慢性前列腺炎和男性不孕症:关联机制和研究进展
Zhang Qinyu1, Shi Jitao1, Xuan Yang2,3,4
1The Second School of Clinical Medicine, Zhejiang Chinese Medical University, 310053, Hangzhou, Zhejiang, China.
World journal of urology
|October 7, 2025
概括
慢性前列腺炎/慢性盆腔疼痛综合征 (CP/CPPS) 通过降低精子质量和增加DNA损伤,显著损害男性生育能力. 了解其复杂的机制是开发有效治疗这种疾病的关键.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 生殖医学 生殖医学
- 免疫学 免疫学 免疫学
背景情况:
- 慢性前列腺炎/慢性盆腔疼痛综合征 (CP/CPPS) 是一种常见的男性疾病.
- CP/CPPS与各种症状有关,包括盆腔疼痛和排泄功能障碍.
- 对于CP/CPPS对男性生育能力的影响仍然不完全理解.
研究的目的:
- 系统地检查CP/CPPS与男性不孕症之间的关联.
- 阐明将CP/CPPS与受损生育能力联系在一起的病理生理机制.
- 总结研究进展并为诊断和治疗策略提供信息.
主要方法:
- 综合了临床研究,元分析和实验数据.
- 检查的精液参数 (度,运动性,形态,DNA碎片) 和精液等离子体生物标志物.
- 探索了神经免疫内分泌,代谢,微循环,肠前列腺轴和线粒体通路.
主要成果:
- CP/CPPS显著降低了精子度,运动性和形态,同时增加了DNA碎片化.
- 关键的机制包括促炎性细胞因子,神经内分泌功能障碍,代谢综合征,肠道失生症和线粒细胞衰竭.
- 以表型为指导的多式疗法 (UPOINT) 在77.5%的患者中显示出显著的症状改善.
结论:
- 在CP/CPPS中男性不孕症的结果来自复杂的炎症,自身免疫,神经内分泌,代谢和线粒体路径.
- 未来的研究应该专注于线粒体自和表观遗传调节.
- 建议采用多学科的,以表型为导向的疗法来解决疼痛-炎症-不孕周期的问题.
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