孕期生殖道感染及病原体种类与难免流产的关系探讨

摘要

目的：探讨孕期生殖道感染与难免流产的关系。方法选取2013－01～2014－07间在我院收治并分娩的难免流产患者共173例，根据胎盘病理结果分为组织学绒毛膜羊膜炎组111例（ A组）和无绒毛膜羊膜炎组62例（ B组），所有病例均进行生殖道支原体、衣原体PCR培养及细菌培养（包括需氧菌和厌氧菌），同时采血液学指标血常规白细胞计数、中性粒细胞比值及CRP水平的测定，并进行统计分析。结果 A组和B组支原体、衣原体及细菌培养阳性率明显高于B组，两组间有显著性差异（P＜0．05），其中A组的细菌培养超过50％以上为厌氧菌假丝酵母菌感染， A组白细胞计数及C反应蛋白（CRP）水平高于B组，两组间有统计学差异（ P＜0．05），而A组和B组的中性粒细胞比值差异无统计学意义（ P＞0．05）。结论生殖道感染尤其是假丝酵母菌、支原体、大肠埃希氏菌等致病菌导致的绒毛膜羊膜炎可能是难免流产发生的原因之一。孕期对高危孕妇进行生殖道病原体的筛查及早期干预，对改善妊娠结局具有一定的临床意义。%Objective To investigate the relationship between the reproductive tract infection during pregnancy and inevitable abor -tion.Methods Choosing 173 patients with inevitable abortion and childbirth from January , 2013 to July, 2014 in the hospital.According to the results of the placental pathology , dividing them into histology chorionic amniotic membrane inflammation group (111 cases) as group A and no chorionic amniotic membrane inflammation group ( 62 cases ) as group B.All cases were genital tract mycoplasma , chlamydia PCR cultivation and bacteria ( including aerobic and anaerobic bacteria ) , at the same time adopting hematology indexes of blood routine and CRP levels of white blood cell count , neutrophils ratio measurement and statistical analysis .Results Mycoplasma, chlamydia and bacteria culture in group A are significantly higher than those of group B .There are significant differences between the two groups (P<0.05).Bac-terial culture of group A is anaerobic bacteria candida yeast infection standing for more than 50%.White blood cell count and C -reactive protein ( CRP) levels of group A are higher than those of group B , and there is the difference between the two groups ( P<0.05 ) , while in group A and group B, there is no statistical difference of the neutrophils ratio (P>0.05).Conclusion Reproductive tract infections espe-cially candida , mycoplasma , e.coli bacteria and other pathogens of chorioamnionitis may be a reason of inevitable abortion .For high-risk pregnant women during pregnancy screening and early intervention of reproductive tract pathogens can improve the pregnancy outcome , and has a certain clinical significance .