摘要目的:应用Meta分析评估解脲支原体与精液质量的关系。方法:参照Cochrane系统评价原则，检索时间为建库至2019年11月31日，在Ovid MEDLINE(R) 、Embase、Central等数据库中，检索"Sperm Vitality" 、"Sperm count" 、"Sperm concentration" 、"Sperm morphology" 、"Sperm quality" 、"Semen quality" 、"Ureaplasma urealyticum"关键词，纳入解脲支原体与精液质量相关的文献，提取合格文章数据，并对精液参数指标分为生育组、不育组进行相关统计学分析。结果:共纳入19篇文献，包含30 572例病例。不育解脲支原体阳性率显著高于生育组，差异有统计学意义( P<0.01)。在不育组中，与解脲支原体阴性患者比较，解脲支原体阳性患者的精液量减少0.28 mL(95% CI：-0.45～-0.12)，精子密度下降11.80×10 6/mL(95% CI：-17.53～-6.07)，前向运动降低4.61%(95% CI：-7.01～-2.22)，正常形态精子降低4.17%(95% CI：-5.66～-2.69)，差异均有统计学意义( P<0.01)，而在生育组中精液量无明显改变，差异无统计学意义( P>0.01)。生育组与不育组的精液pH值比较，差异无统计学意义( P>0.01)。 结论:解脲支原体阳性对不育男性患者精液质量有不利影响，且明显降低其精子密度、正常形态精子这两项指标水平。

abstractsObjective:To evaluate the relationship between ureaplasma urealyticum and semen quality by Meta-analysis.Methods:According to the Cochrane system evaluation principle, we selected Ovid MEDLINE(R), EMBASE, central and other databases at http: //ovidsp.dc2.ovid.com to retrieve(" sperm vitality" or " sperm count" or " sperm concentration" or " sperm morphology" or " sperm quality" or " semen quality" ). ab, ti.And (" Ureaplasma urealyticum" ). ab, ti. Ureaplasma urealyticum and the quality of semen were searched and included, and the literatures were evaluated from three aspects of authenticity, reliability and practicability, the eligible article data were extracted and statistical analyzed by RevMan 5.3 software.Results:A total of 19 articles were included, including 30 572 cases, male infertility vs. male fertility.Ureaplasma urealyticum positive rate: RR=1.88, 95% CI: 1.23-2.86, Z=2.91( P=0.004). Ureaplasma urealyticum positive vs. ureaplasma urealyticum negative: ①Semen volume(mL): MD=- 0.25, 95% CI: - 0.40--0.11; Z=3.35( P=0.0008). Male infertility subgroup: MD=- 0.28, 95% CI: -0.45--0.12; Z=3.31( P=0.0009). Fertility subgroup: MD=-0.13, 95% CI: -0.57-0.31; Z=0.56( P=0.58). ②pH value: MD=-0.04, 95% CI=-0.12-0.03; Z=1.06( P=0.29). Male infertility subgroup: MD=- 0.09, 95% CI: - 0.18-0.01; Z=1.82( P=0.07). Fertility subgroup: MD=0.06, 95% CI: -0.11-0.23; Z=0.70( P=0.48). ③Sperm density (×10 6/mL): MD=-10.55, 95% CI=-15.49--5.61; Z=4.19( P<0.0001). Male infertility subgroup: MD=- 11.80, 95% CI=-17.53--6.07; Z=4.03( P<0.0001). Fertility subgroup: MD=-5.58, 95% CI; -14.48-3.32; Z=1.23( P=0.22). ④Forward motility sperm rate(%): MD=- 3.67, 95% CI=-5.68--1.67; Z=3.59( P=0.0003). Male infertility subgroup: MD=-4.61, 95%CI=-7.01--2.22; Z=3.77( P=0.0002). Fertility subgroup: MD=-0.41, 95% CI=-1.91-1.09; Z=0.53( P=0.59). ⑤Normal sperm morphology (%): MD=-3.84, 95% CI=-5.21--2.48; Z=5.53( P<0.00001). Male infertility subgroup: MD=-4.17, 95%CI=-5.66--2.69; Z=5.52( P<0.00001). Fertility subgroup: MD=-0.89, 95% CI=-2.10-0.32; Z=1.44( P=0.15). Conclusions:Ureaplasma urealyticum positivity has a negative effect on the semen quality of infertile men, and significantly reduces sperm density and normal sperm morphology.