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目的探讨解脲脲原体(ureapla smaurealyticum,Uu)不同血清型别宫内感染与自然流产和高危妊娠及其胎盘绒毛膜改变的关系。方法试验组79例,包括45例自然流产组织,高危妊娠34例(6例早产、28例PROM)胎膜分别进行Uu分离培养,采用代谢抑制试验进行血清型别鉴定以及阳性病例胎盘组织电镜观察,并与51例对照组相比照。结果共计从79例不良妊娠组胎盘组织中分离检出50株Uu(50/79,63.3%),与51例对照人群分离检出15株Uu(15/51,29.4%)比较有显著性差异(P<0.001);经血清型别分析,从不良妊娠组中分离的50株Uu中44株为1、4、5和8型(88%,44/50),与正常妊娠组比较有显著性差异(26.7%,4/15,P<0.001)。电镜下证实,不良妊娠组1、4、5和8型Uu阳性的胎盘组织电镜下检出率(81.8%,36/44),较之非1、4、5和8型Uu(0%,0/6)比较有显著性差异(P<0.001)。提示1、4、5和8型Uu易穿过胎膜;1和4型Uu检出组易发生自然流产、早产、低体重、死胎以及新生儿围生期感染致死。结论1和4型Uu宫内感染与自然流产、早产、PROM等不良妊娠结局相关。
Objective To investigate the relationship between intrauterine infection of different serotypes of Ureaplasma urealyticum (Uu) and spontaneous abortion and high risk pregnancy and its change of placental chorioamnion. Methods 79 cases of experimental group, including 45 cases of spontaneous abortion, high risk pregnancy in 34 cases (6 cases of premature birth, 28 cases of PROM) fetal membranes were Uu separation and culture, metabolic inhibition test for serological type identification and positive cases of placental tissue electron microscopy , And compared with 51 cases of control group. Results A total of 50 strains of Uu (50/79, 63.3%) were isolated from placenta of 79 cases of adverse pregnancy and 15 strains of Uu (15/51, 29.4%) were isolated from 51 cases of control group (P <0.001). According to the serotype analysis, 44 out of 50 Uu isolates were classified as type 1, 4, 5 and 8 (88%, 44/50), which were significantly different from those of normal pregnancy group Sex differences (26.7%, 4/15, P <0.001). Electron microscopy showed that the positive rate of Uu-positive placenta in unwanted pregnancies was 81.8% (36/44), which was significantly lower than that of non-1,4,5 and 8 Uu (0% 0/6) compared with significant differences (P <0.001). Tip type 1, 4, 5 and 8 Uu easily through the fetal membrane; 1 and 4 Uu detection group prone to spontaneous abortion, premature birth, low birth weight, stillbirth and neonatal perinatal infection death. Conclusions Uu intrauterine infections of type 1 and 4 are associated with adverse pregnancy outcomes such as spontaneous abortion, premature birth, and PROM.