摘要
目的:了解男性不育患者生殖道溶脲脲原体感染情况,探讨男性不育患者生殖道溶脲脲原体感染对精液质量、附属性腺功能的影响及可能机制。方法:本研究对202例确诊的男性不育患者的精液标本进行溶脲脲原体培养,对精液参数及精浆α-葡萄糖苷酶、酸性磷酸酶和果糖进行检测,分析生殖道溶脲脲原体感染对精液参数及精浆生化指标的影响。结果:男性不育患者生殖道溶脲脲原体感染率为33.7%;生殖道溶脲脲原体感染阳性组和阴性组间精液量相差不显著[(2.93±1.32)mlvs(2.86±1.52)ml,P=0.774];阳性组精子密度较阴性组患者明显偏低[(84.37±52.92)×106/mlvs(101.90±43.90)×106/ml,P=0.025];阳性组精子活率较阴性组患者明显偏低[(44.62±22.13)%vs(51.83±19.88)%,P=0.036];阳性组患者精子活力明显低于阴性患者[(38.40±15.61)%vs(44.45±15.47)%,P=0.020];两组精液pH值均在正常值范围内,但阳性组明显高于阴性组(7.32±0.10vs7.19±0.29,P=0.003);阳性组与阴性组除侧摆幅度、向前运动、直线运动和摆动性等4项指标相差不显著外,对曲线运动性、直线速度、平均路径速度、平均移动角度)和鞭打频率等5项指标均有影响;阳性组精浆α-葡萄糖苷酶较阴性组明显降低[(40.0±18.7)U/mlvs(47.9±21.0)U/ml,P=0.026],Uu感染阳性组α-葡萄糖苷酶降低的相对危险性是阴性组的2.12倍;两组间精浆酸性磷酸酶和果糖水平无统计学差异(P均>0.05)。结论:在男性不育患者中,生殖道溶脲脲原体感染是精液质量下降的重要危险因素;生殖道溶脲脲原体感染可导致附睾分泌α-葡萄糖苷酶下降,但对前列腺酸性磷酸酶及果糖无明显影响,而这种感染对前列腺和精囊危害相对有限。
Objective： To understand Ureaplasma urealyticum （Uu） infection, analyzed the influence of Uu infection on the seminal quality and the accessory genitical gland function in male infertility patients, and investigate its mechanism. Methods： We cultured 202 semen samples collected from male infertility patients and analyzed the influence of Uu infection on seminal parameters and the biochemical indexes of the seminal plasma. Results： The Uu infection rate was 33.7% in the infertile males, with no statistic differences between the Uu positive and negitive groups either in the average age （28.9 ±4.7 yrs vs 29.6 ±4.0 yrs, P =0.250） or in the seminal quantity （2.93± 1.32 ml vs 2.86 ± 1.52 ml, P =0. 774）. The sperm density, motility and vitality were （84.37±52.92） × 10^6 ml, （44.62 ± 22.13） % and （38.40 ± 15.61 ） % in the Uu positive group, significantly lower than （ 101.90±43.90） × 10^6ml, （ 51.83±19.88 ） % and （44.45 ± 15.47 ） % in the Uu negative group （ P = 0.025, P = 0.036 and P = 0.020 ）. The seminal pH value was normal in beth of the groups, but significantly higher in the Uu positive than in the negative group （7.32 ±0.10 vs 7.19 ±0.29, P =0. 003 ）. VCL, VSL, VAP and MAD were significantly lower, while BCF was significant higher in the former than in the latter [ （ 33.97± 8.96 ） μm/s vs （ 39.70 ± 8.14）μm/s, t = 4.113, P 〈 0.001 ; （ 22.29 ± 6.06 ） μm/s vs （25.20± 6.67 ） μm/s, t = 2.684, P=0.008; （25.96±6.83） μm/s vs （30.02 ±6.81） μm/s, t =3.537, P〈0.001; 46.60±13.68 vs 54.23 ± 15.14, t = 3.112, P = 0.002 ; （6.12±1.89） Hz vs （5.22± 1.64） Hz, t = 3. 164, P = 0.002 ]. All the five indexes were influenced by Uu infection. Compared with the negative group, the seminal plasma a-glucosidase was significantly decreased in the positive group [ （40.0 ± 18.7） U/ml vs （47.9± 21.0 ） U/ml, t = 2. 248, P = 0. 026 ], and the risk of the decrease was 2.12 times higher. No statistic difference was observed in seminal plasma acid phosphatase and seminal plasma fructose between the two groups. Conelusion：Uu infection in the genital tract is an important factor of seminal quality reduction in infertile men and may cause a decreased secretion of α- glueosidase in the epididymis, but it hardly infuences the prostate and seminal vesicle.
出处
《中华男科学杂志》
CAS
CSCD
2008年第6期507-512,共6页
National Journal of Andrology
关键词
男性不育
溶脲脲原体
精液参数
精浆生化指标
male infertility
Ureaplasrna urealyticurn
seminal parameter
biochemical index of seminal plasma
