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目的研究人工流产行为因素和孕育不良,特别是不明原因复发性自然流产(URSA)的相关性,探讨人工流产对封闭抗体缺失的影响。方法收集来自某院妇科共302例病例,正常生育组54例(对照组)和孕育不良妇女248例,其中孕育不良组包括URSA82例、继发性不孕112例、偶发性自然流产54例。采用ELISA法检测各病例组血清中的封闭抗体(BA)。结果正常生育组和孕育不良组的人工流产率分别是13.0%(7/54)、41.5%(103/248),其差异有统计学意义(χ2=15.630,P﹤0.001);人工流产与孕育不良的归因分析,其比值比OR=4.769,95%CI=2.073～10.973;对3种孕育不良发生的OR值和95%CI值分别是:继发性不孕8.621(3.584～20.833)、URSA2.778(1.101～6.993)、偶发性自然流产2.825(1.055～7.576);人工流产次数和年龄与孕育不良的Logistic回归分析:回归系数是1.458和-0.22,P值是0.000和0.516,OR值和95%CI值是4.296(1.968～9.377)、0.979(0.917～1.045);对BA结果阳性和阴性病例的人工流产率进行比较,其差异无统计学意义(χ2=0.620,P=0.471,P﹥0.05),OR=1.209,95%CI=0.754～1.938。结论人工流产是孕育不良的危险因素,随流产次数和年龄的增加,危险度增加;危险度最高的是继发性不孕,其次是偶发性自然流产和URSA;人工流产与封闭抗体的缺失无关。
Objective To study the correlation between abortion factors and infertility, especially unexplained recurrent spontaneous abortion (URSA), and to explore the effect of induced abortion on the absence of occlusion antibodies. Methods A total of 302 cases of gynecology from a hospital, 54 cases of normal fertility group (control group) and 248 cases of malnutrition women, including malnutrition group, including URSA82 cases, 112 cases of secondary infertility, 54 cases of spontaneous abortion. ELISA method was used to detect the serum level of blocking antibody (BA) in each case group. Results The rates of induced abortion were 13.0% (7/54) and 41.5% (103/248) respectively in normal and inbred groups (χ2 = 15.630, P <0.001). Induced abortion and inoculation The odds ratio OR = 4.769, 95% CI = 2.073 ~ 10.973, respectively. The OR and 95% CI of the three kinds of maternal malnutrition were 8.621 (3.584-20.833) URSA2.778 (1.101 ~ 6.993), sporadic spontaneous abortion 2.825 (1.055 ~ 7.576); induced abortion and age and infertility Logistic regression analysis: regression coefficients were 1.458 and -0.22, P values were 0.000 and 0.516, OR And 95% CI were 4.296 (1.968-9.377) and 0.979 (0.917-1.045). There was no significant difference between the two groups in the incidence of induced abortion (χ2 = 0.620, P = 0.471, P > 0.05), OR = 1.209, 95% CI = 0.754-1.938. Conclusions Induced abortion is a risk factor for infertility. The risk increases with the number and age of abortion. The highest risk is secondary infertility, followed by occasional spontaneous abortion and URSA. Induced abortion is not associated with the absence of blocked antibody .