Оценка клинического развития хронических воспалительных заболеваний органов малого таза у женщин репродуктивного возраста с неосложненным пиелонефритом

Abstract

The objective: to establish clinic microbiological features of the development of chronic pelvic inflammatory diseases (PID) in combination with uncomplicated pyelonephritis in women of reproductive age. Materials and methods. 150 women were examined, including 50 (group I) – with chronic pelvic inflammatory diseases; 50 (group II) – chronic pelvic inflammatory diseases in combination with uncomplicated pyelonephritis, and also 50 clinically healthy women of reproductive age (control group) with the inclusion of clinic microbiological and immunological methods of research. Results. The conducted research has shown that chronic PID in 78.0% of women developed latently (“silent inflammatory diseases of genitals”) and were primary in correlation to uncomplicated pyelonephritis. At the same time, uncomplicated pyelonephritis was clinically characterized by manifest development with the frequency up to 3 times per year, predominantly (in 88.0%) expressed from the 25th till the 5th day of the cycle. It was also established that in the etiological spectre of chronic PID in combination with uncomplicated pyelonephritis only in 18.0% of cases an isolated bacterial infection was observed, while mixt-infection was observed in 82.0% of cases. Chronic PID and uncomplicated pyelonephritis in 64.0% of cases had common etiological spectre of agents, represented predominantly by associations E.coli with mollicutes, Chlamydia, often at the background of increased IgG titers to cytomegalovirus. It was established that chronic PID in combination with uncomplicated pyelonephritis were characterized by credible reduction of protective characteristics of mucous membrane of genitals compared to control (in 42.0% and in 64.0% of patients, respectively), especially in case of U. urealyticum at the background of diagnostically meaningful titers IgG in the blood serum to cytomegalovirus. Conclusion. The obtained results evidence the close relation between sexual and urinary systems during the formation of inflammatory process with the prevalence of the group of etiological factors, peculiarities of clinical development and the necessity of their reflection in the unified context. Key words: chronic pelvic inflammatory diseases, uncomplicated pyelonephritis, diagnostics.