抗生素及抗氧化剂治疗白细胞精子症的系统性回顾

Systematic review of antibiotics and antioxidants in the treatment ofleukocytospermia

不孕不育症已成为日益严峻的社会性问题。据统计,因男性因素导致的不孕不育大约占到总数的20%～50%。大约15%的男性不育症是由于泌尿生殖道感染引起的,白细胞精子症是男性性腺和泌尿生殖道感染或炎症过程中出现的精液中白细胞数量异常。目前广谱抗生素和抗氧化剂已被广泛用于治疗因白细胞精症而引起的男性不育,用以抗感染和消除因感染引起的精液中氧自由基的增多。但是直到现在,在治疗白细胞精子症方面,国内外学术界尚无确切的、统一的治疗方案。目前,一些研究显示,抗生素治疗可能会对精子参数改善带来益处,有助于提高白细胞精子症的治愈率,甚至达到细菌学治愈,并提高妊娠率。但是,在抗生素治疗的疗效上,有关研究彼此间的分歧仍然非常大。另外,体外实验研究表明,抗氧化剂也可能对精子功能改善带来益处。但是,目前的数据尚不足以断定抗生素和抗氧化剂治疗因白细胞精子症引起的男性不育症是有效的。对此,还需要做更好的试验设计,以及大样本的调查研究。

Infertility has become an increasingly serious social problem.According to statistics,infertility caused by male factors accounts for about 20%~50%.About 15%of male infertility is caused by urogenital infections.Leukocytospermia is the abnormality of the number of leukocytes in the seminal fluid that occurs during infection or inflammation of the male gonads and genitourinary tract.Broad-spectrum antibiotics and antioxidants have been widely used to treat male infertility caused by leukocytospermia for treating infections and eliminating the increase of oxygen free radical in semen caused by infection.However,up to now,there is no definite and unified treatment plan for the treatment of leukocytospermia in academia.At present,some studies have shown that antibiotic treatment may improve the sperm parameter,increase the cure rate of leukocytospermia,and even achieve bacteriological cure and improve the pregnancy rate.However,the differences between the studies in the efficacy of antibiotic treatment are still significant.In addition,in vitro studies have shown that antioxidants may also benefit sperm function improvement.However,current data are not yet sufficient to conclude that antibiotics and antioxidants are effective in treating male infertility caused by leukocytospermia.In this regard,a better experimental design as well as a large sample of research is needed.