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目的:探讨HBV感染与免疫性男性不育发生率的相关性。方法:筛选3 124例男性不育患者,依照血清乙肝表面抗原(Hbs Ag)结果将其分为HBV感染组和HBV未感染组。再通过免疫珠试验(IBT)测定抗精子抗体将免疫性不育患者又分为HBV感染和未感染的免疫性不育组。统计分析HBV感染和未感染免疫性不育组阳性率的差异、HBV感染和未感染免疫性不育组精液常规参数的差异、HBV感染不育患者血清和精浆HBV DNA拷贝数相关性、血清和精浆HBV DNA拷贝数与精液常规参数的相关性以及精浆HBV DNA拷贝数与免疫性不育发生率的差异。精子浓度、前向运动精子(PR)百分率用计算机辅助精子分析系统,精子形态检查用Diff-Quik染色法。HBs Ag检查用ELISA法,血清和精浆HBV DNA拷贝数用荧光定量PCR法。结果:HBV感染组和未感染组免疫性不育阳性率分别为20.3%和3.3%,差异有统计学意义(χ~2=187.5 P<0.01)。HBV感染和未感染免疫性不育组精液量、精子浓度、PR之间差异无统计学意义(P>0.05),而两组间正常精子形态百分率(MNS)分别为(3.9±1.7)%和(6.3±2.2)%、,差异有统计学意义(P<0.05)。血清和精浆HBV DNA拷贝数存在正相关(rs=0.86,P<0.01)。血清和精浆HBV DNA拷贝数与PR、MNS均呈负相关[(r=-0.233,P<0.01和r=-0.465,P<0.01)和(r=-0.250,P<0.01和r=-0.508,P<0.01)]。精浆HBV DNA不同拷贝数量级组免疫性不育阳性率差异无统计学意义(P>0.05)。结论:HBV感染可增加免疫性不育的发生率,并与精子质量低下有相关性。
Objective: To investigate the correlation between HBV infection and the incidence of male infertility. Methods: A total of 3 124 male infertility patients were screened and divided into HBV infection group and non HBV infection group according to the results of serum HBsAg. Anti-sperm antibodies were further tested by immunobead test (IBT). The patients with immune infertility were further divided into HBV infected and uninfected immune infertile groups. Statistical analysis of HBV infection and uninfected immunological infertility group positive rate differences, HBV infection and uninfected immune infertility group semen differences in the general parameters of HBV infertility serum and seminal plasma HBV DNA copy number, serum And seminal plasma HBV DNA copy number and sperm routine parameters and seminal plasma HBV DNA copy number and the incidence of immunological infertility differences. Sperm concentration, percentage of forward motile spermatozoa (PR) were calculated using a computer-aided sperm analysis system, and sperm profiling using Diff-Quik staining. ELISA for HBsAg, HBV DNA copy number in serum and seminal plasma were determined by real-time PCR. Results: The positive rates of immunologic infertility in HBV infected and uninfected groups were 20.3% and 3.3%, respectively, with statistical significance (χ ~ 2 = 187.5 P <0.01). There was no significant difference in semen volume, sperm concentration and PR between HBV infected and uninfected immunocompromised groups (P> 0.05), while the normal percentage of sperm morphology (MNS) was (3.9 ± 1.7)% and (6.3 ± 2.2)%, the difference was statistically significant (P <0.05). Serum and seminal HBV DNA copy number there is a positive correlation (rs = 0.86, P <0.01). HBV DNA copy number in serum and seminal plasma was negatively correlated with PR and MNS (r = -0.233, P <0.01 and r = -0.465, P <0.01) 0.508, P <0.01)]. There was no significant difference in the positive rates of immunologic infertility between seminal plasma HBV DNA copies of different sizes (P> 0.05). Conclusion: HBV infection can increase the incidence of immunologic infertility and is associated with low sperm quality.