目的 探讨腰骶椎隐性脊柱裂与女性不孕症的关系.方法 连续收集本院2009年7月至2012年4月2 341例经临床证实女性不孕症患者,其中伴发隐性脊柱裂者1 242例,年龄(32±9)岁,并将伴发隐性脊柱裂的患者按照原、继发不孕分为两组,回顾性对比分析两组的子宫输卵管碘油造影、超声卵泡监测、激素检查、抗体检测及临床病史差异.另外选取439例经临床证实女性不孕症患者,子宫输卵管造影排除隐性脊柱裂者作为对照组.结果 在2 341例女性不孕症患者中,伴发隐性脊柱裂的女性不孕症的发生率大约53.06％,其中原发不孕占29.01％,继发不孕占24.05％.原发不孕多表现为缺乏优势卵泡(527例)、畸形子宫(78例)、激素水平异常(676例)、抗精子抗体和抗卵巢抗体阳性(590例)、月经异常(323例)和妇科内分泌疾病(679例)(P＜0.05)；而输卵管梗阻(529例)、子宫炎性改变(305例)、抗心磷脂抗体和抗子宫内膜抗体阳性(314例)、有异常妊娠史(43例)和避孕史(451例)多见于继发不孕者(P＜0.05).结论 腰骶椎隐性脊柱裂可能是导致女性不孕症发生或易感性增高的一个重要原因.%Objective To investigate the relationship between female infertility and spina bifida occulta ( SBO) . Methods Out of a total of 2 341 infertile women in our hospital form July 2009 to April 2012 ,1 242 associated with SPO were revealed( age: 32 ±9 ) . Evaluated and compared the results of hysterosalpingographies ( HSG ) , ultrasound follicle monitoring, hormone assays, serum antibody assays and clinical history in 1 242 primary and secondary infertile women with SBO. The control group contained 439 female infertility patients associated without SBO and they were all confirmed by clinical or HSG. Results Out of a total of 2 341 infertile women, 53.06% of them had SBO, including 29. 01% primary infertile , and 24.05% secondary infertility. Absence of dominant follicle (527 cases), uterus malformation (78 cases) ,abnormal hormone assays (676 cases) , antisperm antibodies and antiovarian antibodies (590 cases) , menstrual abnormalities (323 cases) and gynecology endocrine diseases(679 cases) were more prominent in primary infertile women(P <0. 05). Tubal obstruction (529 cases) ,metritis( 305 cases ), anticardiolipin antibodies and antiendometrium antibodies (314 cases ), histories of abnormal pregnancy (34 cases) and contraceptives use(451 cases) were more commonly observed in secondary infertile women( P < 0. 05 ) . Conclusion The findings indicate that SBO plays a key role in women with infertility and contributes to susceptibility to infertility.
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