男性不育患者生殖道溶脲脲原体感染及精液质量分析

Ureaplasma Urealyticum Infection and Semen Quality Analysis in Male Infertility Patients

目的探讨男性不育患者生殖道溶脲脲原体感染对精液质量的影响。方法方便选取2011年12月—2017年12月于该院接受治疗的男性不育患者150例,对所有患者进行溶脲脲原体培养,其中溶脲脲原体培养阳性患者有58例,溶脲脲原体培养阴性患者有92例,对所有患者的精液参数、精子活动能力、精浆α-葡萄糖苷酶进行检测,对生殖道溶脲脲原体感染对精液质量的影响进行分析。结果溶脲脲原体培养阳性患者的精液量为(2.77±1.35)m L,溶脲脲原体培养阴性患者的精液量为(2.76±1.41)mL(t=0.054,P>0.05)。溶脲脲原体培养阳性患者的精子密度为(84.46±9.62)×10~6/mL,溶脲脲原体培养阴性患者的精子密度为(102.32±10.75)×106/m L(t=10.813,P<0.05)。溶脲脲原体培养阳性患者的精子活率为(44.63±5.11)%,溶脲脲原体培养阴性患者的精子活率为(51.85±6.69)%(t=8.015,P<0.05)。溶脲脲原体培养阳性患者的精子活力为(38.44±4.25)%,溶脲脲原体培养阴性患者的精子活力为(44.56±5.18)%(t=8.484,P<0.05)。溶脲脲原体培养阳性患者的精液pH值为(7.16±0.41),溶脲脲原体培养阴性患者的精液pH值为(7.15±0.43)(t=4.827,P<0.05)。从溶脲脲原体培养阳性患者和溶脲脲原体培养阴性患者精子的活动能力方面来看,溶脲脲原体培养阳性患者的精子在精子平均曲线运动速度,平均直线运动速度,平均路径速度,平均移动角度,平均鞭打频率方面均明显低于溶脲脲原体培养阴性患者,差异有统计学意义(P<0.05)。在精子的头部侧摆幅度、运动的前向性、运动的直线性、运动的摆动性方面,两组患者的对比差异无统计学意义(P>0.05)。溶脲脲原体培养阳性患者的精浆α-葡萄糖苷酶活性为(39.8±17.9),溶脲脲原体培养阴性患者的精浆α-葡萄糖苷酶活性为(48.3±20.6)(t=2.258,P<0.05)。结论男性不育患者生殖道溶脲脲原体感染是导致患者不育的主要危险因素,生殖道溶脲脲原体感染会导致患者附睾分泌精浆α-葡萄糖苷酶的能力下降,导致患者精液质量的大幅度降低,引起患者出现不育。

Objective To investigate the effect of urethra urealyticum infection on semen quality in male infertility patients. Methods A total of 150 male infertility patients who were treated in the hospital from December 2011 to December 2017 were convenient enrolled. All patients were cultured with Ureaplasma urealyticum. Among them, 58 patients were positive for Ureaplasma urealyticum culture. There were 92 patients with negative Ureaplasma cuhure, and the semen parameters, sperm motility, and seminal plasma α-glucosidase were detected in all patients, and the effects of urethra ureaplasma infec- tion on semen quality were analyzed. Results The amount of semen in patients with positive Ureaplasma urealyticum culture was （2.77±1.35） mL, and the amount of semen in patients with negative Ureaplasma urealyticum culture was （2.76±1.41） mL （t=0.054, P〉0.05）. The sperm density of patients with positive Ureaplasma urealyticum culture was （84.46±9.62）×10^6/mL, and the sperm density of patients with negative Ureaplasma urealyticum culture was （102.32±10.75）×10^6/mL （t=10.813, P〈 0.05）. The sperm motility of patients with positive Ureaplasma urealyticum culture was （44.63±5.11）%, and the sperm motility of patients with negative Ureaplasma urealyticum culture was （51.85±6.69）% （t=8.015, P〈0.05）. The sperm motility of patients with positive Ureaplasma urealyticum culture was （38.44±4.25）%, and the sperm motility of patients with negative Ureaplasma urealyticum culture was （44.56±5.18）% （t=8.484, P〈0.05）. The pH value of semen in patients with positive Ure- aplasma urealyticum culture was （7.16±0.41）, and the pH value of semen in patients with negative Ureaplasma urealyticum culture was （7.15±0.43） （t=4.827, P〈0.05）. From the aspect of sperm motility of patients with positive Ureaplasma urea- lyticum culture and negative cuhures of Ureaplasma urealyticum, the average sperm movement speed, average linear motion velocity, and average path of sperm in patients with positive Ureaplasma urealyticum culture speed, average moving angle and average whipping frequency were significantly lower than those of negative Ureaplasma urealyticum culture, and the difference was statistically significant （P〈0.05）. There was no significant difference in the contrast between the two groups （P〉0.05） in terms of the amplitude of the head of the sperm, the forwardness of the movement, the linearity of the move-ment, and the swinging of the movement. The seminal plasma α-glucosidase activity of patients with positive Ureaplasma urealytieum culture was （39.8±17.9）, and the seminal plasma α-glueosidase activity of patients with negative Ureaplasma urealyticum culture was （48.3±20.6）（t=2.258, P〈0.05）. Conclusion The infection of urethra Ureaplasma urealyticum in male infertility patients is the main risk factor for infertility in patients. The infection of urethra Ureaplasma urealytieum leads to the decline of the ability of the epididymis to secrete seminal plasma α-glueosidase. The quality is greatly reduced, causing infertility in patients.