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目的探讨高压氧(HBO)配合抗生素治疗慢性细菌性前列腺炎(CBP)所致不育的临床疗效及机制。方法将CBP不育患者83例按就诊的不同阶段分成两组,A组(51例)为抗生素配合高压氧治疗组,B组(32例)为单纯抗生素治疗组。结果A组的治愈率明显高于B组(P<0．01),A组无效率明显低于B组(P<0．01)。A组精液液化率治疗前后有明显改善(P<0．05),且较B组治疗后改善明显(P <0．05)。两组患者在治疗前后精子密度、精子活率、a、b级精子数方面都有改善(P<0．01或P<0．05),且A组较B组治疗后改善更大(P<0．01或P<0．05)。A组患者在治疗前后精浆Zn、SOD、AsAb转阴率、EPS-WBC、SPA方面都有明显改善(P<0．01),B组在EPS-WBC、SPA方面亦有改善(P<0．01),A组较B组治疗后在精浆Zn、SOD、AsAb阴转率、EPS-WBC、SPA方面改善更大(P<0．01或P<0．05)。A组较B组配偶受孕率明显高(P<0．01),且A组治疗后配偶受孕时间较B组提前(P<0．05)。结论抗生素配合HBO治疗较单纯抗生素治疗CBP不育,能够更有效的改善精液质量、提高受孕机率。
Objective To investigate the clinical efficacy and mechanism of hyperbaric oxygen (HBO) combined with antibiotics in the treatment of infertility caused by chronic bacterial prostatitis (CBP). Methods Eighty-three patients with CBP infertility were divided into two groups according to different stages of treatment. Group A (51 cases) was treated with antibiotics combined with hyperbaric oxygen and group B (32 cases) with antibiotics alone. Results The cure rate of group A was significantly higher than that of group B (P <0.01). The inefficiency of group A was significantly lower than that of group B (P <0.01). A group of semen liquefaction rate was significantly improved before and after treatment (P <0.05), and compared with the B group improved significantly after treatment (P <0.05). The sperm density, sperm motility rate, a, b grade sperm count in both groups were improved before and after treatment (P <0.01 or P <0.05), and group A improved more than group B after treatment <0.01 or P <0.05). The levels of Zn, SOD, AsAb negative rate, EPS-WBC and SPA in group A were significantly improved before and after treatment (P <0.01), and in group B were also improved in EPS-WBC and SPA (P < 0.01). Compared with group B, group A improved significantly in the seminal plasma Zn, SOD, AsAb negative conversion rate, EPS-WBC and SPA (P <0.01 or P <0.05). The pregnancy rate of spouses in group A was significantly higher than that in group B (P <0.01), and the conception time of spouses in group A was earlier than that in group B (P <0.05). Conclusion Antibiotics combined with HBO is more sterile than CBP in treating CBP infertility, which can effectively improve the quality of semen and improve the chance of conception.