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目的探讨性传播疾病对男性免疫性不育的影响。方法回顾分析385例有性传播疾病史男性不育患者和107例无性传播疾病史已正常生育的男性尿道分泌物样本的淋球菌和支原体培养、衣原体检测、涂片找螺旋体、结核杆菌、真菌、滴虫等病原体以及酶联免疫法检测精液抗精抗体、精液分析仪分析精液的各项指标等资料。结果性传播疾病病原体以解脲支原体、衣原体、淋球菌为主,阳性率分别为38.18%、16.10%和5.71%,高于对照组的12.15%、7.48%和0.93%,差异有统计学意义(P<0.05)。性传播疾病3种病原体感染组的精液样本检测抗精抗体阳性率为45.31%,高于非感染组的20.56%,差异有统计学意义(P<0.01)。感染组中抗精抗体阳性患者的精液分析各项指标低于抗精抗体阴性患者,差异有统计学意义(P<0.01)。结论性传播疾病主要病原体为支原体、衣原体、淋球菌,引起男性泌尿生殖道感染后容易诱发机体产生抗精抗体,造成精液各项指标下降,从而导致免疫性不育。
Objective To investigate the impact of sexually transmitted diseases on male infertility. Methods A retrospective analysis of 385 male patients with a history of sexually transmitted diseases and 107 cases of non-sexually transmitted diseases has been normal fertility of male urinary tract secretions samples of Neisseria gonorrhoeae and Mycoplasma culture, Chlamydia detection, smear spirochetes, Mycobacterium tuberculosis, fungi, Trichomoniasis and other pathogens and enzyme-linked immunosorbent assay sperm anti-sperm, semen analyzer semen indicators and other data. Results The main pathogens of sexually transmitted diseases were Ureaplasma urealyticum, Chlamydia and Neisseria gonorrhoeae, the positive rates were 38.18%, 16.10% and 5.71% respectively, which were higher than those of the control group (12.15%, 7.48% and 0.93%, respectively) P <0.05). The positive rate of anti-sperm antibody was 45.31%, higher than 20.56% in non-infected group, the difference was statistically significant (P <0.01). In the infected group, the indexes of semen analysis in anti-sperm-positive patients were lower than that in anti-sperm antibody negative patients (P <0.01). Conclusions The major pathogens of sexually transmitted diseases are Mycoplasma, Chlamydia and Neisseria gonorrhoeae, which cause the body to produce anti-sperm antibody after causing genitourinary infection in men, resulting in the decline of semen parameters, leading to immune sterility.