乙肝病毒携带者不育男性精液质量分析

目的:分析携带乙肝病毒(HBV)的不育男性的精液质量,探讨HBV感染对男性精液质量的影响。方法:选择2018年门诊初诊的782例不育男性,年龄25~35岁,根据HBV感染情况分为小三阳组(血清学检查乙肝表面抗原、e抗体、核心抗体阳性,n=286)和大三阳组(血清学检查乙肝表面抗原、e抗原、核心抗体阳性,n=230),以未感染者作为对照组(n=266),对上述3组进行精液常规、精子顶体酶活性及精子染色质结构分析,比较3组结果是否有差异。结果:①小三阳组精子浓度[(71.49±60.03)×10^6/ml]、前向运动精子百分率[(30.70±14.79)%]、精子活率[(42.67±17.23)%]、精子存活率[(81.07±10.19)%]、正常形态精子百分率[(5.72±3.47)%]均低于大三阳组[(88.20±82.62)×10^6/ml、(34.88±15.60)%、(45.77±16.58)%、(82.55±7.55)%、(6.93±4.45)%]和对照组[(89.29±53.80)×10^6/ml、(37.82±13.63)%、(48.16±14.03)%、(85.26±6.39)%、(7.27±4.43)%],除精子存活率以外差异均有统计学意义(P<0.05);大三阳组精子浓度、前向运动精子百分率、精子活率、精子存活率、正常形态精子百分率均低于对照组,其中前向运动精子百分率、精子存活率的差异有统计学意义(P<0.05);②小三阳组的精子顶体酶活性[(57.07±26.38)μIU/10^6精子]显著低于大三阳组[(63.03±28.75)μIU/10^6精子,P<0.05]和对照组[(78.00±33.49)μIU/10^6精子,P<0.01];大三阳组的精子顶体酶活性显著低于对照组(P<0.01);③小三阳组精子DNA碎片指数[DFI,(14.79±9.46)%]和高可染性[HDS,(9.62±6.20)%]均高于大三阳组[(12.95±7.29)%、(8.43±4.72)%]和对照组[(11.60±5.98)%、(8.41±4.59)%],差异有统计学意义(P<0.05);大三阳组的DFI和HDS均高于对照组,仅DFI的差异有统计学意义(P<0.05)。结论:HBV携带者的男性精液质量显著低于未感染者,HBV感染可能是引起男性生育力降低的原因之一。

Semen quality of infertile men carrying hepatitis B virus

Objective:To study the semen parameters of infertile men carrying hepatitis B virus(HBV)and the influence of HBV infection on semen quality.Methods:We collected the semen samples from 782 infertility males aged 25-35 years old.According to the results of serological examinations,we divided the patients into groups A(HBsAg,HBeAb and HBcAb positive,n=286),B(HBsAg,HBeAg and HBcAb positive,n=230)and C(non-HBV control,n=266),and comparatively analyzed the routine semen parameters,sperm acrosin activity,sperm DNA fragmentation index(DFI)and high DNA stainability(HDS)among the three groups of patients.Results:Compared with the patients of groups B and C,those of group A showed markedly decreased sperm concentration([88.20±82.62]and[89.29±53.80]vs[71.49±60.03]×10^6/ml,P<0.05),progressively motile sperm(PMS)([34.88±15.60]%and[37.82±13.63]%vs[30.70±14.79]%,P<0.05),sperm motility([45.77±16.58]%and[48.16±14.03]%vs[42.67±17.23]%,P<0.05),sperm viability([82.55±7.55]%and[85.26±6.39]%vs[81.07±10.19]%,P>0.05)and morphologically normal sperm(MNS)([6.93±4.45]%and[7.27±4.43]%vs[5.72±3.47]%,P<0.05),with sperm concentration,PMS,sperm motility,sperm viability and MNS remarkably lower in group B than in C.Sperm acrosin activity was significantly reduced in group A in comparison with groups B and C([57.07±26.38]vs[63.03±28.75]and[78.00±33.49]μIU/10^6,P<0.01),remarkably lower in group B than in C(P<0.01).The sperm DFI and HDS,however,were markedly higher in group A than in B([14.79±9.46]%vs[12.95±7.29]%and[11.60±5.98]%,P<0.05;[9.62±6.20]%vs[8.43±4.72]%and[8.41±4.59]%,P<0.05),and both higher in group B than in C.Conclusion:Semen quality is lower in infertile men carrying HBV and therefore HBV infection is one of the causes of male infertility.