36例梗阻性无精子症附睾液中精子参数和细菌培养结果分析  

The analysis of semen parameters and bacterial culture results in epididymal fluid from 36 patients with obstructive azoospermia

作　　者：刘胡旺 郑菊芬[2] 向祖琼[2] 陈斌[2] 赵磊文[2] 高龙[2] 韩银发[2] 王益鑫[2] 

机构地区：[1]浙江瑞安市计划生育宣传技术指导站,瑞安325200 [2]上海交通大学医学院附属仁济医院上海市男科学研究所

出　　处：《中国男科学杂志》2009年第7期40-43,共4页Chinese Journal of Andrology

摘　　要：目的分析不同病因梗阻性无精子症患者附睾液中的精子参数和细菌培养结果。方法将36例梗阻性无精子症患者按不同病因分成A、B和C3组，A组（14例）为有明确附睾炎症病史的附睾炎症梗阻：B组（7例）为无明确生殖道炎症病史的精道梗阻；C组（15例）为先天性双侧输精管缺如。将这些患者行诊断性经皮附睾穿刺精子抽吸术（PESA），分析附睾液中的精子参数，同时将附睾液做常规细菌培养和结核杆菌培养。结果3组患者中，附睾精子密度≥20×10^6／ml，1-20×10^6／ml及≤1×10^6／ml的分别占33．3％（12／36），41．7％（15／36）和25％（9／36），各组间的精子密度无统计学差异（P〉0．05）；附睾液中有A或B级活动精子，仅有c级活动精子及仅有D级精子的患者分别占41．7％（15／36），36．1％（13／36）和22．2％（8／36），各组间的精子活动力无统计学差异（P〉0．05）；所有病例标本的常规细菌培养和结核杆菌培养均为阴性。结论对于不同病因导致精道梗阻的患者，附睾液中精子的密度和活动力无统计学差异，大多数PESA附睾液标本中的精子足够用于单精子卵胞浆内注射（ICSI）治疗；梗阻性无精子症患者非急性炎症期附睾液中不存在活动性细菌感染，可以安全应用于ICSI治疗。Objective To analyze the semen parameters and bacterial culture results of epididymal fluid from 36 obstructive azoospermia patients with different etiology. Methods Total of 36 patients diagnosed as obstructive azoospermia were enrolled in this study. All patients were divided into three groups based on different etiology such as Group A （14 cases, Inflammatory epididymal obstruction with a definite history of epididymitis）, Group B （7 cases, Reproductive duct obstruction without a definite history of reproductive duct inflammation） and Group C （15 cases, Congenial bilateral absence of the vas deferens）. They all underwent dignostic percutaneous epididymal sperm aspiration （PESA）, and their epididymal fluid were collected for semen analysis, routine bacterial culture and tuberculosis bacili culture. Results Patients with sperm number ≥ 20 × 10^6/ml, 1-20 × 10^6/ml and ≤〈 1 ×10^6/ml in the epididymal fluid accounted for 33.3%（12/36）, 7%（15/36）and 25%（9/36） respectively. There was no significant difference in the sperm number among three groups （P〉0.05）. Patients with grade A or B sperm, with grade C sperm and with grade D sperm in the epididymal fluid accounted for 41.7%（15/36）, 36.1%（13/36）and 22.2% （8/36）respectively. There was no significant difference in the sperm motility among groups（P〉0.05）; The routine bacterial culture and tuberculosis bacili culture for the epididymal fluid from all patients were negative. Conclusion All data in the study suggested that no significant changes were found in the sperm number and motility in the epididymal fluid from obstructive azoospermia patients with different etiology, and the sperm number and motility in the epididymal fluid from the most obstructive azoospermia patients were qualified for intracytoplasmic sperm injection （ICSI）. The epididymal fluid specimens from PESA should be safelyused for ICSI due to no bacterial infection in the epididymal fluid.

关 键 词：梗阻性无精子症 炎症 附睾精子 细菌培养 

分 类 号：R698.2[医药卫生—泌尿科学]