反复移植失败伴慢性子宫内膜炎不同检测方法比较及高危因素分析

摘要

目的:探讨不同方法对辅助生殖反复失败(RIF)合并慢性子宫内膜炎(CE)的检出率,分析RIF合并CE的高危因素.方法:选取36例因RIF需要行官腔镜检查的患者为研究对象,于官腔镜检查时取子宫内膜组织进行常规HE染色和CD138免疫组化染色并截取官腔镜下子宫内膜图片,收集病史分析其高危因素.结果:RLF伴CE患者标本3种方法检测,诊断CE阳性率CD138免疫组化高于官腔镜检查和HE染色(47.2％、38.8％、13.8％),3种检测方法一致性较差(Kappa＜0.4);人工流产史、输卵管堵塞是RIF合并CE的高危因素.结论:官腔镜可以广泛应用于临床检查,CD138免疫组化在确诊CE中具有较高优势;建议应用CD138免疫组化检测,利于明确病因及时治疗.人工流产史、输卵管堵塞是RLF伴CE的高危因素,在临床诊治中应引起重视.%Objective:To explore the detection rate of chronic endometritis (CE) of women with repeated implantation failure (RIF) by different methods,and to analyze the risk factors of women with RIF and CE.Methods:Thirty-six patients who experienced hysteroscopy because of RIF were enrolled in the study.Except to the hysteroscopic endometrial images were taken,the endometrial tissues of these women were obtained during hysteroscopy,and then were treated by routine HE staining and CD138 immunohistochemical staining.High risk factors of diseases were analyzed after medical history of these women collected.Results:The positive rate of CD138 (47.2％) was higher than that of hysteroscopy and HE staining (38.8 ％ and 13.8 ％).The consistency of these three detection methods was poor (Kappa ＜0.4).Abortion history,tubal clogging were the risk factors of women with RIF and CE.Conclusion:Hysteroscopy can be widely used in clinical examination.CD138 immunohistochemistry using for diagnosing CE has a higher advantage,so CD138 immunohistochemical detection is suggested to use for helping ensure the cause of diseases and women with CE can be treated timely.Abortion history and tubal clogging is the risk factors of women with RIF and CE,and the two risk factors should be paid attention when clinical diagnosis and treatment.