男性不育患者生精细胞HCMV、HSV感染检测及形态学研究  

Infection of Cytomegalovirus and herpes Simplex Virus and Morphologyof the Infected Spermatogenic Cells in Infertile Men

作　　者：吴坤河[1] 周庆葵[2] 黄健红[3] 赖日权[4] 林飞鸿[2] 李兵[2] 张畅斌[5] 周伟宁[5] 朱照平[3] 

机构地区：[1]广东省妇幼保健院病理科,广东广州510010 [2]广东省妇幼保健院男性科,广东广州510010 [3]广东省妇幼保健院检验科,广东广州510010 [4]广州军区广州总医院病理科,广东广州510010 [5]广东省妇幼保健院PCR室,广东广州510010

出　　处：《中华男科学杂志》2007年第12期1075-1079,共5页National Journal of Andrology

基　　金：广东省医学科研基金(B2005008)

摘　　要：目的:探讨男性不育患者精液中生精细胞人类巨细胞病毒(HCMV)、单纯疱疹病毒Ⅱ型(HSV-Ⅱ)感染状况及其形态学特征。方法:收集83例精液检查中发现较多生精细胞男性不育患者精液,洗涤收集细胞后提取DNA,用PCR方法进行HCMV、HSV-Ⅱ筛查,阳性者精液细胞涂片用免疫细胞化学法(ICC)做相应的病毒标记,并另行细胞学染色作形态学观察。结果:83例精液样本PCR检测HCMV阳性8例,HSV-Ⅱ阳性4例,未发现2种病毒同时阳性病例。8例HCMV阳性病例ICC标记生精细胞HCMV晚期抗原均见阳性表达,HCMV早期抗原均为阴性表达;4例HSV-Ⅱ阳性病例ICC标记生精细胞3例阳性表达,1例弱阳性。12例病毒阳性病例均发现较多未成熟生精细胞,并有不同程度的核染色质固缩、出现空泡、核膜破损、核崩解、凋亡小体等凋亡现象,但未能找到病毒感染的特异性形态学改变(如病毒包涵体)。病毒感染阳性组精子密度明显低于阴性组(P<0.05)。结论:生精细胞HCMV、HSV-Ⅱ感染时可出现不同程度的病理性损害,影响生精功能,感染的生精细胞形态学表现为出现凋亡现象等病理性改变;不育男性患者精液中出现病理性生精细胞,其生精细胞HCMV感染率可能较高。Objective： o study the infection of human cytomegalovirus （HCMV） and herpes simplex virus type Ⅱ （ HSV- Ⅱ ） and the morphological characteristics of the infected spermatogenic cells in the semen of infertile men. Methods ： We washed and concentrat- ed the spermatogenic cells obtained from 83 semen samples of infertile men, extracted DNA and then screened HCMV and HSV- Ⅱ by polymerase chain reaction （PCR）. Immunocytochemistry （ICC） was used to detect the expression of correlative virus antigens of the positive semen cells, and the cytology smear was employed to observe the morphological changes of the spermatogenic cells under the microscope after cytology staining. Results： Of all the semen samples, 8 were HCMV positive, 4 HSV-Ⅱ positive, but none were both HCMV and HSV-Ⅱ positive. HCMV late antigens were positively and HCMV early antigens negatively expressed in the spermato- genic cells of the 8 HCMV positive cases. In the 4 HSV-Ⅱ positive cases, 3 were positively and 1 weakly positively expressed. In the semen of the 12 positive cases were found large numbers of immature spermatogenic cells, with different manifestations of apoptosis, such as chromatin pyenosis, vacuoles, damaged nuclear membrane, and apoptotic bodies, but without virus infection-induced specific morphological alteration. Sperm concentration of the positive group was significantly lower than that of the negative （ P 〈 0.05 ）. Conclusion ： Spermatogenic cells infected by HCMV and HSV- Ⅱ may cause pathologic lesions and affect spermatogenesis. Morphologi- cally, the infected spermatogenic cells may undergo some pathologic alteration, such as apoptosis. The rate of HCMV infection is high- er among infertile males with pathologic cells in the semen.

关 键 词：男性不育 生精细胞 人类巨细胞病毒 单纯疱疹病毒 聚合酶链反应 免疫细胞化学 

分 类 号：R698.2[医药卫生—泌尿科学]