反复移植失败伴慢性子宫内膜炎不同检测方法比较及高危因素分析  

Comparison of different detection methods for chronic endometritis of women with repeated implantation failure and analysis risk factors of diseases

作　　者：田海英[1,2] 徐祥波 王蔼明 张悦[1] 贺斌 高金芳 

机构地区：[1]内蒙古民族大学附属医院,通辽028007 [2]海军总医院生殖中心 [3]国家卫生计生委科学技术研究所

出　　处：《中国计划生育学杂志》2017年第4期263-266,共4页Chinese Journal of Family Planning

基　　金：国家十二五科技支撑项目NO.2012BAI32B05

摘　　要：目的:探讨不同方法对辅助生殖反复失败(RIF)合并慢性子宫内膜炎(CE)的检出率,分析RIF合并CE的高危因素。方法:选取36例因RIF需要行宫腔镜检查的患者为研究对象,于宫腔镜检查时取子宫内膜组织进行常规HE染色和CD138免疫组化染色并截取宫腔镜下子宫内膜图片,收集病史分析其高危因素。结果:RLF伴CE患者标本3种方法检测,诊断CE阳性率CD138免疫组化高于宫腔镜检查和HE染色(47.2%、38.8%、13.8%),3种检测方法一致性较差(Kappa<0.4);人工流产史、输卵管堵塞是RIF合并CE的高危因素。结论:宫腔镜可以广泛应用于临床检查,CD138免疫组化在确诊CE中具有较高优势;建议应用CD138免疫组化检测,利于明确病因及时治疗。人工流产史、输卵管堵塞是RLF伴CE的高危因素,在临床诊治中应引起重视。Objective： To explore the detection rate of chronic endometritis （CE） of women with repeated implantation failure （RIF） by different methods, and to analyze the risk factors of women with RIF and CE. Methods： Thirty--six patients who experienced hysteroscopy because of RIF were enrolled in the study. Except to the hysteroscopic endome- trial images were taken, the endometrial tissues of these women were obtained during hysteroscopy, and then were treated by routine HE staining and CD138 immunohistochemical staining. High risk factors of diseases were analyzed after medical history of these women collected. Results： The positive rate of CD138 （47.2%） was higher than that of hysteroscopy and HE staining （38.8 % and 13.8 % ）. The consistency of these three detection methods was poor （Kappa 〈0.4）. Abortion history, tubal clogging were the risk factors of women with RIF and CE. Conclusion： Hysteroscopy can be widely used in clinical examination. CD138 immunohistochemistry using for diagnosing CE has a higher advan- tage, so CD138 immunohistochemical detection is suggested to use for helping ensure the cause of diseases and women with CE can be treated timely. Abortion history and tubal clogging is the risk factors of women with RIF and CE, and the two risk factors should be paid attention when clinical diagnosis and treatment.

关 键 词：慢性子宫内膜炎 CD138 反复移植失败 

分 类 号：R714.8[医药卫生—妇产科学]