男性继发不育患者临床特点分析

目的调查二胎生育男性不育症患者的基本临床特点。方法选取北京协和医院和北京市仁和医院男科门诊就诊的男性不育患者410例,其中一胎不育患者(A组)264例,二胎不育患者(B组)146例,采用门诊问卷收集患者的一般信息和精液分析数据,并采用勃起功能国际问卷5(IIEF-5)调查患者的勃起功能状况。结果在调查的410例男性不育患者中,A组、B组患者的年龄分别是(31.3±5.4)岁和(39.5±4.8)岁(P0.01);合并一种以上慢性疾病(糖尿病、高血压、前列腺疾病)的发生率分别是14.8%(39/264)和24.7%(36/146)(P0.05);每月性交次数分别为(9.7±1.2)次和(6.5±1.4)次(P0.01);勃起功能障碍(ED)的发生率分别为50.8%(134/264)和70.5%(103/146)(P0.01),其中B组不育者的重度ED发生率为10.3%,明显高于A组不育者的1.1%(P0.01);A组的精子浓度(39.7±10.6)×10~6/m L]高于B组(34.6±8.5)×10~6/m L](P0.01),但A组的精子总数(114.3±33.4)×10~6]少于B组(150.4±41.1)×10~6](P0.01);A组的a级精子活力12.6%±5.5%高于B组的8.5%±3.2%(P0.01),两者在前向运动精子(a+b)及精子总活动(a+b+c)率方面没有统计学差异。结论二胎生育男性不育患者具有年龄大、合并慢性疾病多、性交次数少、易发生E D、精子质量尚可的特点,临床诊疗工作要给予必要的关注和进行相应的调整。

Research on clinical characteristics of secondary male infertile patients

Objective To investigate the clinical characteristics of male infertile patients planning for the second baby.Methods Four hundred and ten male infertile outpatients attended andrological clinic of Peking Union Medical College Hospital and Beijing Renhe Hospital were studied.There were 264 patients planning first pregnancy (group A) and 146 patients planning second pregnancy (group B),respectively.A questionnaire was used for collecting the general information and sperm analysis data.Erectile dysfunction (ED) was measured by International Index of Erectile Function-5 (IIEF-5).Results Average age of the male infertility planning first and second pregnancy was (31.3 ± 5.4) years and (39.5 ± 4.8) years (P＜0.01).The incidence of concomitant diseases (diabetes,hypertension,prostatic diseases) was 14.8％ (39/264) and 24.7％ (36/146) (P＜0.05).Frequency of sexual intercourse per month was 9.7± 1.2 and 6.5 ± 1.4 (P＜0.01).The incidence of ED was 50.8％ (134/264) and 70.5％ (103/146) (P＜0.01).Among male patients planning second pregnancy,the incidence of severe ED was 10.3％,significantly higher than that in group B (1.1％) (P＜0.01).The sperm concentration in group A was (39.7 ± 10.6) × 106/mL and significantly higher than that in group B (34.6 ± 8.5) × 106/mL],while the total sperm number in group A (114.3 ± 33.4) × 106] was lower than that in group B (150.4 ± 41.1) × 106] (P＜0.01).Fast forward movement sperm was (12.6％ ± 5.5 ％) in group A and (8.5％ ± 3.2％) in group B,respectively (P＜0.01).In terms of total sperm motility and grade a and b sperm,there was no statistical difference between two groups.Conclusion There are some clinical characteristics among male infertile patients planning the second pregnancy,such as older age,higher incidence of concomitant diseases and ED,lower intercourse frequency and moderate sperm quality.We should pay more attention to these patients and properly adjust clinical decision.