학술논문
난관요인을 가진 불임환자에서 Chlamydia Trachomatis감염의 의의
Chlamydial Infection in Women with Tubal Pregnancy
Chlamydial Infection in Women with Tubal Pregnancy
Document Type
Article
Source
Obstetrics & Gynecology Science. Apr 30, 1993 36(4):534
Subject
Language
Korean
ISSN
2287-8572
Abstract
연세의료원 산부인과에 내원하여 진단 및 처치를 받은 불임환자중 난관요인을 가진 환자 35 명과 다른 요인의 불임환자 31명 총 66명을 대상으로 하여 chlamydia trachomatis 감염을 조사 하여 다음과 같은 결론을 얻었다. 1. 환자들의 평균 나이는 항체 양성환자가 29.4세, 음성환자가 28.1세이었다. 2. 원발성 불임환자가 41명이었고 속발성 불임환자가 25명이었으며 항체 양성은 각각 33%, 28%이었고 두 군사이에 통계학적 의의는 없었다. 3. 평균 불임기간은 항체 양성환자군이 3.7년이었고, 음성환자군은 3.2년이었다. 4. 평균 ESR 수치와 백혈구 수치의 증가는 없었다. 5. 항체 양성인 환자의 약 10%에서만 증상을 나타냈다. 6. 불임환자 61%에서 항체 양성이었고, 이중 난관요인을 가진 환자는 68%로서 다른 요인의 불임환자보다 의의있게 높았고
Chlamydial infection is one of the most common of the sexually transmitted pathogens, and produce tubal damage to cause infertility. Traditionally, at least 20% to 35% of infertile couples are considered to have tubal infertility, and chlamydia trachomatis is probably highly associated with tubal infertility. We undertook this study to determine whether chlamydial infection would be an etiologic factor of the infertile cases in which a tubal factor is responsible for infertility. Sixty-six women who came to the infertility clinic at the Yonsei University, College of Medicine, Severance Hospital were subject to serologic tests and cultures, and subsequent tubal evaluation was done with hysterosalpingogram, laparoscopy, and laparotomy. The number of patients with tubal factor was 35, and those with other factors was 31. The results obtained were as follows: 1. The mean age was 29.4 years in seropositive patients, and 28.1 years in seronegative patients. 2. The number of patients with primary infertility was 41 and those with secondary infertility was 25. 3. The average duration of infertility was 3.7 years in seropositive patients and 3.2 years in seronegative patients. 4. There were no elevated values of ESR or WBC count. 5. Only 10% of seropositive patients complained of symptoms. 6. Sixty-one percent of infertile women were seropositive, and among them 68% were associated with tubal factors. In seronegative patients, 38% were associated with tubal factors. 7. Infertility with tubal factors was due to tubal obstruction in 68%, adhesions in 26%, and hydrosalpinx in 8% of patients. 8. Tubal infertility showed significantly higher incidence in patients who had antibody titers greater than 1:128. 9. Sensitivity was 77%, specificity was 58%, NPV was 69%, and PPV was 685 for serologic tests.
Chlamydial infection is one of the most common of the sexually transmitted pathogens, and produce tubal damage to cause infertility. Traditionally, at least 20% to 35% of infertile couples are considered to have tubal infertility, and chlamydia trachomatis is probably highly associated with tubal infertility. We undertook this study to determine whether chlamydial infection would be an etiologic factor of the infertile cases in which a tubal factor is responsible for infertility. Sixty-six women who came to the infertility clinic at the Yonsei University, College of Medicine, Severance Hospital were subject to serologic tests and cultures, and subsequent tubal evaluation was done with hysterosalpingogram, laparoscopy, and laparotomy. The number of patients with tubal factor was 35, and those with other factors was 31. The results obtained were as follows: 1. The mean age was 29.4 years in seropositive patients, and 28.1 years in seronegative patients. 2. The number of patients with primary infertility was 41 and those with secondary infertility was 25. 3. The average duration of infertility was 3.7 years in seropositive patients and 3.2 years in seronegative patients. 4. There were no elevated values of ESR or WBC count. 5. Only 10% of seropositive patients complained of symptoms. 6. Sixty-one percent of infertile women were seropositive, and among them 68% were associated with tubal factors. In seronegative patients, 38% were associated with tubal factors. 7. Infertility with tubal factors was due to tubal obstruction in 68%, adhesions in 26%, and hydrosalpinx in 8% of patients. 8. Tubal infertility showed significantly higher incidence in patients who had antibody titers greater than 1:128. 9. Sensitivity was 77%, specificity was 58%, NPV was 69%, and PPV was 685 for serologic tests.