男性泌尿生殖道线索细胞的调查及与不育相关性研究

Investigation of male urinogenital clue cell and its relationship with male infertility

目的探讨精液中线索细胞与男性不育的关系。方法对957例患者精液，直接涂片显微镜下查找线索细胞，阳性者再作革兰染色及细菌培养确证，同时进行精液参数分析。结果精液线索细胞检出率为23．5％（225／957）与细菌培养符合率为95．1％、精子活率、精子a级、a＋b级活力、密度及低渗肿胀率明显低于阴性组及正常对照组，而精子畸形率、精液pH值明显高于阴性组和正常对照组（P〈0．01）。30例不育者配偶依据Amsel诊断标准确诊为细菌性阴道病（Bv）28例（93．3％）。结论Bv病原体可通过性生活侵犯到男性泌尿生殖道各部位，影响精液质量，是不育的重要因素之一，并黏附于鳞状上皮形成线索细胞而对加德纳菌及短小球杆菌感染致不育的判断具有独特价值。

Objective To investigate the relationship between clue cell in semen and male infertility. Method Semen specimens from 957 patients were examined with microscope. Gram staining was performed when clue cell were found to be present in semen. At the same time, general characteristics of the sperm were analyzed. Results There were clue cells in 23.5% （225/957） of the total specimens, in which, 95. 1% clue cells were gram staining positive. The concentration and vitality of living sperm in semen presented with clue cell were significantly lower, but the abnormal sperm and pH value were much higher than that in normal control （ P 〈0. 01）. In addition, 28 sexual partners of 30 infertility patients were identified as having bacterial vaginosis. Conclusion Gardnerella vaginalis and short coccobacillus were mostly transmitted from infected sexual partner. It could cause squamous epithelial cell forming clue cell, and lead to infertility by changing pH which mainly affect reproduction of the sperm. This study suggested that clue cell has a unique vale for the diagnosis of infertility causing by Gardnerella vaginalis and short coccobacillus.