预防性治疗潜伏性结核对女性生殖健康作用的临床研究
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摘要
目的探讨预防性治疗对于潜伏性结核女性患者生殖生育功能的改善情况。方法采用前瞻性对照方法,选取2014年6月至2015年6月体检筛查的育龄潜伏性结核菌感染(latent tuberculosis infection,LTBI)女性患者,分为预防性治疗组(n=98)及对照组(n=83)。其中,预防性治疗组采用异烟肼单药治疗6个月,对照组不做预防性治疗处理,观察3年随访期内两组患者妊娠情况。结果预防性治疗组不孕症发生率、输卵管阻塞率、自然妊娠率、异位妊娠率、妊娠合并结核发生率均低于对照组,而活产率高于对照组,差异有显著性。结论 LTBI影响女性生殖健康,该类患者接受预防性治疗能够改善其生殖生育功能,建议育龄特别是有生育要求的LTBI女性患者接受规范的预防性治疗。
Objective To investigate the effect of preventive treatment on reproductive function in female patients with latent tuberculosis.Method A prospective control method was adopted to select LTBI female patients of childbearing age during the period of June2014 to June2015 and physical examination in our hospital.They were divided into preventive treatment group and control group.The treatment group was treated with isoniazid monotherapy for 6 months,and the pregnancy in the two groups was observed.Result The incidence of infertility,the rate of tubal obstruction,the rate of spontaneous pregnancy,the rate of ectopic pregnancy and the rate of pregnancy associated tuberculosis were lower in the preventive treatment group than in the control group,while the live birth rate was higher than that of the control group.Conclusion LTBI affects female reproductive health,and preventive treatment can improve their reproductive function.It is suggested that women of child-bearing age,especially those with fertility requirements,should undergo standardized preventive treatment.
Objective To investigate the effect of preventive treatment on reproductive function in female patients with latent tuberculosis.Method A prospective control method was adopted to select LTBI female patients of childbearing age during the period of June2014 to June2015 and physical examination in our hospital.They were divided into preventive treatment group and control group.The treatment group was treated with isoniazid monotherapy for 6 months,and the pregnancy in the two groups was observed.Result The incidence of infertility,the rate of tubal obstruction,the rate of spontaneous pregnancy,the rate of ectopic pregnancy and the rate of pregnancy associated tuberculosis were lower in the preventive treatment group than in the control group,while the live birth rate was higher than that of the control group.Conclusion LTBI affects female reproductive health,and preventive treatment can improve their reproductive function.It is suggested that women of child-bearing age,especially those with fertility requirements,should undergo standardized preventive treatment.
引文
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[3]刘二勇,周林,成诗明,等.结核分枝杆菌潜伏性感染及预防性治疗研究进展的系统评价[J].中国防痨杂志,2013,35(4):231-239.
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[5]杨玉杰,朱艳霞,张彦玲,等.潜伏性结核菌感染对女性内生殖系统的影响[J].临床合理用药,2015,8(10A):6-7.
[6]徐琰琪,吕品,陈秀娟.生殖器结核对体外受精-胚胎移植技术助孕的影响[J].生殖与避孕,2016,36(3):230-233.
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[10]World Health Organization.Guidelines on the management of latent tuberculosis infection[EB/OL].Geneva:World Health Organization,2015.http://www.who.int/tb/publications/latenttuberculosis-infection/en.
[11]Center for Disease Control and Prevention.Latent tuberculosis infection:A guide for primary health care providers[EB/OL].http://www.cdc.gov/tb/publications/ltbi/treatment.htm#treatment Regimens.
[12]Bothamley GH,Ehlers C,Salonka I,et al.Pregnancy in patients with tuberculosis:a TBNET cross-sectional survey[J].BMC Pregnancy Childbirth,2016,16(1):304.
[13]Chopra S,Siwatch S,Aggarwal N,et al.Pregnancy outcomes in women with tuberculosis:a 10-year experience from an Indian tertiary care hospital[J].Trop Doct,2017,47(2):104-109.
[14]El-Messidi A,Czuzoj-Shulman N,Spence AR,et al.Medical and obstetric outcomes among pregnant women with tuberculosis:a population-based study of 7.8 million births[J].Am J Obstet Gynecol,2016,215(6):797.
[15]Sheriff FG,Manji KP,Manji MP,et al.Latent tuberculosis amongpregnant mothers in a resource poor setting in Northern Tanzania:across-sectional study[J].BMC Infect Dis,2010,7(10):52-58.
[2]林存智,王海荣,朱新红,等.结核菌素皮肤试验阳性人群是否应该接受化学预防治疗[J].中华临床医师杂志(电子版),2014,23(8):4160-4172.
[3]刘二勇,周林,成诗明,等.结核分枝杆菌潜伏性感染及预防性治疗研究进展的系统评价[J].中国防痨杂志,2013,35(4):231-239.
[4]吕品,陈秀娟.潜伏性结核对输卵管性原发不孕及助孕结局的影响[J].国际流行病学传染病学杂志,2015,42(2):141-142.
[5]杨玉杰,朱艳霞,张彦玲,等.潜伏性结核菌感染对女性内生殖系统的影响[J].临床合理用药,2015,8(10A):6-7.
[6]徐琰琪,吕品,陈秀娟.生殖器结核对体外受精-胚胎移植技术助孕的影响[J].生殖与避孕,2016,36(3):230-233.
[7]唐神结,高文.临床结核病学[M].北京:人民卫生出版社,2011.472-478.
[8]胡燕军,陈立峰.女性盆腔结核60例临床特征及诊断[J].浙江预防医学,2005,17(7):39-40.
[9]梁建琴,武丽娟.重视抗结核药物的规范化应用[J].中国临床医生杂志,2016,44(6):11-13.
[10]World Health Organization.Guidelines on the management of latent tuberculosis infection[EB/OL].Geneva:World Health Organization,2015.http://www.who.int/tb/publications/latenttuberculosis-infection/en.
[11]Center for Disease Control and Prevention.Latent tuberculosis infection:A guide for primary health care providers[EB/OL].http://www.cdc.gov/tb/publications/ltbi/treatment.htm#treatment Regimens.
[12]Bothamley GH,Ehlers C,Salonka I,et al.Pregnancy in patients with tuberculosis:a TBNET cross-sectional survey[J].BMC Pregnancy Childbirth,2016,16(1):304.
[13]Chopra S,Siwatch S,Aggarwal N,et al.Pregnancy outcomes in women with tuberculosis:a 10-year experience from an Indian tertiary care hospital[J].Trop Doct,2017,47(2):104-109.
[14]El-Messidi A,Czuzoj-Shulman N,Spence AR,et al.Medical and obstetric outcomes among pregnant women with tuberculosis:a population-based study of 7.8 million births[J].Am J Obstet Gynecol,2016,215(6):797.
[15]Sheriff FG,Manji KP,Manji MP,et al.Latent tuberculosis amongpregnant mothers in a resource poor setting in Northern Tanzania:across-sectional study[J].BMC Infect Dis,2010,7(10):52-58.