摘要
目的:本研究旨在分析男性泌尿生殖道解脲脲原体(Uu)、人型支原体(Mh)和沙眼衣原体(Ct)感染对精液的影响。方法:选择2014年10月至2023年1月在山东省日照市人民医院生殖医学科就诊的1022例男性,其中不育症组393例,复发性流产组139例,对照组490例。按年龄分为两组,年龄<36岁为852例,年龄≥36岁的为170例。所有患者均进行精液常规、精子形态学、Uu、Mh和Ct检测。统计分析Uu、Mh和Ct阳性率及其对精液质量的影响和不同年龄分组Uu、Mh和Ct感染阳性率组间比较。结果:1022例就诊者中Uu阳性344例,占比33.6%,Mh阳性49例,占比4.7%,Ct阳性31例,占比3.0%。Uu、Mh和(或)Ct阳性患者精子浓度、精子总数、精子前向运动率(PR)、精子活动率(PR+NP)和正常形态精子百分率率明显低于阴性组,两组总体差异具有统计学意义(P<0.05)。Uu感染阳性率,不育症组41.7%,复发性流产组30.2%,对照组28.2%,三组数据阳性率总体差异具有统计学意义(P<0.001);Mh感染阳性率,不育症组6.9%,复发性流产组8.6%,对照组2.0%,三组数据阳性率总体差异具有统计学意义(P<0.001);Ct感染阳性率,不育症组6.1%,复发性流产组2.9%,对照组0.6%,三组数据阳性率总体差异具有统计学意义(P<0.001);Uu感染阳性率年龄<36岁为35.8%,年龄≥36岁的为22.9%,两组数据阳性率总体有统计学差异(χ^(2)=10.5,P<0.05)。结论:就诊人群中,男性泌尿生殖道Uu感染率明显高于Mh和Ct,是引起男性泌尿生殖道感染的主要致病菌。Uu、Mh和Ct感染对精子浓度、精子总数、精子前向运动率(PR)、精子活动率(PR+NP)和正常形态精子百分率均有不利影响,会导致精液质量下降,影响男性生育力。生殖道感染与年龄密切相关,低年龄组Uu感染率比较高。
Objective:This study aimed to assess the impact of urogenital ureaplasma urealyticum(Uu),Mycoplasma hominis(Mh),and Chlamydia trachomatis(Ct)infections on semen quality in men.Methods:In this study,1022 males were enrolled at the Department of Reproductive Medicine,Rizhao People's Hospital,Shandong Province from October 2014 to January 2023.The participants included 393 in the infertility group,139 in the recurrent miscarriage group,and 490 in the control group.Based on age,852 cases were<36 years old,and 170 cases were≥36 years old.All patients underwent routine semen analysis and tests for Uu,Mh,and Ct,with results statistically analyzed for their impact on semen quality and compared among different age groups.Results:Among the 1022 patients,344(33.6%)were Uu-positive,49(4.7%)were Mh-positive,and 31(3.0%)were Ct positive.The sperm concentration,total sperm count,forward sperm motility rate(PR),sperm motility rate(PR+NP)and normal sperm morphology rate of Uu Mh and/or Ct-positive patients were significantly lower than those of the negative group,and the overall difference between the two groups was statistically significant(P<0.05).The positive rate of Uu infection was 41.7%in the infertility group,30.2%in the recurrent miscarriage group and 28.2%in the control group,and the overall positive rate of the three groups was statistically significant(P<0.05).The positive rate of Mh infection was 6.9%in the infertility group,8.6%in the recurrent miscarriage group and 2.0%in the control group,and the overall positive rate of the three groups was statistically significant(P<0.001).The positive rate of Ct infection was 6.1%in the infertility group,2.9%in the recurrent miscarriage group and 0.6%in the control group,and the overall positive rate of the three groups was statistically significant(P<0.001).The positivity rate of Uu infection was 35.8%at the age of<36 years and 22.9%at the age≥36 years,and there was a statistically significant difference in the positivity rate between the two groups(χ^(2)=10.5,P<0.05).Conclusion:The prevalence of Uu infection in the male urogenital tract is significantly higher than that of Mh and Ct,which is the main pathogen of urogenital tract infection in men.Uu,Mh and Ct infections have adverse effects on sperm concentration,total sperm count,sperm forward motility rate(PR),sperm motility rate(PR+NP)and normal sperm morphology rate,which will lead to a decrease in semen quality and affect male fertility.Genital tract infections are closely related to age,and the prevalence of Uu infection is higher in the younger age group.
作者
李梅
胡春晓
卢绪楼
于丽华
许秀梅
王雪菲
谭胜楠
龚雪琳
邢士超
LI Mei;HU Chun-xiao;LU Xu-lou;YU Li-hua;XU Xiu-mei;WANG Xue-fei;TAN Sheng-nan;GONG Xue-lin;XING Shi-chao(School of Basic Medicine Qingdao Medical College Qingdao University Qingdao,266071,Shandong,China;People's Hospital of Rizhao,Shandong Province,Rizhao 276800,China;Women's and Children's Hospital of Qingdao University,Qingdao,Shandong,266034)
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2023年第7期639-644,共6页
National Journal of Andrology
基金
国家自然科学基金面上项目(81671625)
教育部产学合作协同育人项目(220605402021719)
北京大学人民医院研究与发展基金(RDGS2022-14)
山东省自然科学基金(ZR2023Mh304)
青岛市医药卫生科研指导项目(2022WJZD136)
山东省医药卫生科技发展计划(202222010801)
关键词
解脲脲原体
人型支原体
沙眼衣原体
精液质量
不育症
复发性流产
Ureaplasma urealyticum
Mycoplasma hominis
Chlamydia trachomatis
semen quality
infertility
recurrent miscarriage
作者简介
共同第一作者:李梅(1991-),女,山东日照市人,主管检验师,本科,从事医学检验学。对文章贡献相同;共同第一作者:胡春晓(1991-),女,山东日照市人,主管检验师,硕士研究生,从事医学检验学。对文章贡献相同;通讯作者:邢士超,Email:xingshichao@qdu.edu.cn
