弓形虫感染对雄性生殖健康影响的实验与临床研究

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目的研究弓形虫感染对雄性大鼠生育力的影响,调查男性不育患者弓形虫感染水平,探讨弓形虫感染对男性生殖健康的影响及其可能的致病机制。方法以30只成年雄性SD清洁级大鼠为研究对象,随机分为感染组,腹腔注射弓形虫速殖子2×105/ml 2 ml,阿奇霉素治疗组,腹腔注射弓形虫速殖子2×105/ml 2 ml。感染第2天以200 mg/(kg.d)剂量喂服阿奇霉素,连喂7 d;正常对照组腹腔注射灭菌生理盐水2 ml。9周后测定各组大鼠的生育力、附睾尾精子数、血清睾酮(T)、黄体生成素(LH)及卵泡刺激素(FSH)水平,睾丸组织酸性磷酸酶(ACP)、碱性磷酸酶(ALP)、乳酸脱氢酶X(LDH-X)和脂质过氧化物酶(LPO)活性。对169例男性不育患者和35例正常生育男性进行弓形虫感染的血清学调查,并检测精浆ACP、α-葡萄糖苷酶(α-Glu)、果糖(Fru)及NO水平。结果3组动物与雌鼠交配后,雌鼠的受孕率、平均产仔数感染组显著低于正常对照组、阿奇霉素治疗组(P均<0.05)。但胎鼠的平均身长、体重、尾长差异则均无统计学意义(P均>0.05);附睾尾精子数感染组(279.4±81.7)×106/g与正常对照组(380.9±121.8)×106/g、阿奇霉素治疗组(361.2±51.9)×106/g比较,差异有统计学意义(P均<0.05);精子活率感染组(48.84±4.63)%与正常对照组(79.84±2.93)%、阿奇霉素治疗组(69.40±3.57)%比较,差异有统计学意义(P均<0.05);感染组大鼠T浓度与正常对照组、阿奇霉素治疗组相比显著性下降(P均<0.05),血清LH也有下降,FSH无明显变化;感染组ACP为(61.4±7.08)U/mg,显著低于正常对照组(79.2±17.7)U/mg和阿奇霉素治疗组(79.0±13.1)U/mg(P均<0.05);感染组LDH-X为(76.7±7.89)U/mg,显著低于正常对照组(90.3±8.17)U/mg、阿奇霉素治疗组(89.3±13.08)U/mg(P均<0.05)。睾丸组织的ALP、LPO酶活性差异均无统计学意义(P均>0.05)。169例男性不育者精浆弓形虫感染率为18.35%,显著高于正常生育男性精浆弓形虫感染率的2.86%。31例男性不育患者精浆抗弓形虫IgG抗体阳性组的精浆ACP较阴性组及正常生育组低,差异有统计学意义(P均<0.05);169例男性不育患者精浆NO为(146.68±38.87)μmol/L,显著高于35例正常生育男性的(84.92±26.72)μmol/L(P<0.01);而3组α-Glu、Fru检测结果差异均无统计学意义(P均>0.05)。结论弓形虫感染对雄性生殖健康具有一定程度的影响。 Objective To study the effects of Toxoplasma gondii infection on fertility in male rats and to investigate the infection level of Toxoplasma gondii in male infertility and to explore the influence of Toxoplasma gondii infection on male reproductive health and its possible pathogenic mechanism. Methods Thirty adult male SD rats were randomly divided into 2 groups: infected group, intraperitoneal injection of Toxoplasma gondii 2 × 105 / ml 2 ml, azithromycin treatment group, intraperitoneal injection of Toxoplasma gondii 2 × 105 / ml 2 ml. On the second day of infection, the azithromycin was given at a dose of 200 mg / (kg.d) for 7 days. The normal control group was given 2 ml of sterile saline. After 9 weeks, the fertility, sperm count of epididymal sperm, serum testosterone (T), luteinizing hormone (LH) and follicle stimulating hormone (FSH), testicular tissue acid phosphatase (ACP), alkaline phosphatase Enzyme (ALP), lactate dehydrogenase X (LDH-X) and lipid peroxidase (LPO) activity. The serological investigation of Toxoplasma gondii infection in 169 male infertility patients and 35 normal fertile men was performed. The levels of ACP, α-Glu, Fru and NO were also measured. Results After mating with female rats, the pregnancy rate and average litter size of female rats were significantly lower than those of normal control group and azithromycin treatment group (all P <0.05). However, there was no significant difference in average body length, body weight and tail length of fetal rats (P> 0.05). The number of spermatozoa in spermatogenic tract (279.4 ± 81.7) × 106 / g was significantly higher than that in normal control group (380.9 ± 121.8) × (48.84 ± 4.63)% in the active infection group and 79.84 ± 2.93 in the normal control group (P <0.05). The difference was statistically significant (P <0.05) %, Azithromycin treatment group (69.40 ± 3.57)%, the difference was statistically significant (P all <0.05); the concentration of T in the infected group was significantly lower than that in the normal control group and azithromycin treatment group (all P < (P <0.05), serum LH also decreased and FSH had no significant change. The ACP in infected group was significantly lower than that in normal control group (79.2 ± 17.7 U / mg vs 79.0 ± 13.1 U / mg (P <0.05). The LDH-X in the infected group was (76.7 ± 7.89) U / mg, which was significantly lower than that in the normal control group (90.3 ± 8.17 U / mg and 89.3 ± 13.08 U / mg All <0.05). There was no significant difference in ALP and LPO activity in testis (P> 0.05). The infection rate of seminal plasma of T. gondii was 18.35% in 169 cases of male infertility, which was significantly higher than 2.86% of the normal pregnant women. In 31 male infertility patients, seminal plasma ACP in seminal plasma against Toxoplasma gondii was lower than that in negative group and normal fertility group (P <0.05), and NO in 169 male infertility patients was (146.68 ± 38.87) μmol / L, which was significantly higher than that of 35 normal fertile men (84.92 ± 26.72 μmol / L, P <0.01). There was no significant difference in the results of α-Glu and Fru All> 0.05). Conclusion Toxoplasma gondii infection has a certain impact on male reproductive health.
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