Abstract
Abstract. In order to optimize the detection and diagnosis of genital tuberculosis evaluation of the specific local antituberculosis immunity in 39 patients with infertility entered to the Department of Gynecology for the implementation of therapeutic and diagnostic laparoscopy has been carried out. All patients were divided into 3 groups: the 1st one included patients with tubal-peritoneal infertility, the group 2 included patients with infertility not associated with the defeat of the fallopian tubes, the third group was presented by patients with tubal-peritoneal infertility associated with genital tuberculosis who completed the basic course of anti-tuberculosis treatment. It was established that in case of the tubal-peritoneal infertility the local humoral immunity was characterised by increasing of IgM in the whole peritoneal fluid. Among women who recovered from genital tuberculosis increasing of IgA and IgG to M. tuberculosis was revealed in contrast to patients with infertility not associated with damage of fallopian tubes (p 0.05). In 25% of patients of the 1st group genital tuberculosis was diagnosed. The diagnostic criteria for early detection of genital tuberculosis were determined and the algorithm of genital tuberculosis identification have been proposed.
Highlights
In order to optimize the detection and diagnosis of genital tuberculosis evaluation of the specific local antituberculosis immunity in 39 patients with infertility entered to the Department of Gynecology for the implementation of therapeutic and diagnostic laparoscopy has been carried out
All patients were divided into 3 groups: the 1st one included patients with tubal-peritoneal infertility, the group 2 included patients with infertility not associated with the defeat of the fallopian tubes, the third group was presented by patients with tubal-peritoneal infertility associated with genital tuberculosis who completed the basic course of anti-tuberculosis treatment
It was established that in case of the tubalperitoneal infertility the local humoral immunity was characterised by increasing of IgM in the whole peritoneal fluid
Summary
ОЦЕНКА СОСТОЯНИЯ ЛОКАЛЬНОГО СПЕЦИФИЧЕСКОГО ГУМОРАЛЬНОГО ИММУНИТЕТА У ПАЦИЕНТОК С БЕСПЛОДИЕМ, В ТОМ ЧИСЛЕ АССОЦИИРОВАННЫМ С ГЕНИТАЛЬНЫМ ТУБЕРКУЛЕЗОМ. С целью оптимизации выявления и диагностики генитального туберкулеза проведена оценка специфического противотуберкулезного локального иммунитета у 39 пациенток с бесплодием, направленных в отделение гинекологии для осуществления лечебно-диагностической лапароскопии. Раннее выявление туберкулеза женских половых органов наряду со своевременной и адекватной специфической терапией позволяют восстановить фертильность в 19,6–34,0% случаев [9, 13], но зачастую у пациенток, перенесших генитальный туберкулез, методом выбора является экстракорпоральное оплодотворение (ЭКО) [4]. Нам представляется перспективной и обоснованной оценка местного специфического гуморального иммунитета для выявления и ранней диагностики генитального туберкулеза у пациенток с бесплодием. Цель: оптимизация выявления и диагностики генитального туберкулеза на основании оценки показателей локального гуморального специфического иммунитета у пациенток с бесплодием
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