mycoplasma infection with vaginal infection in infertility group was 28.02%, which was significantly higher than that in control group (14.15%, P 0.05). The positive rate of simple vaginal infection in infertility group was 15.95%, and that in control group was 17.92%. There was no significant difference between the two groups (P 0.05).
2. Chlamydia trachomatis was not detected in cervical secretion of tubal pregnancy group and control group, and the positive rate of Mycoplasma in cervical secretion of tubal pregnancy group was 62.96%, which was significantly higher than that of control group (47.06%, P 0.05).
Chlamydia trachomatis was not detected in cervical secretion and pelvic fluid of 3,305 patients, and mycoplasma culture in cervical secretion of 305 patients was positive in 152 cases (49.84%). Mycoplasma culture in pelvic fluid was positive in 0 cases, and the positive rate of cervical secretion was significantly higher than that in pelvic fluid (P 0.05).
4. Single UU infection is sensitive to tetracyclines, macrolides and quinolones. Single Mh infection is sensitive to tetracyclines, macrolides and quinolones. UU and Mh infection are sensitive to tetracyclines, macrolides and quinolones.
[Conclusion]
Mycoplasma infection is one of the causes of infertility and tubal pregnancy; Mycoplasma may be associated with other pathogenic microorganisms; Mycoplasma detection rate in pelvic fluid is lower than cervical secretions; when a single UU infection, it is sensitive to tetracyclines, macrolides and quinolones; when a single Mh infection, it is sensitive to tetracyclines. Resistance to macrolides and quinolones, susceptibility to tetracyclines and resistance to macrolides and quinolones in UU and Mh co-infection.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R711.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 戴鑫琦,劉海霞,李玉軍;輸卵管妊娠絨毛組織中沙眼衣原體和解脲支原體的DNA檢測(cè)[J];青島大學(xué)醫(yī)學(xué)院學(xué)報(bào);2004年01期

2 欒瑞玲;曹慧;;女性下生殖道支原體存在情況及與疾病關(guān)系[J];青島大學(xué)醫(yī)學(xué)院學(xué)報(bào);2008年06期

3 劉志紅,鄧玉清,王玉潔,吳瑞芳;解脲支原體和沙眼衣原體感染與輸卵管妊娠的關(guān)系[J];中國(guó)醫(yī)師雜志;2004年10期

4 趙英會(huì);張念華;侯海峰;王玉;張忠;侯盼飛;于愛(ài)蓮;;輸卵管妊娠主要危險(xiǎn)因素的Meta分析[J];第四軍醫(yī)大學(xué)學(xué)報(bào);2007年11期

5 李敏清,黃婉,黃燕清;67例不孕癥患者宮頸與輸卵管、盆腔液支原體、衣原體和細(xì)菌感染檢測(cè)[J];廣東醫(yī)學(xué);2001年04期

6 劉厚明;詹能勇;羅凱;肖顏玉;單萬(wàn)水;;女性泌尿生殖道支原體感染及耐藥性分析[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2010年05期

7 張岱;米蘭;;支原體與婦產(chǎn)科感染性疾病[J];國(guó)際婦產(chǎn)科學(xué)雜志;2011年06期

8 廖秦平;張岱;;中國(guó)女性生殖道感染診治現(xiàn)狀及研究進(jìn)展[J];國(guó)際婦產(chǎn)科學(xué)雜志;2011年06期

9 郭慧梅;田瑩;;輸卵管妊娠與生殖道支原體感染關(guān)系的臨床分析[J];河北醫(yī)學(xué);2008年02期

10 趙運(yùn)果;張晚魚;趙邦榮;;生殖道感染沙眼衣原體和解脲支原體與輸卵管性不孕的分析[J];中國(guó)計(jì)劃生育學(xué)雜志;2010年04期

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