生殖支原体感染对男性不育患者精液质量的影响  

Impact of Mycoplasma genitalium infection on the semen quality of infertile males

作　　者：闫泽晨[1] 商学军 刘玮 万秀霞[3] 万长春[4] 许松 钟勇 翁志强 YAN Ze-chen;SHANG Xue-jun;LIU Wei;WAN Xiu-xia;WAN Chang-chun;XU Song;ZHONG Yong;WENG Zhi-qiang(Department of Surgery, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan 450052, China;De- partment of Andrology, 5. Department of Urology, 6. Department of Outpatients, Nanjing School of Clinical Medicine, Southern Medical University / Nanjing General Hospital of Nanfing Military Region, Nanfing, Jiangsu 210002, China;Virtual Laboratory Section, Laboratory of Human Integrated Biological Functions, School of Basic Medicine, Qingdao University, Qingdao, Shandong 266071, China;Department of Clinical Laboratory, Jinhu People＇s Hospital, Jinhu, Jiangsu 211600, China)

机构地区：[1]郑州大学第一附属医院外科医学部,河南郑州450052 [2]南方医科大学南京临床医学院/南京军区南京总医院男科,江苏南京210002 [3]青岛大学基础医学院人体机能学实验室虚拟实验室,山东青岛266071 [4]金湖县人民医院检验科,江苏金湖211600 [5]南方医科大学南京临床医学院/南京军区南京总医院泌尿外科,江苏南京210002 [6]南方医科大学南京临床医学院/南京军区南京总医院门诊部,江苏南京210002

出　　处：《中华男科学杂志》2018年第4期317-321,共5页National Journal of Andrology

基　　金：国家自然科学基金(81771646;81701506);国家"十二五"科学支撑计划(2012BAI32B03);2017年度军队计生专项研究任务计划(17JS013);江苏省社会发展面上项目(BE2017724)~~

摘　　要：目的:探讨泌尿生殖道生殖支原体(MG)在男性不育患者中的感染情况及其对精液质量的影响。方法:收集2015年3月~7月来南京军区南京总医院生殖医学中心门诊的352例不育患者的精液标本。MG感染采用实时荧光核酸恒温扩增检测技术(SAT)检测,精液分析根据《WHO人类精液检查与处理实验室手册》第5版进行操作,分析精液pH值、精液量、精子总数、精子浓度、精子总活力、前向运动精子百分率(PR)、不动精子百分率(IM)、精子DNA碎片化指数(DFI)等。数据统计用t检验(t-tests)与非参数检验(Wilcoxon test)方法。结果:不育患者MG感染率为3.4%(12/352);比较MG阳性与MG阴性不育患者间精液分析结果发现,MG阴性患者在精液量[(3.84±0.12)ml vs(2.85±0.14)ml,P=0.008]、PR[(23.57±0.99)%vs(15.86±1.72)%,P=0.032]均要显著高于MG阳性患者,DFI[(20.71±1.55)%vs(30.73±2.24)%,P=0.014]则显著低于MG阳性患者。而精液p H值(7.39±0.01 vs 7.38±0.02,P=0.774)、精子浓度[(60.05±4.29)×10~6/ml vs(52.96±15.78)×10~6/ml,P=0.683]、精子总数[(221.56±15.43)×10~6vs(154.15±46.37)×10~6,P=0.236]、精子总活率[(33.52±1.51)%vs(29.04±3.11)%,P=0.626]、IM[(62.34±1.69)%vs(60.95±5.63)%,P=0.691]组间均无统计学差异。结论:本研究证明:男性不育患者泌尿生殖道MG感染患者并不在少数,应引起重视;泌尿生殖道MG感染对精液质量有潜在负面影响,特别是精子活力。Objective： To explore Mycoplasma genitalium （MG） infection in the urogenital tract of infertile men and its influence on semen quality. Methods ： Semen samples were collected from 352 infertile males in the Center of Reproductive Medicine of Nanjing General Hospital from March to July 2015. MG infection was detected by real-time fluorescence simultaneous amplification and testing and semen ana- lyses were conducted according to the WHO Laboratory Manual for the Examination and Processing of Human Semen （Sth Ed） on the semen pH value, semen volume, total sperm count, sperm concentration, total sperm motility, percentages of progressively motile sperm （PMS） and immotile sperm （IMS）, and sperm DNA fragmentation index （DFI）. The data obtained were subjected to statistical analysis by t-test and non-parametric test （Wilcoxon test）. Results ： MG infection was found in 3.4% （12/352） of the infertile patients. Compared with the MG- positive cases, the MG-negative ones showed a significantly higher semen volume （ [2.85 ± 0. 14] vs [3.84 ± 0.12] ml, P = 0.008） and percentage of PMS （ [ 15.86± 1.72 ] vs [60. 95 ± 5.63 J %, P = 0.032） but a lower DFI （ [ 30. 73± 2.24 ] vs [ 20. 71 ± 1.55 ] %, P = 0.014）. However, no statistically significant differences were observed between the two groups in the semen pH value （7.38 ±0.02 vs 7.39 ±0.01, P = 0. 774）, sperm concentration （ [ 52.96 ±15.78 ] vs [60.05 ± 4.29 ] ×10^6/ml, P = 0.683）, sperm count （[154.15 ± 46.37] vs [221.56 ± 15.43] ×l0^6, P = 0.236）, total sperm motility （[29.04 ± 3.11] vs [33.52 ± 1.51] %,P = 0.626）, or percentage of IMS （[23.57± 0.99] vs [62.34± 1.69] %,P = 0.691）. Conclusion： Urogenital MG infection is common in infertile males and potentially affects the semen quality, especially sperm vitality of the patient.

关 键 词：生殖支原体 不育 精液质量 实时荧光核酸恒温扩增检测技术(SAT) 

分 类 号：R697[医药卫生—泌尿科学]