吸烟对男性不育患者生育能力的影响
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摘要
目的:分析男性不育门诊患者吸烟与精液参数、生殖系统感染及流产之间的相关性。方法:对男性不育门诊5 447例患者进行分组。按是否吸烟分为不吸烟组、≤10支/d组、11～20支/d组及>20支/d组;按烟龄分为≤5年组、6～10年组及>10年组。然后比较分组内各参数之间的差异,分析相关原因。结果:本研究发现吸烟明显减少精液量,降低精子浓度,减少精子总量,但是对前向运动精子及精子正常形态率影响不大。虽然吸烟组和不吸烟组配偶自然流产史百分率比较差异无统计学意义,但是烟龄长的自然流产率明显增加(P<0.05)。精子正常形态率与每日吸烟量有关。吸烟虽然能增加解脲支原体的感染率,但与细菌感染无关。结论:吸烟对精液质量有不良影响,大量吸烟对精液质量的影响尤为明显。我们应该提倡健康的生活方式,并尽量减少不良生活习惯对生育的影响。
Objective:To analyze the correlation among smoking,semen parameters,reproductive system infection and miscarriage in infertile male outpatients so as to guide clinical work.Method:There were 5 447 male infertility patients who were divided into two groups.One group,which was based on whether they smoke or not,was divided into non-smoking group,≤10 cigarettes smoked per day group,11-20 cigarettes smoked per day group,and over 20 cigarettes smoked per day group.The other group,according to the number of years of smoking,was divided into≤5 years group,6-10 years group,and the group of over 10 years.Then the difference among the parameters of the groups were compared,and the related reasons were analyzed.Result:The study found that smoking significantly reduced the amount of semen,sperm concentration,and the total amount of sperm.However,smoking had little effect on forward movement of sperms and normal sperm morphology.Although there was no difference in the percentage of spontaneous abortion between spouses of smokers and nonsmokers,the percentage of spontaneous abortion in spouses of longtime smokers significantly increased(P <0.05).Normal sperm morphology was correlated with the number of cigarettes smoked per day.Smoking can increase the infection rate of Ureaplasma urealyticum,but it has nothing to do with bacterial infection.Conclusion:Smoking had an adverse effect on semen quality,and the effect of heavy smoking on semen quality was particularly obvious.We should advocate a healthy lifestyle and minimize the impact of bad habits on fertility.
Objective:To analyze the correlation among smoking,semen parameters,reproductive system infection and miscarriage in infertile male outpatients so as to guide clinical work.Method:There were 5 447 male infertility patients who were divided into two groups.One group,which was based on whether they smoke or not,was divided into non-smoking group,≤10 cigarettes smoked per day group,11-20 cigarettes smoked per day group,and over 20 cigarettes smoked per day group.The other group,according to the number of years of smoking,was divided into≤5 years group,6-10 years group,and the group of over 10 years.Then the difference among the parameters of the groups were compared,and the related reasons were analyzed.Result:The study found that smoking significantly reduced the amount of semen,sperm concentration,and the total amount of sperm.However,smoking had little effect on forward movement of sperms and normal sperm morphology.Although there was no difference in the percentage of spontaneous abortion between spouses of smokers and nonsmokers,the percentage of spontaneous abortion in spouses of longtime smokers significantly increased(P <0.05).Normal sperm morphology was correlated with the number of cigarettes smoked per day.Smoking can increase the infection rate of Ureaplasma urealyticum,but it has nothing to do with bacterial infection.Conclusion:Smoking had an adverse effect on semen quality,and the effect of heavy smoking on semen quality was particularly obvious.We should advocate a healthy lifestyle and minimize the impact of bad habits on fertility.
引文
1 Cheek J H.Treatment of male infertility[J].Clin Exp Obstet Gynecol,2007,34(4):201-206.
2谷翊群,陈振文,卢文红,等译.世界卫生组织人类精液检查与处理实验室手册[M].北京:人民卫生出版社,2011:8-8.
3叶应妩,王毓三,申子瑜.全国临床检验标准操作规程[M].3版.南京:东南大学出版社,2006:715-923.
4 Practice Committee of American Society for Reproductive Medicine.Smoking and infertility[J].Fertil Steril,2008,90(5Suppl):S254-S259.
5 Al-Turki H A.Effect of smoking on reproductive hormones and semen parameters of infertile Saudi Arabians[J].Urol Ann,2015,7(1):63-66.
6龚国通,李大文,成俊萍,等.吸烟量对男性精液质量及体外受精结局的影响[J].广西医学,2015,37(7):900-903.
7钱英超,隋洪.吸烟对男性精液质量的影响分析[J].检验医学与临床,2015,12(20):3095-3097.
8李强,崔向荣,井宣.吸烟对男性精液质量、精子DNA完整性及Chk1基因表达的影响[J].生殖医学杂志,2015,24(12):1019-1024.
9宋岳强,沙艳伟,郑仁瑞,等.男性职业、吸烟及精液质量与自然流产的相关性[J].中国妇幼保健,2011,26(20):3127-3129.
