CD138阳性治疗后在体外受精-胚胎移植中的临床研究  

Clinical study of patients with abnormal expression of CD138 after treatment in in vitro fertilization-embryo transfer

作　　者：乔洪武[1] 李静[1] 张文[1] 管一春[1] Qiao Hongwu;Li Jing;Zhang Wen;Guan Yichun(Center of Reproductive Medicine,the Third Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院生殖医学科,450052

出　　处：《中华实验外科杂志》2022年第6期1180-1182,共3页Chinese Journal of Experimental Surgery

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210455)。

摘　　要：目的比较免疫组织化学染色CD138阳性的慢性子宫内膜炎患者经过周期性抗生素治疗后与正常不孕患者在早卵泡期长效长方案(长长方案)体外受精-胚胎移植(IVF-ET)中临床结局的差异。方法收集2020年1月至12月在郑州大学第三附属医院生殖医学中心行长长方案IVF-ET助孕的患者, 所有患者均行宫腔镜检查, 按照子宫内膜活检CD138免疫组织化学染色分为CD138阳性组(86例)和正常组(1 183例);两组患者在宫腔镜检查后进入长长方案周期, 进入周期前对CD138阳性组给予抗生素周期性治疗14 d;采用独立样本t检验比较两组之间HCG日内膜厚度、移植日内膜厚度以及胎儿出生体重的差异;采用χ^(2)检验比较两组之间临床妊娠率、早期流产率、早产率和活产率的差异。结果 CD138阳性组与正常组之间HCG日内膜厚度[(11.44±2.21) mm比(11.38±2.17) mm]、移植日内膜厚度[(11.57±2.23) mm比(11.54±2.23) mm)]及胎儿出生体重[(3 195±646) g比3 244±632) g]的差异均无统计学意义(P>0.05);两组之间临床妊娠率(54.65%比63.14%)、早期流产率(8.51%比10.58%)、早产率(10.64%比11.24%)以及活产率(46.51%比53.76%)的差异均无统计学意义(P>0.05)。结论免疫组织化学染色CD138阳性的慢性子宫内膜炎患者经过抗生素周期性治疗后可有效改善其临床结局, 对疑似慢性子宫内膜炎患者应尽快行宫腔镜检查+子宫内膜活检, 必要时并给予周期性的抗生素治疗。Objective To compare the clinical outcomes of patients with abnormal expression of CD138 after treatment and diagnosed with chronic endometritis in early follicular phase prolonged protocol of in vitro fertilization-embryo transfer(IVF-ET).Methods A retrospective analysis was performed on patients who underwent IVF-ET with GnRH agonist protocols from January to December 2020 in the Reproduction Center of the Third Affiliated Hospital of Zhengzhou University.All patients underwent hysteroscopy and were divided into CD138-positive group(n=86)and normal group(n=1183)according to CD138 immunohistochemical staining of endometrial biopsy.All patients underwent hysteroscopy before entering the cycle,and the CD138-positive group was given periodic antibiotic treatment for 14 days.Independent sample T test was used to compare the difference of endometrial thickness on HCG day,endometrial thickness on transplantation day and fetal birth weight between two groups.The clinical pregnancy rate,early abortion rate,premature delivery rate and live birth rate were compared between the two groups byχ^(2) test.Results There were no significant differences in endometrial thickness on the day of HCG injection[(11.44±2.21)mm vs.(11.38±2.17)mm],endometrial thickness on the day of transplantation[(11.57±2.23)mm vs.(11.54±2.23)mm]and fetal birth weight[(3195±646)g vs.(3244±632)g]between the two groups.There were no significant differences in clinical pregnancy rate(54.65%vs.63.14%),miscarriage rate(8.51%vs.10.58%),preterm birth rate(10.64%vs.11.24%)and live birth rate(46.51%vs.53.76%)between the two groups.Conclusion Periodic treatment with antibiotics can effectively improve the clinical outcome of patients with abnormal expression of CD138 who have been diagnosed with chronic endometritis.For patients with suspected chronic endometritis,hysteroscopy+endometrial biopsy should be performed as soon as possible,and periodic antibiotic therapy should be given if necessary.

关 键 词：CD138 慢性子宫内膜炎 子宫内膜活检 体外受精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]