【作者】 冯苗； 李素春； 刘标英； 潘萍； 吴穗妹；

【Author】 FENG Miao,LI Suchun,LIU Biaoying,PAN Ping,Wu Suimei Guangdong Provincial Family Planning Research Institute,510600

【机构】 广东省计划生育专科医院妇科；

【摘要】 目的探讨供精人工授精(AID)妇女宫颈炎状况及宫颈炎对宫颈黏液的影响。方法 2010年6月至2010年10月对广东省计划生育专科医院行AID助孕的无精子症配偶500例取阴道分泌物及宫颈管黏液行病原体检查,白细胞检测;同时抽静脉血行ELISA法抗精子抗体(AsAb),单纯疱疹病毒(HSV),巨细胞病毒(CMV)检测。围排卵期进行宫颈黏液评分,血AsAb升高的妇女进一步行围排卵期宫颈黏液Kremer’s test及SCMC检测。结果 (1)按照诊断标准,500名妇女分为宫颈炎组92例(18.4%),对照组408例(81.6%)。(2)宫颈炎组宫颈黏液CT,UU,BV,HPV感染率较对照组明显增高,差异均有统计学意义(P<0.01)。宫颈炎组血HSV,CMV感染率较对照组明显增高,差异均有统计学意义(P<0.05)。(3)宫颈炎组围排卵期宫颈黏液评分较对照组(9.32±1.91分对12.67±2.14分)增加,差异有统计学意义(P<0.05)。两组宫颈黏液的量,成丝性,羊齿化结晶程度比较差异无统计学意义(P>0.05);而宫颈炎组较对照组宫颈黏液黏稠,黏液细胞数明显增多,差异均有统计学意义(P<0.01)。(4)宫颈炎组血AsAb阳性检出率33.7%(31/92),明显高于对照组9.8%(40/408),差异有统计学意义(P<0.01)。宫颈炎组宫颈黏液Kremer,s test及SCMC异常率分别为10.7%(10/92),9.8%(9/92);均较对照组1.2%(5/408),1.2%(5/408)增加,差异有统计学意义(P<0.01)。结论宫颈炎可能造成宫颈黏液理化性状改变及宫颈免疫学功能异常,通过多个环节影响精子的存活,活动,储存和获能,从而导致不孕。育龄妇女应该积极治疗宫颈炎。更多还原

【Abstract】 Objective To investigate the status of cervicitis and effect on cervical mucus in women of artificial insemination by donor(AID). Methods During June 2010 to October 2010,500 women of AID treated in Infertility Clinic of Guangdong Provincial Family Planning Research Institute were scanned for the pathogen and leukocyte from cervical secretions and vaginal discharge.Serum antisperm antibodies(AsAb),herpes simple virus(HSV) and cytomegalovirus(CMV) level were also examined by ELISA method,meanwhile cervical mucus score(CMS) was carried out during periovulatory phase. Kremer,s test and sperm-cervical mucus contact(SCMC) test were underwent in women with high AsAb level. Results According to the diagnosis standard,500 women were divided into two groups:cervicitis group(n=92,18.4%) and the control group(n=408,81.6%).The positive rates of chlamydia trachomatis(CT),ureaplasma urealyticum(UU), bacterial vaginosis(BV),HSV,CMV and HPV in cervicitis group were significantly higher than those in the control group(P<0.05).The cervical mucus score in cervicitis group was significantly higher than that in the control group (9.32±1.91 vs.12.67±2.14,P<0.05).There were no significant differences of cervical mucus volume,drawing degree and fern crystals between the two group(P>0.05),while there were significant differences of cervical mucus viscosity and cells between the two group(P<0.01).The positive rate of serum AsAb level in the cervicitis group was significantly higher than that in the control group(33.7%vs.9.8%,P<0.01).The abnormal rate of Kremer s test(10.7%vs.1.2%) and SCMC test(9.8%vs.1.2%) in the cervicitis group were also significantly higher than that in the control group(P<0.01). Conclusion Cervicitis may result in some physicochemical characteristic change and immunological dysfunction of cervical mucus,and induce infertility through several aspects such as the effect on the sperm viability,motility,storage and capacitation.It is important for early diagnosis and treatment of cervicitis for reproductive aged women.更多还原