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目的通过对316例输卵管性不孕患者生殖道沙眼衣原体、解脲支原体、人型支原体感染以及耐药情况进行检测分析,研究其与不孕症的关系,并探讨用药合理性。方法收集316例2013年2月至2016年9月至我院进行诊治的输卵管性不孕患者作为研究组,并选取同期297例来进行检查的健康人作为对照组。对两组人员生殖道分泌物进行沙眼衣原体(Chlamydia trachomatis,Ct)、解脲支原体(Ureaplasma urealyticum,Uu)、人型支原体(Mycoplasma hominis,Mh)检测,并进行药敏试验。结果研究组患者Ct、Uu、Mh、Ct+Uu、Uu+Mh感染率以及总感染率均明显高于对照组,差异均具有统计学意义(Ps<0.05)。Uu对原始霉素、四环素、强力霉素、交沙霉素、阿奇霉素、克拉霉素、红霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星耐药性较高。Mh对原始霉素、四环素、强力霉素、交沙霉素敏感性较高(90%以上),对氧氟沙星、环丙沙星、阿奇霉素、克拉霉素耐药性较高。Uu+Mh对原始霉素、四环素、交沙霉素敏感性较高(90%以上),对阿奇霉素、氧氟沙星、环丙沙星耐药性较高。结论对输卵管性不孕患者,应进行生殖道分泌物Ct、Uu、Mh的检测,判断是否发生感染或混合感染,并根据药敏结果选择合适的抗生素进行治疗,以提高治疗效果。
Objective To detect and analyze the genital C. trachomatis, Ureaplasma urealyticum, Mycoplasma hominis and their drug resistance in 316 cases of tubal infertility, to study the relationship between infertility and sterility, and to explore the rationality of medication. Methods 316 patients with tubal infertility who were admitted to our hospital from February 2013 to September 2016 were enrolled as study group, and 297 normal subjects were selected as control group. Chlamydia trachomatis (Ct), Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) were detected in the reproductive tract secretions of both groups, and drug susceptibility tests were performed. Results The infection rates of Ct, Uu, Mh, Ct + Uu, Uu + Mh and the total infection rate in the study group were significantly higher than those in the control group, with statistical significance (Ps <0.05). Uu was more sensitive to pristinamycin, tetracycline, doxycycline, jasminemycin, azithromycin, clarithromycin, erythromycin (more than 90%), and toloxacin and ciprofloxacin high. Mh to pristinamycin, tetracycline, doxycycline, josamycin high (90%), ofloxacin, ciprofloxacin, azithromycin, clarithromycin higher resistance. Uu + Mh is more sensitive to pristinamycin, tetracycline and jasamycin (more than 90%), and has higher resistance to azithromycin, ofloxacin and ciprofloxacin. Conclusion In patients with tubal infertility, genital tract secretions Ct, Uu, Mh should be detected to determine whether there is an infection or mixed infection. According to the susceptibility results, select the appropriate antibiotics for treatment to improve the treatment effect.