人工流产与孕育不良及封闭抗体缺失的相关性研究  

Study on relationship between abortion, bad breed and lack of blocking antibody

作　　者：张劲丰[1] 苏荣[1] 庄健海[1] 吴英[1] 安宏亮[1] 庞俏茹[1] 吴丹[1] 何娴[1] 简少珍[1] 杨延斌[1] 

机构地区：[1]佛山市中医院检验科,广东佛山528000

出　　处：《现代预防医学》2013年第17期3190-3192,3199,共4页Modern Preventive Medicine

基　　金：广东省医学科研基金项目(A2010605)

摘　　要：目的研究人工流产行为因素和孕育不良,特别是不明原因复发性自然流产(URSA)的相关性,探讨人工流产对封闭抗体缺失的影响。方法收集来自某院妇科共302例病例,正常生育组54例(对照组)和孕育不良妇女248例,其中孕育不良组包括URSA82例、继发性不孕112例、偶发性自然流产54例。采用ELISA法检测各病例组血清中的封闭抗体(BA)。结果正常生育组和孕育不良组的人工流产率分别是13.0%(7/54)、41.5%(103/248),其差异有统计学意义(χ2=15.630,P﹤0.001);人工流产与孕育不良的归因分析,其比值比OR=4.769,95%CI=2.073～10.973;对3种孕育不良发生的OR值和95%CI值分别是:继发性不孕8.621(3.584～20.833)、URSA2.778(1.101～6.993)、偶发性自然流产2.825(1.055～7.576);人工流产次数和年龄与孕育不良的Logistic回归分析:回归系数是1.458和-0.22,P值是0.000和0.516,OR值和95%CI值是4.296(1.968～9.377)、0.979(0.917～1.045);对BA结果阳性和阴性病例的人工流产率进行比较,其差异无统计学意义(χ2=0.620,P=0.471,P﹥0.05),OR=1.209,95%CI=0.754～1.938。结论人工流产是孕育不良的危险因素,随流产次数和年龄的增加,危险度增加;危险度最高的是继发性不孕,其次是偶发性自然流产和URSA;人工流产与封闭抗体的缺失无关。OBJECTIVE To study the relationgship of abortion, abnormal inoculation, and unexplained recurrent spontaneous abortion （URSA）, and to discuss the effect of abortion on deficiency of blocking antibody. METHODS 302 cases from Gynecology Department in our hospital were collected including 54 cases of normal reproductive women group （control group） and 248 cases of the women with abnormal inoculation （82 cases with URSA, 112 cases wit secondary infertility and 54 cas- es with occasional spontaneous abortion） . The blocking antibody （BA） was tested by using ELISA method. RESULTS The abortion rate of the control group and the abnormal inoculation group respectively was 13.0% （7/54） and 41.5% （103/248）, the difference was statistically significant （X2 = 15.630, P 〈 0.001 ） ; the attribution analysis of abortion and abnormal inocu- lation showed that the odds ratio （OR） was 4.769, and 95%CI was 2.073-10.973; the OR values （95%CI） of the three ab- normal inoculation groups respectively was 8.621 （3.584-20.833） of the secondary infertility group, 2.778 （1.101-6.993） of the URSA group, 2.825 （1.055-7.576） of the occasional spontaneous abortion group; The logistic regression analysis on number and age of abortion and abnormal inoculation showed that the regression coefficient was 1.458 and -0.22, P-value was 0.000 and 0.516, OR value （95%CI） was 4.296 （1.968-9.377） and 0.979 （0.917-1.045）, respectively; the differ- ence of the abortion rate between BA positive cases and negative cases was not statistically significant （ ~ = 0.620, P = 0.471, P 〉 0.05）, OR = 1.209, 95%CI = 0.754-1.938. CONCLUSION Abortion is the risk factor of abnormal inoculation. With the increase in the number of abortion and age of women, the risk is increasing. The highest risk is secondary infertility, followed by occasional spontaneous abortion and URSA. Abortion is no relevant to the missing of BA.

关 键 词：人工流产 孕育不良 封闭抗体 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]