男性不育患者生殖道溶脲脲原体感染对精液质量影响的研究

目的:了解男性不育患者生殖道溶脲脲原体感染情况,探讨男性不育患者生殖道溶脲脲原体感染对精液质量、附属性腺功能的影响及可能机制。方法:本研究对202例确诊的男性不育患者的精液标本进行溶脲脲原体培养,对精液参数及精浆α-葡萄糖苷酶、酸性磷酸酶和果糖进行检测,分析生殖道溶脲脲原体感染对精液参数及精浆生化指标的影响。结果:男性不育患者生殖道溶脲脲原体感染率为33.7%;生殖道溶脲脲原体感染阳性组和阴性组间精液量相差不显著(2.93±1.32)mlvs(2.86±1.52)ml,P=0.774];阳性组精子密度较阴性组患者明显偏低(84.37±52.92)×106/mlvs(101.90±43.90)×106/ml,P=0.025];阳性组精子活率较阴性组患者明显偏低(44.62±22.13)%vs(51.83±19.88)%,P=0.036];阳性组患者精子活力明显低于阴性患者(38.40±15.61)%vs(44.45±15.47)%,P=0.020];两组精液pH值均在正常值范围内,但阳性组明显高于阴性组(7.32±0.10vs7.19±0.29,P=0.003);阳性组与阴性组除侧摆幅度、向前运动、直线运动和摆动性等4项指标相差不显著外,对曲线运动性、直线速度、平均路径速度、平均移动角度)和鞭打频率等5项指标均有影响;阳性组精浆α-葡萄糖苷酶较阴性组明显降低(40.0±18.7)U/mlvs(47.9±21.0)U/ml,P=0.026],Uu感染阳性组α-葡萄糖苷酶降低的相对危险性是阴性组的2.12倍;两组间精浆酸性磷酸酶和果糖水平无统计学差异(P均>0.05)。结论:在男性不育患者中,生殖道溶脲脲原体感染是精液质量下降的重要危险因素;生殖道溶脲脲原体感染可导致附睾分泌α-葡萄糖苷酶下降,但对前列腺酸性磷酸酶及果糖无明显影响,而这种感染对前列腺和精囊危害相对有限。

Ureaplasma Urealyticum Infection in the Genital Tract Reduces Seminal Quality in Infertile Men

OBJECTIVE: To understand Ureaplasma urealyticum (Uu) infection, analyzed the influence of Uu infection on the seminal quality and the accessory genitical gland function in male infertility patients, and investigate its mechanism. METHODS: We cultured 202 semen samples collected from male infertility patients and analyzed the influence of Uu infection on seminal parameters and the biochemical indexes of the seminal plasma. RESULTS: The Uu infection rate was 33.7% in the infertile males, with no statistic differences between the Uu positive and negitive groups either in the average age (28.9 +/- 4.7 yrs vs 29.6 +/- 4.0 yrs, P = 0.250) or in the seminal quantity (2.93 +/- 1.32 ml vs 2.86 +/- 1.52 ml, P = 0.774). The sperm density, motility and vitality were (84.37 +/- 52.92) x 10(6) ml, (44.62 +/-22.13) % and (38.40 +/- 15.61) % in the Uu positive group, significantly lower than (101.90 +/- 43.90) x 10(6) ml, (51.83 +/- 19.88) % and (44.45 +/- 15.47) % in the Uu negative group (P = 0.025, P = 0.036 and P = 0.020). The seminal pH value was normal in both of the groups, but significantly higher in the Uu positive than in the negative group (7.32 +/- 0.10 vs 7.19 +/- 0.29, P = 0.003). VCL, VSL, VAP and MAD were significantly lower, while BCF was significant higher in the former than in the latter (33.97 +/- 8.96) microm/s vs (39.70 +/- 8.14) microm/s, t = 4.113, P < 0.001; (22.29 +/- 6.06) microm/s vs (25.20 +/- 6.67) microm/s, t = 2.684, P = 0.008; (25.96 +/- 6.83) microm/s vs (30.02 +/- 6.81) microm/s, t = 3.537, P < 0.001; 46.60 +/- 13.68 vs 54.23 +/- 15.14, t = 3.112, P = 0.002; (6.12 +/- 1.89) Hz vs (5.22 +/- 1.64) Hz, t = 3. 164, P = 0.002]. All the five indexes were influenced by Uu infection. Compared with the negative group, the seminal plasma alpha-glucosidase was significantly decreased in the positive group (40.0 +/-18.7) U/ml vs (47.9 +/- 21.0) U/ml, t = 2.248, P = 0.026], and the risk of the decrease was 2.12 times higher. No statistic difference was observed in seminal plasma acid phosphatase and seminal plasma fructose between the two groups. CONCLUSION: Uu infection in the genital tract is an important factor of seminal quality reduction in infertile men and may cause a decreased secretion of alpha-glucosidase in the epididymis, but it hardly infuences the prostate and seminal vesicle.