幽门螺杆菌感染与原发性不孕症的相关性  

Correlation between Helicobacter pylori infection and primary infertility

作　　者：黄煌[1] 李旌[1] 梅璐[1] 刘思濛 蒋杰[1] 米阳 汤有才[1] 孙丽君[2] 郑鹏远[1] 

机构地区：[1]郑州大学第五附属医院消化内科幽门螺杆菌河南省工程实验室,450052 [2]郑州大学第三附属医院生殖医学中心

出　　处：《中华消化杂志》2017年第11期743-749,共7页Chinese Journal of Digestion

基　　金：国家自然科学基金（81370494）;郑州市创新型科技人才队伍建设工程基金（131PLJRC656）;河南省科技创新杰出人才基金（134200510022）

摘　　要：目的探讨H．pylori的感染状态是否与原发性不孕症相关，H．pylori感染是否能够造成原发性不孕症患者外周血促炎因子的异常升高，细胞毒素相关基因A（CagA）蛋白是否在其中发挥关键作用。方法选取2015年9月至2016年8月就诊的原发性不孕症（不孕组）患者213例和健康对照者97名。将原发性不孕症患者按照常见病因分为单一因素、合并2种以上因素和不明原因。使用H．pylori抗体分型检测试纸检测血清H．pyloriIgG抗体和CagA抗体，ProcartaPlex多细胞因子检测系统检测细胞因子IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-13、IL-18、IL-1β、粒细胞和巨噬细胞集落刺激因子（GM—CSF）、IFN-γ、TNF—α、IL-12p70。采用卡方检验和独立样本t检验进行统计学分析，并进行风险评估。结果不明原因不孕组患者的血清H．pylori IgG抗体阳性率高于健康对照组E74．0％（37／50）比56．7％（55／97）]，差异有统计学意义（OR=2．173，95％CI1．028～4．595，χ^2=4．216，P=0．040）。不孕组与健康对照组H．pylori阳性感染患者中的CagA抗体阳性率比较[71．7％（91／127）比74．5％（41／55）]差异无统计学意义（OR=0．863，95％C10．421～1．772，P〉0．05）。H．pylori阳性不孕组患者血清IL-8、IL-18和IFN-γ水平分别为（35．14±12．16）、（11．83±4．01）和（11．05±3．17）ng／L，均高于H．pylori阳性健康对照组[分别为（21．44±12．35）、（9．89±2．23）和（8．90±1．45）ng／L]和H．pylori阴性不孕组[分别为（11．45±8．63）、（7．90±0．99）和（8．18±1．10）ng／L]，差异均有统计学意义（t=6．947、3．366、4．811和15．596、8．900、8．068，P均〈0．05）。不明原因H．pylori阳性不孕组血清IL-8、IL-18、IFN—γ水平分别为（39．97±11．52）、（13．12±4．61）、（13．06±3．70）ng／L，均分别高于单一因素者的（31．65±11．20）、（11�Objective To investigate whether Helicobacter pylori （H. pylori） infection correlated with primary infertility, whether H. pylori infection caused the abnormal elevation of pro-inflammatory eytokines in primary infertility women, and whether cytotoxin associated gene A （CagA） protein played a key role in it. Methods From September 2015 to August 2016, 213 patients with primary infertility （infertility group） and 97 healthy individuals （control group） were selected. According to the common etiologies, patients with primary infertility were divided into groups with single-factor infertility, multifactorial infertility and unexplained reason groups. Serum H. pylori IgG antibody and CagA antibody were examined by H. pylori antibody type test kits, The levels of interleukin （IL）-2, IL-4, IL-5, IL 6, IL-8, IL-10, IL-13, IL-18, IL-1β, granulocyte-macrophage-eolony stimulating factor （GM-CSF）, interferon-γ （IFN-γ）, tumor necrosis factor-α （TNF-α） and IL-12p70 were tested by ProcartaPlex Immunoassays. Chi square test and independent sample t test were performed for statistical analysis and risk was assessed. Results The positive rate of serum H. pylori IgG antibody of patients with primary infertility was higher than that of healthy control group （74.0%, 37/50 vs 56.7%, 55/97）, and the difference was statistically significant （odds ratio （OR） = 2. 173, 95 % confidence interval （CI） 1. 028 to 4. 595 ,χ^2 =4. 216, P= 0. 040）. There was no statistically significant difference in the positive rate of CagA antibody between primary infertility group and healthy control group （ 71.7 % , 91 / 127 vs 74.5 %, 41/55, OR=0.863,95% CI0.421 to 1.772, P〉0.05）. The serum levels of IL-8, IL-18 and IFN-γ of H. pylori positive primary infertility patients were （ 35. 14 ± 12.16）, （ 11.83 ±4.01 ） and （ 11.05± 3. 17） ng/L, respectively, which were all higher than those of H. pylori positive healthy control group （（21.44±12.35）, （9. 89±2. 23） and （8. 90±1

关 键 词：螺杆菌 幽门 原发性不孕症 CAGA蛋白 细胞因子类 

分 类 号：R711.6[医药卫生—妇产科学]