输精管绝育术复通前后血清抗精子抗体的变化与妊娠的关系  

The Relationship Between Changes of Serum Antisperm Antibodies Before and Post Vasovasostomy and Pregnancy Rate

作　　者：卢文红 梁小薇 谷翊群 李鸿 吴志刚 陈振文 

机构地区：[1]国家人口与计划生育委员会科研所男性临床研究室,北京100081

出　　处：《中华男科学杂志》2006年第1期32-35,38,共5页National Journal of Andrology

基　　金：世界卫生组织P25项目资助(90807)

摘　　要：目的:比较3种术式输精管绝育术(直视钳穿输精管结扎术、输精管注射粘堵、可复性输精管注射栓堵)复通前后血清抗精子抗体情况的变化和差异,评价复孕与血清抗精子抗体及精液质量的关系。方法:对88例采用3种不同术式进行输精管绝育术术后2年复通的受试对象,分别在复通后3、6、12、24个月对精子出现、血清抗精子抗体和女方妊娠情况进行随访观察。结果:①3种术式绝育术间复通前后血清抗精子抗体的阳性率差异无显著性(P>0.05)。②复通术前后血清抗精子抗体阳性率变化差异无显著性(P>0.05)。③在接受复通手术的对象中,精子出现组和精子未出现组血清抗体阳性率间差异无显著性(P>0.05)。④血清抗精子抗体的阳性率、强度(活动精子挂珠率)和种类对妊娠无直接影响(P>0.05)。⑤复通对象中,已孕组和未孕组血清抗体阳性率间差异无显著性(P>0.05)。⑥精子密度≥20×106/m l组妊娠率明显高于精子密度<20×106/m l组(P<0.01)。结论:输精管绝育术术式对抗精子抗体无影响;复通术没有消除血清抗精子抗体或降低其阳性率;血清抗精子抗体对妊娠无直接影响;复通后的精液质量与复通后的复孕有直接关系。Objective ： To investigate the changes and variation of serum antisperm antibodies （AsAb） from the men who received vasovasostomy 2 years after one of three methods of male sterilization, and evaluate the relationship between serum AsAb and pregnancy rate. Methods： Sperm reappearance, serum AsAb and pregnancy rate were investigated in 88 subjects who underwent reversal operation 2 years after one of three methods of male sterilization at 3, 6, 12 and 24 months post vasovasostomy. Results ： There was no significant difference in positive rate of AsAb among groups of vasovasostomized men post one of three methods of sterilization, and between groups before and post vasovasostomy and between groups with and without sperm reappearance, respectively. The positive rate, intensity （percentage of motile sperm coated with beads ） and type of serum AsAb had no influences on pregnancy. No significant difference was observed in positive rate of AsAb between pregnant group and non-pregnant group. The pregnancy rate of the group in which sperm concentration was more than 20 × 10^6/ml was apparently higher than that of the group in which sperm concentration was less than 20 × 10^6/ml. Conclusion： The serum AsAb and their positive rate can not be eliminated or decreased by vasovasostomy post male sterilization. The serum AsAb has no influence on pregnancy. There is a close relationship between sperm quality and pregnancy post vasovasostomy.

关 键 词：输精管绝育术 复通 血清抗精子抗体 妊娠 

分 类 号：R699.8[医药卫生—泌尿科学]