10 Khadem N,Poorhoseyni A,Jalali M,et al.Sperm DNAfragmentationin couples with unexplained recurrent spontaneous abortions[J].Andrologia,2014,46(2):126-130.
11 Absalan F,Ghannadi A,Kazerooni M,et al.Value of sperm chromatindispersion test in couples with unexplained recurrent abortion[J].J Assist Reprod Genet,2012,29(1):11-14.
12张俊峰,彭炜,王涛,等.精子DNA碎片及其在不育症诊治中的应用[J].临床泌尿外科杂志,2018,33(8):669-674.
13 Urióstegui-Acosta M,Hernández-Ochoa I,SánchezGutiérrez M,et al.Methamidophos alters sperm function and DNA at differentstagesofspermatogenesis in mice[J].Toxicol Appl Pharmacol,2014,279(3):391-400.
14 Zatecka E,Castillo J,Elzeinova F,et al.The effect of tetrabromobisphenolA on protamine content and DNAintegrity in mouse spermatozoa[J].Andrology,2014,2(6):910-917.
15 Gorpinchenko I,Nikitin O,Banyra O,et al.The influence of directmobile phone radiation on sperm quality[J].Cent European J Urol,2014,67(1):65-71.
16 Sellami H,Znazen A,Sellami A,et al.Molecular detection of Chlamydia trachomatis and other sexually transmitted bacteria insemen of male partners of infertile couples in Tunisia:the effect onsemen parameters and spermatozoa apoptosis markers[J].PLoS One,2014,9(7):e98903.
17 Komiya A,Kato T,Kawauchi Y,et al.Clinical factors associatedwith sperm DNA fragmentation in male patients with infertility[J].Scientific World Journal,2014,2014:868303.
18 Pakrashi A,Chatterjee S.Effect of tobacco consumption on the function of male accessory sex glands[J].Int JAndrol,1995,18(5):232-236.
2谷翊群,陈振文,卢文红,等译.世界卫生组织人类精液检查与处理实验室手册[M].北京:人民卫生出版社,2011:8-8.
3叶应妩,王毓三,申子瑜.全国临床检验标准操作规程[M].3版.南京:东南大学出版社,2006:715-923.
4 Practice Committee of American Society for Reproductive Medicine.Smoking and infertility[J].Fertil Steril,2008,90(5Suppl):S254-S259.
5 Al-Turki H A.Effect of smoking on reproductive hormones and semen parameters of infertile Saudi Arabians[J].Urol Ann,2015,7(1):63-66.
6龚国通,李大文,成俊萍,等.吸烟量对男性精液质量及体外受精结局的影响[J].广西医学,2015,37(7):900-903.
7钱英超,隋洪.吸烟对男性精液质量的影响分析[J].检验医学与临床,2015,12(20):3095-3097.
8李强,崔向荣,井宣.吸烟对男性精液质量、精子DNA完整性及Chk1基因表达的影响[J].生殖医学杂志,2015,24(12):1019-1024.
9宋岳强,沙艳伟,郑仁瑞,等.男性职业、吸烟及精液质量与自然流产的相关性[J].中国妇幼保健,2011,26(20):3127-3129.
10 Khadem N,Poorhoseyni A,Jalali M,et al.Sperm DNAfragmentationin couples with unexplained recurrent spontaneous abortions[J].Andrologia,2014,46(2):126-130.
11 Absalan F,Ghannadi A,Kazerooni M,et al.Value of sperm chromatindispersion test in couples with unexplained recurrent abortion[J].J Assist Reprod Genet,2012,29(1):11-14.
12张俊峰,彭炜,王涛,等.精子DNA碎片及其在不育症诊治中的应用[J].临床泌尿外科杂志,2018,33(8):669-674.
13 Urióstegui-Acosta M,Hernández-Ochoa I,SánchezGutiérrez M,et al.Methamidophos alters sperm function and DNA at differentstagesofspermatogenesis in mice[J].Toxicol Appl Pharmacol,2014,279(3):391-400.
14 Zatecka E,Castillo J,Elzeinova F,et al.The effect of tetrabromobisphenolA on protamine content and DNAintegrity in mouse spermatozoa[J].Andrology,2014,2(6):910-917.
15 Gorpinchenko I,Nikitin O,Banyra O,et al.The influence of directmobile phone radiation on sperm quality[J].Cent European J Urol,2014,67(1):65-71.
16 Sellami H,Znazen A,Sellami A,et al.Molecular detection of Chlamydia trachomatis and other sexually transmitted bacteria insemen of male partners of infertile couples in Tunisia:the effect onsemen parameters and spermatozoa apoptosis markers[J].PLoS One,2014,9(7):e98903.
17 Komiya A,Kato T,Kawauchi Y,et al.Clinical factors associatedwith sperm DNA fragmentation in male patients with infertility[J].Scientific World Journal,2014,2014:868303.
18 Pakrashi A,Chatterjee S.Effect of tobacco consumption on the function of male accessory sex glands[J].Int JAndrol,1995,18(5):232-236.