输精管结扎术后附睾液抗精子抗体的研究

Study on antisperm antibody in epididymal fluid after vasectomy

目的探讨抗精子抗体（AsAb）在输精管结扎术后患者附睾液中的表达及其对生育力的影响。方法对201l1年1月至2014年9月住院行输精管复通术的132例患者（A组）进行附睾液的AsAb检测，与同期132例育龄男性（B组）的精浆AsAb表达情况进行对比，随访1年，观察两组对象配偶的妊娠情况。结果A组患者附睾液AsAb的总阳性率为9．10％（12／132），其中IgG为1．52％（2／132）、IgM为0．76％（1／132）、IgA为6．82％（9／132）；B组的精浆AsAb总阳性率为8．33％（11／132），其中IgG为2．27％（3／132）、IgM为0．76％（1／132）、IgA为5．30％（7／132），两组间比较差异无统计学意义∽〉0．05）。随访1年后，A组患者配偶的妊娠率为23．48％（31／132），略比B组34．85％（46／132）低，两者间比较差异有统计学意义（P〈0．05）。结论输精管结扎术后附睾液中AsAb的表达程度与正常育龄男性精浆AsAb表达相当，但其复通后配偶的妊娠率要略比正常育龄期男性配偶的妊娠率低，AsAb可能对输精管复通后男性的生育力有一定影响。

Objectivo To investigate the expression of antisperm antibody in epididymal fluid after vasectomy and explore its effects on the fertility. Methods Total of 132 patients （group A） who underwent vasectomy reversal during the 2011-1 - 2014-9 were enrolled in the study. The antisperm antibody in the epididymal fluid of patients were detected. Other 132 fertile men （group B） were set as the controls. All subjects were followed up for I year, and their spouse＇s pregnancy were observed. Rosults The total positive rate of antisperm antibodies in the epididymal fluid of group A was 9.10%（12/132）, among them the IgG was 1.52%（2/132）, IgM was 0.76% （1/132）, IgA was 6.82% （9/132）, and the total positive rate of antisperm antibody in the seminal plasma of group B was 8.33% （11/132）, among them the IgG was2.27% （3/132）, IgM was 0.76% 0/132）, IgA was 5.30% （7/132）, there was no significant difference between the two groups （P〉0.05）, after followed up for I years, the spouse＇s pregnancy rate of group A was 23.48%（31/132）, it was little lower than that of the group B（34.85%,46/132）, There was statistical difference between the two groups（P〈0.05）. Conclusion The expression level of antisperm antibody in the epididymal fluid of the patients after vasectomy was close to that of the normal reproductive age men, but the spouse＇s pregnancy rate of the patients who underwent vasectomy reversal is little lower than that of the normal reproductive male＇s apouse.