Abstract:
To analyze the infection of chlamydia (CT) and gonorrhea (NG) in female infertility and male infertility population, and to explore the correlation between CT and NG infection and infertility. A case-control study was conducted to retrospectively analyze the specimens submitted by patients from the Third Xiangya Hospital of Central South University from January 2021 to December 2022. The results showed that a total of 32 184 specimens were collected, and the positive rates of CT were 4.41% (1 419/32 184), and positive rats of NG were 1.42% (457/32 184). In the infertility group (n=3 366), 2 987 were females and 379 were males. In the control group (n=3 366), 2 509 were females and 857 were males. The CT positive rate of the infertility group was 13.61% (458/3 366), which was significantly higher than that of the control group 3.30% (111/3 366), and the difference was statistically significant (χ2=4.245, P<0.05), and the NG positive rate of the infertility group was 6.36% (214/3 366), which was significantly higher than that of the control group 0.89% (30/3 366), and the difference was statistically significant (χ2=4.011, P<0.05). A total of 23 992 female genital tract swab specimens were collected, including 2 987 in the infertility group and 2 509 in the control group, and the positive rate of CT in the female infertility subgroup was 10.41% (311/2 987), which was significantly higher than that in the control group 3.75% (94/2 509), the difference was statistically significant (χ2=4.132, P<0.05), and the NG positive rate of 8.73% (261/2 987) in the female infertility subgroup was significantly higher than that in the control group 0.40% (10/2 509), and the difference was statistically significant (χ2=4.242, P<0.05). A total of 8 192 male urine samples were collected, including 379 in the infertility group and 857 in the control group, and the CT positive rate of the male infertility subgroup was 13.72% (52/379), which was significantly higher than that of the control group 3.38% (29/857), and the difference was statistically significant (χ2=5.267, P<0.05), and the positive rate of NG in the male infertility subgroup was 12.66% (48/379), which was significantly higher than that of the control group 0.93% (8/857), and the difference was statistically significant (χ2=4.166, P<0.05). Among the 2 987 female specimens in the infertility group, 1 034 were in the primary infertility subgroup and 1 953 were in the secondary infertility subgroup, and the positive rates of CT were 7.93% (82/1 034) and 15.72% (307/1 953), respectively, and the positive rates of NG were 3.87% (40/1 034) and 8.65% (169/1 953) respectively, and the difference was not statistically significant (χ2=0.185, P>0.05) and (χ2=0.002, P>0.05). In conclusion, the infection rate of genital tract CT and NG is high in the infertility population, CT and NG are recommended as routine examination indicators for eugenics and infertility screening.
本研究分析衣原体(CT)和淋球菌(NG)在女性不孕和男性不育人群中的感染情况,探讨CT和NG感染与不孕不育的相关性。采取病例对照研究回顾性分析2021年1月至2022年12月中南大学湘雅三医院患者送检标本的CT和NG结果,初诊为不孕或不育的划分为不孕不育组,同期就诊的近3年内有孕育史的患者系统随机抽样设为对照组,对不同亚组内的CT和NG感染率进行χ2分析。结果显示,总共采集标本32 184份,CT感染率为4.41%(1 419/32 184),NG感染率为1.42%(457/32 184)。在全部标本中,选择将女性首次临床诊断为不孕、男性首次诊断为不育者,划分为不孕不育组(n=3 366),其中女性标本为2 987例,男性标本为379例;在全部标本中,选择同期接受门诊检查的近3年内有孕育史人群系统随机抽样纳入对照组(n=3 366),其中女性标本为2 509例,男性标本为857例。其中不孕不育组的CT感染率13.63%(458/3 366)明显高于对照组3.30%(111/3 366),差异有统计学意义(χ2=4.245,P<0.05),NG感染率6.38%(214/3 366)明显高于对照组0.89%(30/3 366),差异有统计学意义(χ2=4.011,P<0.05)。女性生殖道拭子标本共23 992份,其中不孕组有2 987份,对照组有 2 509份,不孕组的CT感染率10.41%(311/2 987)明显高于对照组3.75%(94/2 509),差异有统计学意义(χ2=4.132,P<0.05),NG感染率8.73%(261/2 987)明显高于对照组0.40%(10/2 509),差异有统计学意义(χ2=4.242,P<0.05)。男性尿液标本共8 192份,其中不育组有379份,对照组有857份,不育组的CT感染率13.72%(52/379)明显高于对照组3.38%(29/857),差异有统计学意义(χ2=5.267,P<0.05),NG感染率12.60%(48/379)明显高于对照组0.93%(8/857),差异有统计学意义(χ2=4.166,P<0.05)。不孕不育组的女性标本2 987例中,原发不孕亚组有1 034例,继发不孕亚组有1 953例,两个亚组中CT感染率分别为7.93%(82/1 034)和15.72%(307/1 953),NG感染率分别为3.87%(40/1 034)和8.65%(169/1 953),比较差异无统计学意义(χ2=0.185,P>0.05)和(χ2=0.002,P>0.05)。综上,生殖道CT和NG在不孕不育人群中感染率较高,建议CT和NG作为优生优育和不孕不育筛查的常规检查指标。.