慢性非细菌性前列腺炎患者精液质量改变和抗生素治疗效果

Effect of Chronic Abacterial Prostatitis on Semen Quality and Efficacy of Antibacterial Agents

目的 :观察慢性非细菌性前列腺炎 (CAP)对精液质量的影响和抗生素对CAP的治疗效果。 方法 :对诊断为CAP的 86例患者进行精液分析 ,同时测定血清和精浆的抗精子抗体 (AsAb) ,并和 2 0例正常男性进行比较。然后把 86例CAP患者随机分成用抗生素组和未用抗生素组共 2组 ,每组 4 3例 ,用抗生素组除选用 3种抗生素序贯治疗外 ,其余治疗 2组相同。连续治疗 3个月 ,每个月随访 1次。 结果 :CAP患者精子活动率、前向运动精子百分率和正常形态精子均明显低于正常对照组 (P <0 .0 0 5 ) ;精浆和血清AsAb阳性率均明显高于正常对照组 (P <0 .0 1 )。应用抗生素组精子活动率、前向运动精子百分率和正常形态精子等提高均明显大于未用抗生素组 (P <0 .0 5 ) ,临床治疗效果也明显优于未用抗生素组 (P <0 .0 5 )。 结论 :CAP使精液质量和男性生育力下降。抗生素治疗可明显改善CAP患者的精液质量 。

Objective: To appraise the effect of chronic abacterial prostatitis (CAP) on semen quality and the efficacy of antibacterial agents. Methods: The semen of 86 cases of CAP and 20 normal men were analysed together with the antisperm antibodies in their blood and semen, and the antisperm antibodies in the blood and spermatic fluid were determined. Then the 86 patients were randomized into two groups, one treated with Chinese traditional medicine, indomethacin and three kinds of antibacterial agents, the other with Chinese traditional medicine and indomethacin only. The treatment lasted 3 months, and a follow-up visit was paid every month. Results: Sperm motility and normal modality of the CAP group were 59.8 % and 52.8 %, respectively, significantly lower than those of the normal group ( P < 0.005 ). The positive rates of the antisperm antibodies in the blood and spermatic fluid were 46.5 % and 50 %, respectively, significantly higher than those of the normal group. The clinical efficacy was significantly better in the group treated with antibacterial agents than the one without( P < 0.05 ). Conclusion: CAP can affect sperm quality and decrease fertility. Antibacterial agents can obviously enhance sperm quality and the cure rate of CAP.