育龄妇科内分泌疾病人群中的慢性子宫内膜炎横断面调查OA

Objectives:To investigate the detection rate of chronic endometritis(CE)in women of childbearing age with infertility,recurrent miscarriage and abnormal uterine bleeding. Methods:A total of 1 757 patients aged 21-40 years diagnosed with infertility,recurrent miscarriage,or abnormal uterine bleeding(meeting with at least one of these criteria)who underwent hysteroscopy or hysterolaparoscopy in the Gynecological Endocrinology Ward of Peking Union Medical College Hospital between January 2019 and April 2024 were recruited.Endometrial characteristics under microscopy,histomorphological examination,and immunohistochemical results of CD 138 were analyzed for the detection rates of CE among the three methods.Further analysis of the CD 138 positivity status across different diseases was conducted,and the logistic regression analysis on the relationship between CD 138 positivity and various disease variables was performed. Results:According to the hysteroscopic findings,histopathology,and CD138 immunohistochemical positivity,the detection rates for CE in the included population were 8.4％,4.1％,and 52.5％,respectively.The univariate analysis revealed that patients with historical factors including a history of in vitro fertilization(IVF)failure,recurrent miscarriage,induced abortion,and symptoms of intermenstrual bleeding,as well as diagnostic conditions such as endometrial polyps,endometriosis,atypical endometrial hyperplasia,intrauterine adhesions,cesarean scar diverticulum,and non-obstructive microlesions of the fallopian tubes,significantly exhibited a positive rate of CD 138 staining(P＜0.05).Multivariate logistic analysis indicated that endometrial polyps,endometriosis and non-obstructive microlesions of the fallopian tubes were promoting factors for CD 138 positivity(P＜0.05). Conclusions:The positivity rates of CD 138 in the included patients were generally high,so this marker was insufficient for diagnosing CE solely.CE exhibited a strong association with lesions related with endometriosis,most likely being a concurrent or secondary condition,warranting further investigation.