Clinical Observation on Impacts of Ureaplasma Urealytieum Infection upon Quality of Sperm
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摘要:
目的 研究精液质量异常与生殖道解脲支原体感染之间的关系，并探讨其可能的作用机理。 方法 将男性不育患者347例按是否有UU感染分为UU阳性和UU阴性两组，分别检测两组的精液质量（精液量、精子密度、精子活率、前向运动精子比例）及精液液化时间，精子畸形率。UU阳性组给予阿奇霉素，多西环素治疗转阴后，再次收集精液进行分析。 结果 UU阳性组治疗前精液各项指标均低于UU阴性组（P < 0.01，经治疗转阴后，精液量提高了20.59%；精子密度增加了16.44%；精子活率增加了19.56%；a级精子比例增加了24.89%；a+b级精子比例增加了32.69%；精子畸形率下降了1.39%，尤其在精液不液化的改善上，从治疗前液化率20.11%提高到转阴后92.53%，效果显著，与治疗前相比，差异有统计学意义（P < 0.05），与UU阴性组相比，差异无统计学意义（P > 0.05）。 结论 男性生殖道解脲支原体感染可降低精液质量，尤其可延长精液液化时间，增加男性不育率，因此在临床治疗男性不育时，不可忽视对UU的检测和治疗，发现UU感染应及时治疗，可减少男性不育的发生。 Abstract:Objectives To explore the relationship between sperm abnormality and genital ureaplasma urealytieum（UU） infection, and discuss how do they interact with each other. Methods Three hundreds and forty-seven patients with male infertility were divided into UU-positive and UU-negative groups based on if they suffered UU infection. Subsequently, two groups were observed in terms of quality of sperm（including sperm count, sperm density, sperm mobility and proportion of forward motile sperm）, liquefaction time and rate of sperm abnormalities. After the UU-positive group was treated with azithromycin and became UU-negative, sperm was recollected from them for analysis. Results Before the UU-positive group was treated, all of its sperm indicators were lower than the UU-negative group（P < 0.01）. After they were treated and became negative, the sperm count, sperm density, mobility, proportion of Grade A sperm and ratio of Grade A+B sperm increased by 20.59%, 16.44%, 19.56%, 24.89% and 32.69% respectively, while the sperm deformity rate declined by 1.39%. In particular, the liquefaction rate increased from 20.11% before treatment to 92.53% after the group was treated and became UU-negative. The effects of treatment were evident, and differences were statistically significant before and after treatment（P < 0.01）. Compared with the UU-negative group, the differences were not statistically significant（P > 0.05）. Conclusions Male genital ureaplasma urealytieum infection may weaken sperm quality, particularly prolong liquefaction time of sperm and increase male infertility, Once UU infection is detected, prompt treatment is needed, so as to reduce male infertility. -
Key words:
- Ureaplasma urealytieum /
- Sperm abnormality /
- Sperm nonliquefaction /
- Male infertility
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表 1 UU阳性组治疗前后与UU阴性组精液参数（
${{\bar x}}$ ±s）Table 1. Comparison of semen parameters between UU positive group and UU negative group before and after treatment（
${{\bar x}} \pm s$ ）before and after treatment（${{\bar x}}$ ± s）分组 n 精液量
（mL）精子密度
（106/mL）精子活率
（%）a级精子比例
（%）a+b级精子比例 精子畸形率
（%）UU阳性治疗前 174 3.01 ± 0.77 58.72 ± 35.47 39.88 ± 12.67 21.93 ± 10.11 30.77 ± 11.68 90.08 ± 9.32 UU阳性治疗后 174 3.36 ± 0.65* 68.44 ± 30.79* 47.68 ± 13.40* 27.39 ± 8.39* 40.83 ± 9.70* 88.83 ± 7.17* UU阴性 173 3.20 ± 0.50 69.22 ± 27.07* 48.33 ± 12.22* 27.15 ± 7.36* 41.89 ± 8.63* 89.72 ± 7.12* T 1.01 0.87 2.61 1.48 0.63 1.74 P 0.028 0.032 0.041 0.029 0.023 0.037 与治疗前比较，*P < 0.05。 
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表 2 UU阳性组治疗前后与UU阴性组精液液化时间[n （%）]
Table 2. Comparison of semen liquefaction time between UU positive group and UU negative group before and after treatment [n （%）]
分组 精液液化时间（n） < 30 min < 60 min > 60 min UU阳性治疗前 0 35（20.11） 139 UU阳性治疗后 56 161*（92.53） 13* UU阴性 55 173*（100.00） 0* T 0.63 1.71 2.21 P 0.058 0.034 0.041 与治疗前比较，*P < 0.05
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