摘要
目的探讨生育力指数及T淋巴细胞亚群对子宫内膜异位症合并不孕症腹腔镜术后患者预后的影响。方法选取2013年1月—2015年9月于本院行腹腔镜术的168例子宫内膜异位症合并不孕症患者为观察组,同期选择112例本院参与体检的健康已婚女性作为对照组,对所有患者进行子宫内膜异位症生育力指数(EFI)评分,分别于术前、术后1 d、术后7 d抽取患者及体检日正常女性肘静脉血5 ml,采用间接免疫荧光法(IFA)进行T细胞亚群分析,统计CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、阳性细胞数,计算CD_(4)^(+)/CD_(8)^(+)比值。结果腹腔镜术后3年内,子宫内膜异位症合并不孕症患者妊娠率为53.6%,观察组患者术前CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)比值均低于对照组(P<0.05),CD_(8)^(+)高于对照组(P<0.05);腹腔镜术后1d患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)比值降低(P<0.05),CD_(8)^(+)升高(P<0.05),术后7d患者CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)比值升高(P>0.05);CD_(8)^(+)降低(P<0.05);腹腔镜术前、术后1d、术后7d条件下,CD_(8)^(+)均低于妊娠失败患者(P<0.05);logistic回归分析结果显示:CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)是预后不良妊娠结局的独立危险因素。结论子宫内膜异位症生育力指数及T淋巴细胞亚群水平与子宫内膜异位症合并不孕症患者术后妊娠情况有关,可作为子宫内膜异位症合并不孕症预后评价的参考指标。
Objective To investigate the effects of fertility index and T lymphocyte subsets on the prognosis of patients with endometriosis combined infertility after laparoscopic surgery.Methods 168 patients with endometriosis combined infertility who underwent laparoscopy in our hospital from January 2013 to September 2015 were selected as the study group,in the same period,another 112 healthy married women who took part in physical examination in our hospital were selected as the control group,Endometriosis Fertility Index(EFI)score was applied to all patients,5ml of cubital venous blood was taken from patients and normal women before operation,1st day after operation and 7th day after operation,respectively,T cell subsets were analyzed by indirect immunofluorescence assay(IFA),the numbers of CD_(3)^(+),CD_(4)^(+)and CD_(8)^(+),positive cells were counted,the CD_(4)^(+)/CD_(8)^(+)was calculated.Results Within 3 years after laparoscopic surgery,the pregnancy rate of patients with endometriosis combined infertility was 53.6%,the preoperative CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)ratio of the observation group were lower than those of the control group(P<0.05),and CD_(8)^(+)was higher than that of the control group(P<0.05);One day after laparoscopic surgery CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)ratio decreased(P<0.05),CD_(8)^(+)increased(P<0.05);The CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)ratio increased 7 days after operation(P>0.05),and CD_(8)^(+)decreased(P<0.05);CD_(8)^(+)was lower in patients with pregnancy failure before laparoscopic surgery,1 day after operation and 7 days after operation(P<0.05);Logistic regression analysis showed that CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)were independent risk factors for poor pregnancy outcome.Conclusion The fertility index and T lymphocyte subsets of endometriosis are related to the postoperative pregnancy status of patients with endometriosis complicated with infertility,which may be used as a reference index for prognosis evaluation of endometriosis complicated with infertility.
作者
李红
LI Hong(Qinghai Kangle Hospital)
出处
《中国生育健康杂志》
2021年第3期238-242,共5页
Chinese Journal of Reproductive Health
