男性不育患者生殖道感染与精液参数的临床研究

Impact of reproductive tract infection on the semen quality of infertile males

目的:比较泌尿男性门诊孕前体检者和男性不育患者的溶脲脲原体(UU)、沙眼衣原体(CT)和淋球菌(NG)感染率,分析男性精液参数异常的可能病因。方法:选择2017年1月~2018年12月就诊的男性不育患者143例为观察组,选择同时间段孕前体检的90例男性为对照组,对比分析两组受检者的精液自动化分析和病原学检测结果。结果:观察组和对照组的CT感染率分别为3.5%(5/143)、0,NG感染率为0.4%(1/143)、0,UU感染率为23.8%、23.3%,两组比较均无统计学意义(P>0.05)。两组受检者的精液量、精子浓度、总精子数、精子总活力、前向运动精子比例差异无统计学意义(P>0.05),但观察组精子畸形率高于对照组(P<0.05);UU阳性组和UU阴性组的精子浓度、活力和精子畸形率差异无统计学意义(P>0.05),而UU阳性组的重度畸形精子症发病率明显高于UU阴性组(P<0.05)。结论:育龄男性生殖道感染中UU感染发生率较高,UU感染影响精液中精子形态,可能是男性不育的原因之一。

Objective:To explore Ureaplasma urealyticum(UU),Chlamydia trachomatis(CT)and Neisseria gonococcus infection in the reproductive tract of infertile men and its influence on semen quality.Method:Semen samples were collected from 143 infertile males in the clinic of urology of Tongde Hospital of Zhejiang from January 2017 to December 2018.UU infection was detected by culture method and semen analyses were conducted according to the WHO Laboratory Manual for the Examination and Processing of Human Semen(5 th Ed)on the semen pH value,semen volume,total sperm count,sperm concentration,total sperm motility,percentages of progressively motile sperm and immotile sperm.The data obtained were subjected to statistical analysis by t-test and non-parametric test(chi-square test).Result:UU infection was found in 23.6%(55/233)of total,and UU infection rate was 23.8%,23.3%in the infertile patients group and pre-pregnancy physical examination group,respectively.CT infection rate was 3.5%,0 in two groups,respectively.Meanwhile,NG infection rate was 0.4%,0 in two groups,respectively.The total semen quality of male infertile group was slightly lower than that of pre-pregnancy physical examination group,but there was no significant difference in seminal fluid volume,sperm concentration,total sperm count,total sperm motility,forward motility or UU infection rate between the two groups(P>0.05).However,abnormal sperm rate in male infertile group was higher than that in pregnant group(P<0.05).No statistically significant difference was observed between UU-positive group and UU-negative group in the semen concentration,sperm count,total sperm motility,progressive sperm motility,abnormal sperm rate,while significant difference exists in the incidence of severe dysmorphic spermatozoa(P<0.05).Conclusion:Urogenital UU infection is common in males of reproductive age and it has adverse effects on morphology of semen resulting in male infertility.