CD138对不孕合并慢性子宫内膜炎的诊断价值及其相关因素分析  

Enhancement of Diagnosis of Chronic Endometritis by CD138 and Assessment of Risk Factors Associated with Chronic Endometritis on Infertility

作　　者：陈玉清[1] 方瑞丽[1] 罗苑娜[2] 罗灿峤[3] 聂钊堂 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080 [2]中山大学附属第一医院病案管理科,广东广州510080 [3]中山大学附属第一医院病理科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2015年第4期569-573,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2013B021800237;2012B040304007);广州市科技计划项目(201300000169)

摘　　要：【目的】探讨CD138免疫组化在慢性子宫内膜炎(CE)诊断中的作用,及助孕患者合并CE的高危因素。【方法】选取93例检查证实为正常宫腔形态,准备行助孕治疗的患者为研究对象,取子宫内膜组织进行常规HE染色和CD138免疫组化染色,同时收集患者病史、跟踪其生殖预后。【结果】1CE的检出率:CD138免疫组化高于HE染色(27.96%vs 26.89%,P<0.05);2妊娠率:CD138阳性患者(7.7%)比CD138阴性患者(31.3%)低(P=0.017);3单因素分析结果表明既往有月经淋漓不尽史、人流史及合并有输卵管堵塞等与CE有一定联系(P<0.05),Logistic回归分析结果证实月经淋漓不尽(P=0.014,OR=5.394,95%CI1.405-20.699),既往人流史(P=0.029,OR=3.194,95%CI1.125-9.073)、输卵管堵塞(P=0.028,OR=3.274,95%CI1.139-9.415)是CD138阳性的独立危险因素。【结论】CD138免疫组化可提高CE诊断率,既往淋漓不尽病史、人流史输卵管堵塞病史是慢性子宫内膜炎的高危因素,应建议其进行CD138免疫组化检测。【Objective】 To evaluate the detected diagnostic value of CD138 in chronic endometritis and compare with that of conventional HE staining as well as investigate the risk factors in infertile patients with chronic endometritis. 【Methods】 Endometrial tissue of 93 infertile patients who recently received hysteroscopy and laparoscopy to confirm with normal uterine cavity for being prepared for assisted reproductive therapy was taken to routine HE staining and immunohistochemical staining for CD138. Clinical data of all patients were analyzed retrospectively and pregnant outcomes were followed up. 【Results】 1 The detection rate ：Immunohistochemical staining for CD138 can raise the detected capacity of chronic endometritis compared with HE staining（27.96%vs 26.89%, P 0.05）. 2Clinical pregnancy rate ： Compared with patients without chronic endometritis（31.3%）, patients with chronic endometritis（7.7%） were less likely to be pregnant（P = 0.017）. Univariate analysis and further regression analysis showed chronic endometritis correlated with history of dripping wet ungodliness（P = 0.014, OR = 5.394, 95% CI 1.405-20.699）, induced abortion（P = 0.029, OR = 3.194, 95% CI 1.125-9.073） and fallopian tube blockages（P = 0.028, OR = 3.274, 95% CI 1.139-9.415）. 【Conclusion】 Immunohistochemical staining for CD138 can improve the detected capacity of chronic endometritis as a remmendation for patients with risk factors included history of dripping wet ungodliness, induced abortion and fallopian tube blockages.

关 键 词：慢性子宫内膜炎 CD138 不孕 

分 类 号：R71[医药卫生—妇产科学]