湖南地区910例男性不育患者沙眼衣原体、解脲支原体感染对精子质量影响的研究

Effects of CT and UU infection on sperm quality in 910 male infertility patients in Hunan

目的检测湖南地区男性不育患者精液中沙眼衣原体(CT)、解脲支原体(UU)的感染情况,并探讨CT、UU感染对精液常规及精子DNA完整性的影响。方法选取2020年4月至2021年3月于湖南省妇幼保健院生殖不孕不育门诊就诊的男性不育患者的精液标本910份作为研究对象,按照《世界卫生组织人类精液检查与处理实验室手册》第5版标准行精液分析,采用实时聚合酶链反应(PCR)检测标本中是否存在CT、UU,采用流式细胞术检测精子DNA碎片率。根据检测结果分为CT感染不育组、UU感染不育组和未感染不育组,选取2020年上半年行精液检查显示病原体阴性且在回访调查中发现使配偶正常受孕男性为对照组,分析CT、UU感染对精液各参数的影响。结果910例湖南地区男性不育患者精液中检出CT 42例(4.62%),UU 98例(10.77%),CT与UU混合感染11例(1.21%),均未感染781例(85.82%);CT感染不育组和UU感染不育组之间精子质量比较,差异无统计学意义(P>0.05);和未感染不育组比较,CT和UU感染可导致前向运动精子率下降、畸形精子率升高、精子DNA碎片率升高,差异具有统计学意义(P<0.05);与对照组比较,CT和UU感染不育组前向运动精子率明显下降、畸形精子率明显升高、精子DNA碎片率明显升高,差异具有统计学意义(P<0.05)。结论CT、UU感染会导致男性不育患者精子质量下降、精子DNA完整性受损,精子核DNA完整性可作为评判精子质量的独立指标。

Objective To determine the prevalence of Chlamydia trachomatis(CT)and Ureaplasma urealyticum(UU)in semen samples of the infertile males in Hunan and to investigate the effects of CT and UU infection on semen routine parameters and sperm DNA integrity.Methods 910 semen samples of male infertile patients treated in Hunan Provincial Maternal and Child Health Hospital from April 2020 to March 2021 were selected as the research objects.Semen routine analysis were performed according to the 5th edition WHO Manual of human semen processing laboratory,real-time polymerase chain reaction(PCR)was used to detect the presence of CT and UU,and flow cytometry was used to detect the rate of sperm DNA fragmentation.According to the test results,the patients were divided into CT infected infertility group,UU infected infertility group and uninfected infertility group.Men who underwent semen examination in the first half of 2020,were negative for pathogen detection and found to have made their spouses pregnant normally in the follow-up survey were selected as the control group.The effects of CT and UU infection on semen parameters were analyzed.Results Among 910 male infertile patients in Hunan area,42 cases(4.62%)of CT,98 cases(10.77%)of UU,11 cases(1.21%)of CT and UU mixed infection were detected,and 781 cases(85.82%)were not infected.There was no significant difference in sperm quality between CT infected infertility group and UU infertility group(P>0.05).Compared with the uninfected infertile group,CT and UU infection could reduce sperm progressive motility(PR),increase sperm deformity rate and sperm DNA fragmentation index(DFI),and the difference was statistically significant(P<0.05).Compared with the normal fertility group,the sperm PR in CT and UU infected infertile group decreased significantly,sperm deformity rate and sperm DFI increased significantly(P<0.05).Conclusions CT and UU infection can reduce sperm quality in male infertile patients,cause damage to sperm DNA integrity.Sperm DNA integrity is an independent index to evaluate sperm quality.