[摩洛哥不育男性群体中抗沙眼衣原体IgG的患病率及作用]

[Prevalence and role of IgG anti-Chlamydia trachomatis in a population of infertile men in Morocco].

作者信息

Frikh M, Mrimar N, Kasouati J, Hamzaoui A, Maleb A, Lemnouer A, Choukairi O, Barkiyou M, El Ouennass M

机构信息

Service de bactériologie, hôpital militaire d'instruction Mohammed V, faculté de médecine et pharmacie, université Mohammed V, avenue des FAR, Hay Riad, 10100 Rabat, Maroc.

Service d'hygiène et de médecine de collectivité, hôpital militaire d'instruction Mohamed V Rabat, université Mohammed V, Rabat, Maroc.

出版信息

Prog Urol. 2019 Oct;29(12):612-618. doi: 10.1016/j.purol.2019.08.261. Epub 2019 Aug 28.

DOI:10.1016/j.purol.2019.08.261

PMID:31473105

Abstract

INTRODUCTION

Infertility is a global public health problem that affects 15% of couples of childbearing age. Male infertility is involved in 20 to 50% of cases. These figures are sharply increasing around the world. Several factors may be responsible for this infertility with especially hormonal, genetic, toxic or infectious factors. The latter are dominated mainly by Chlamydia infection. Among the most serious complications of this infection are infertility related to urethritis, epididymitis and irreversible total azoospermia in men and tubal obstructions and ectopic pregnancies in women.

STUDY OBJECTIVE

To determine the prevalence of IgG anti-Chlamydia trachomatis in men consulting for infertility and the association between previous contact with this bacterium and the impairment of sperm quality and sperm function.

MATERIAL AND METHODS

Prospective study over 26months of 143 patients referred to the service for infertility assessment of the couple. Demographic data, primary or secondary character of infertility, risk factors (tobacco, inguinal hernia, varicocele and history of urogenital infections), semen parameters (volume, mobility, pH, vitality and morphological abnormalities) were studied as well as the determination of the anti-C. trachomatis IgG titer. The prevalence of Chlamydia infection and the association of the infection and alteration of the various parameters of the semen were analyzed.

RESULTS

The average age of patients was 38.5±8.55. Infertility was primary in 72% of patients. Among the patients, 54.5% had an abnormal spermogram. Chlamydia IgG antibodies were positive in 37.1% of patients whose 58.5% had abnormal spermogram. Analysis of sperm parameters of patients with and without IgG C. trachomatis showed an altered vitality in Chlamydia positive patients with an OR at 2.41, P=0.02, (95% CI: 1.15-5.06).

CONCLUSION

The prevalence of Chlamydia infection is high in infertile male. C. trachomatis IgG antibodies may be associated with an alteration of spermatozoa vitality without significant impairment of other semen parameters.

LEVEL OF EVIDENCE

摘要

引言

不孕症是一个全球性的公共卫生问题，影响着15%的育龄夫妇。男性不育在20%至50%的病例中存在。这些数字在全球范围内急剧上升。多种因素可能导致这种不育，尤其是激素、遗传、毒性或感染因素。后者主要以衣原体感染为主。这种感染最严重的并发症包括男性因尿道炎、附睾炎导致的不育以及不可逆的完全无精子症，女性则包括输卵管阻塞和异位妊娠。

研究目的

确定因不育前来咨询的男性中抗沙眼衣原体IgG的患病率，以及既往接触该细菌与精子质量和精子功能受损之间的关联。

材料与方法

对转诊至该科室进行夫妇不育评估的143名患者进行了为期26个月的前瞻性研究。研究了人口统计学数据、不育的原发性或继发性特征、危险因素（烟草、腹股沟疝、精索静脉曲张和泌尿生殖系统感染史）、精液参数（体积、活力、pH值、存活率和形态异常）以及抗沙眼衣原体IgG滴度的测定。分析了衣原体感染的患病率以及感染与精液各项参数改变之间的关联。

结果

患者的平均年龄为38.5±8.55岁。72%的患者不育为原发性。在患者中，54.5%的人精液分析异常。37.1%的患者沙眼衣原体IgG抗体呈阳性，其中58.5%的人精液分析异常。对有和没有沙眼衣原体IgG的患者的精子参数分析显示，衣原体阳性患者的精子存活率改变，优势比为2.41，P=0.02，（95%可信区间：1.15-5.06）。