【目的】研究不同类型沙眼衣原体蛋白在输卵管性不孕中的致病作用,预测具有临床检测价值的沙眼衣原体蛋白抗体。【方法】本研究共纳入输卵管性不孕组(TFI)58例,正常生育组(FC)41例,非输卵管性不孕组(IFC)18例。血清检测CT-IgG ELISA试...【目的】研究不同类型沙眼衣原体蛋白在输卵管性不孕中的致病作用,预测具有临床检测价值的沙眼衣原体蛋白抗体。【方法】本研究共纳入输卵管性不孕组(TFI)58例,正常生育组(FC)41例,非输卵管性不孕组(IFC)18例。血清检测CT-IgG ELISA试剂盒检测三组人群血清中CT-IgG的表达情况;利用前期获得表达、纯化的6种沙眼衣原体蛋白,建立这6种沙眼衣原体蛋白抗体的ELISA检测方法,分别检测6种沙眼衣原体蛋白抗体在TFI组、FC组和IFC组血清中的表达情况;对三组研究对象6种沙眼衣原体蛋白抗体的OD值进行统计描述,以CT-IgG的检测结果(阳/阴)为参考标准,绘制6种沙眼衣原体蛋白抗体的受试者工作特征曲线,利用约登指数确定各抗体的截断值。以TFI作为参考类,将FC、IFC分别与参考类建立两个无序多分类logistic回归模型,探究沙眼衣原体蛋白抗体、年龄预测TFI、FC和IFC的价值,并利用后退法筛选变量。【结果】各组研究对象CT376和CT443抗体OD值不全相同,CT-IgG阳性率不全相同。经两两比较发现,TFI组的CT376抗体OD值高于FC组(0.86 vs. 0.60,P=0.026)。TFI组的CT376抗体OD值高于IFC组(0.86 vs. 0.64,P=0.026)。IFC组CT443抗体OD值高于TFI组(0.59vs. 0.34,P=0.036),高于FC组(0.59 vs. 0.30,P=0.02)。经过比较,CT376抗体的阳性率在三组间不全相同(P<0.05);无序多分类logistic回归分析结果表明:TFI与FC建立的无序多分类logistic回归分析结果显示,CT-IgG [P <0.001,OR=0.084,95%CI(0.025,0.284)]、CT376抗体[P=0.068, OR=0.359,95%CI(0.120,1.078)]。CT-IgG是输卵管性不孕发生的独立危险因素,CT376抗体尚不能成为输卵管性不孕的独立危险因素;TFI与IFC建立的无序多分类logistic回归分析显示,在不孕的患者中,CT-IgG [P<0.05,OR=0.194,95%CI(0.046,0.817)]、CT376抗体[P<0.05,OR=0.176,95%CI(0.038,0.818)]和CT381抗体[P<0.05,OR=0.112,95%CI(0.016,0.796)]是输卵管性不孕发生的独立危险因素。【结�展开更多
Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the ...Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%;CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.展开更多
文摘【目的】研究不同类型沙眼衣原体蛋白在输卵管性不孕中的致病作用,预测具有临床检测价值的沙眼衣原体蛋白抗体。【方法】本研究共纳入输卵管性不孕组(TFI)58例,正常生育组(FC)41例,非输卵管性不孕组(IFC)18例。血清检测CT-IgG ELISA试剂盒检测三组人群血清中CT-IgG的表达情况;利用前期获得表达、纯化的6种沙眼衣原体蛋白,建立这6种沙眼衣原体蛋白抗体的ELISA检测方法,分别检测6种沙眼衣原体蛋白抗体在TFI组、FC组和IFC组血清中的表达情况;对三组研究对象6种沙眼衣原体蛋白抗体的OD值进行统计描述,以CT-IgG的检测结果(阳/阴)为参考标准,绘制6种沙眼衣原体蛋白抗体的受试者工作特征曲线,利用约登指数确定各抗体的截断值。以TFI作为参考类,将FC、IFC分别与参考类建立两个无序多分类logistic回归模型,探究沙眼衣原体蛋白抗体、年龄预测TFI、FC和IFC的价值,并利用后退法筛选变量。【结果】各组研究对象CT376和CT443抗体OD值不全相同,CT-IgG阳性率不全相同。经两两比较发现,TFI组的CT376抗体OD值高于FC组(0.86 vs. 0.60,P=0.026)。TFI组的CT376抗体OD值高于IFC组(0.86 vs. 0.64,P=0.026)。IFC组CT443抗体OD值高于TFI组(0.59vs. 0.34,P=0.036),高于FC组(0.59 vs. 0.30,P=0.02)。经过比较,CT376抗体的阳性率在三组间不全相同(P<0.05);无序多分类logistic回归分析结果表明:TFI与FC建立的无序多分类logistic回归分析结果显示,CT-IgG [P <0.001,OR=0.084,95%CI(0.025,0.284)]、CT376抗体[P=0.068, OR=0.359,95%CI(0.120,1.078)]。CT-IgG是输卵管性不孕发生的独立危险因素,CT376抗体尚不能成为输卵管性不孕的独立危险因素;TFI与IFC建立的无序多分类logistic回归分析显示,在不孕的患者中,CT-IgG [P<0.05,OR=0.194,95%CI(0.046,0.817)]、CT376抗体[P<0.05,OR=0.176,95%CI(0.038,0.818)]和CT381抗体[P<0.05,OR=0.112,95%CI(0.016,0.796)]是输卵管性不孕发生的独立危险因素。【结�
文摘Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%;CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.