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91Vol.9No.120032NationalJournalofAndrologyFeb.2003##郭应禄1,李宏军2(11,100034;21,210002):,,,:;:R697:A:1009-3591(2003)01-0001-06¹TheChallengeofMaleReproductiveHealthYing-LuGUO1,Hong-JunLI2(1.InstituteofUrology,PekingUniversity,Beijing100034,China;2.LaboratoryofReproductionandGenetics,NanjingGeneralHospitalofNanjingCommand,PLA,Nanjing210002,China)Abstract:Recently,researchonmalereproductiveabilitybringsalongtheconcernonmalereproductivehealth.Atpresenttime,thesituationofreproductivehealthwasnotoptimisticandmanyproblemsneedtobesolved.Inthisarticle,manyimportanttopicswereincluded,suchasthechangingandthepossiblereasonsofmalereproductivehealth;muchconcernwasneededforbabies,children,andmalejuvenile;increasingtendencyoftheinfectionratesofmaleurogenitalsystem;researchonmaleinfertilityneededtobeex-ploreddeeply;therewasnosatisfactorymethodsformalecontraception;thediagnosisandtreatmentofmaleerectiledysfunctionwerenotsufficientfortheneed;researchonandropausewasattheprimarystage;liferegimeofmenneededtobeadjusted.ConcerningformalereproductivehealthistheresponsibilityofbothmedicalworkersandwholesocietyNatlJAndrol,2003,9(1):1-6Keywords:Male;Reproductivehealth1988,(WHO),[1],2010;;,,;,;#1#¹:2002-09-22:(1930-),,,,,,,56,,,,[1],,[2],,,[2~4]11.1人类精液质与量的改变Saidi[5]29,60,:[1]Carlsen(1992)231494761,20,,,2%[1],,1.2睾丸癌隐睾与男性生殖道的先天性畸形,,3.6~5.2,,,(2);,12,,8[6],,,,,()(MIS),,1.3性别比率的改变,Moller450,,1,2--3-,,[1]1.4男性生殖健康改变的原因,,(Sertolicell),(FSH)SertolicellSertolicell,FSH,,,,,[1]2,,,,,,(),,#2#200329[7],,,9.2%~30%,3.4%~5.8%,,,,,[6],,,,,30%,,,,,,,,,[8],[9],[10,11],,,,,,;,,,,,,,,3,[12,13\,,,,,[14,15\,,,,,,,[12]48%,5%~35%,,,10%,(WHO)19805-6,19871992,1999,1993WHO/0(assistedreproductivetechniques,ART),,,ART,,ART,#3#1(artificialinsemination,AI)(GIFT)(IVF-ET)(ICSI),ICSI,,,ART,,(preimplanta-tiongeneticdiagnosis,PGD),[16],ART5,,,,,/0,,,/06(erectiledysfunction,ED),,,(Viagra),ED,,,,ED,,,,ED,ED[17],ED,EDED,,,,[17]ED,,,,ED,,[17],,,,,,,ED,,[17],,,7[18],,(maleclimacteric/andropause)(ADAM)1994/0(partialandrogendeficiencyoftheagingmale,PADAM),,,,,[19~21],,,,#4#200329[22]1998,2050,6015,138010%,,[20],,,,,PADAM,,,[21],,,,,[23~26],,,PADAM,PADAM,,88.1禁止食用影响生育的食物,,;,,;(),,,,,,,,,8.2避免接触损害生殖功能的物质,,,,,[1,27],,,,,,,,,,,/08.3节制或戒除烟酒嗜好,,,--[28],;,,;,;,8.4不要滥用药物,,,,,,,(),/0,,,,#5#18.5适量补充某些微量元素,,:,,,,,,,,,9/0,,,,,,,,,,,,,,,,[4][1]IrvineDS.Malereproductivehealth:causeforconcern[J]?An-drologia,2000,32(4-5):195-208.[2],,.[J].,2002,11(2):84-90.[3],,,.24[J].,2002,11(2):79-83.[4],,.21[J].,2001,1(5):465-466.[5]SaidiJA,ChangDT,GoluboffET,etal.DecliningspermcountsintheUnitedStates?Acriticalreview[J].JUrol,1999,161(2):460-462.[6]OhJ,LandmanJ,EversA,etal.Managementofthepostpu-bertalpatientwithcryptorchidism:anupdatedanalysis[J].JUrol,2002,167(3):1329-1333.[7]NasrallahP,NairG,CongeniJ,etal.Testicularhealthaware-nessinpubertalmales[J].JUrol,2000,164(3Pt2):1115-1117.[8]KassEJ,StorkBR,SteinertBW.Varicoceleinadolescencein-ducesleftandrighttesticularvolumeloss[J].BriJUrol,2001,87(6):499-501.[9]JarowJP.Effectsofvaricoceleonmalefertility[J].HumReprodUpdate,2001,7(1):59-64.[10]PintusC,RodriguezMJ,ManzoniC,etal.Varicoceleinped-iatricpatients:comparativeassessmentofdifferenttherapeuticap-proaches[J].Urology,2001,57(1):154-157.[11]RichterF,StockJA,LasalleM,etal.Managementofprepu-bertalvaricoceles-resultsofaquestionnairestudyamongpediatricurologistsandurologistswithinfertilitytraining[J].Urology,2001,58(1):98-102.[12],.[M].:,2002.413-426,470-480.[13]KassEH.Asymptomaticinfectionsoftheurinarytract[J].JUrol,2002,168(2):420-423.[14]VigilP,MoralesP,TapiaA,etal.Chlamydiatrachomatisin-fectioninmalepartnersofinfertilecouples:incidenceandspermfunction[J].Andrologia,2002,34(3):155-161.[15]DeguchiT,MaedaSI.Mycoplasmagenitalium:anotherimpor-tantpathogenofnongonococcalurethritis[J].JUrol,2002,167(3):1210-1217.[16],.[J].,2002,11(2):124-127.[17],.[J].,2002,8(6):438-441.[18],,.[J].,1998,19(7):441-444.[19]KesselB.Sexualityintheolderperson[J].AgeAgeing,2001,30(2):121-124.[20]MoralesA,HeatonJPW,CarsonCC.Andropause:amisnomerforatrueclinicalentity[J].JUrol,2000,163(3):705-712.[21].[J].,2001,20(6):462-464.[22]SchulmanCC.Theagingmale:achallengeforurologists[J].CurrOpininUrol,2000,10(4):337-342.[23]BhasinS,BuckwalterAJG.Testosteronesupplementationinold-ermen:arationalideawhosetimehasnotyetcome[J].JAn-drol,2001,22(5):718-731.[24]ComhaireFH.Andropause:hormonereplacementtherapyintheageingmale[J].EurUrol,2000,38(6):655-662.[25]MoralesA,LunenfeldB.Androgenreplacementtherapyinagingmenwithsecondaryhypogonadism[J].AgingMale,2001,4(3):151-162.[26]TenoverJL.[J].,2001,7(3):141-146.[27]AdlerID.Spermatogenesisandmutagenicityofenvironmentalhazards:extrapolationofgeneticriskfrommousetoman[J].Andrologia,2000,32(4-5):233-237.[28],,,.[J].,2002,8(1):35-37.()#6#200329