不育男性精浆弹性蛋白酶水平与精液主要参数及精子DNA完整性的关系分析
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摘要
目的探讨不育男性精浆弹性蛋白酶(SPE)水平与精液主要参数及精子DNA完整性的关系。方法回顾分析2016年12月-2017年4月于广东省中医院就诊的112例不育患者的临床资料,根据SPE水平分为异常组(SPE≥600 ng/mL)和正常组(SPE<600 ng/mL),比较两组精液主要参数及精子DNA碎片指数(DFI)的差异;异常组患者细分为确认感染组(SPE>1 000 ng/mL)与疑似感染组(600≤SPE≤1 000 ng/mL),比较两组精液主要参数及DFI的差异。结果异常组精子总活力、前向运动精子百分率、正常形态精子百分率与正常组相比明显降低,异常组精子DFI明显高于正常组,差异均有统计学意义(P<0.05)。SPE异常患者中,确认感染组精子总活力、前向精子运动百分率明显低于疑似感染组,差异均有统计学意义(P<0.05)。112例不育男性SPE水平与DFI呈正相关(r=0.33,P=0.00)。结论 SPE水平异常对精子活力、精子形态、精子DNA完整性及损伤程度影响显著,对精液pH值、精子浓度、精子总数无明显影响;不论隐性感染还是疑似感染都对精子活力影响显著,对精液其他参数及DFI的影响无显著差异。
Objective To discuss the correlation of seminal plasma elastase(SPE)level with main semen parameters and sperm DNA integrity in infertile men. Methods The clinical data of 112 infertility patients from December 2016 to April2017 in Guangdong Provincial Hospital of Traditional Chinese Medicine were analyzed retrospectively. According to SPE level,they were divided into abnormal group(SPE≥600 ng/mL) and normal group(SPE<600 ng/mL);main semen parameters and sperm DNA fragment index(DFI)between two groups were compared. Patients in abnormal group were subdivided into confirmed infection group(SPE>1 000 ng/mL)and suspected infection group(600≤SPE≤1 000 ng/mL);the discrepancies between the two groups of main semen parameters and DFI were compared statistically. Results The sperm total motility,the rate of progressively motile sperm(PR),the rate of morphologically normal sperm in abnormal group were significantly lower than those in the normal group. DFI was dramatically higher in the abnormal group than in the normal group;differences were statistically significant(P<0.05). Among the patients with abnormal SPE,the sperm total motility and PR in the confirmed infection group were observably lower than those in the suspected infection group;differences were significant(P<0.05). Moreover,among the 112 infertile men,a positive correlation shown between DFI and SPE level(r=0.33,P=0.00). Conclusion Abnormal SPE level had a significant effect on sperm motility,sperm morphology,sperm DNA integrity,and degree of damage,while no significant effect on semen pH,sperm concentration,and sperm counting. Both infected and suspected infection patients had a significant effect on sperm motility;there was no significant difference in other parameters of semen and DFI.
Objective To discuss the correlation of seminal plasma elastase(SPE)level with main semen parameters and sperm DNA integrity in infertile men. Methods The clinical data of 112 infertility patients from December 2016 to April2017 in Guangdong Provincial Hospital of Traditional Chinese Medicine were analyzed retrospectively. According to SPE level,they were divided into abnormal group(SPE≥600 ng/mL) and normal group(SPE<600 ng/mL);main semen parameters and sperm DNA fragment index(DFI)between two groups were compared. Patients in abnormal group were subdivided into confirmed infection group(SPE>1 000 ng/mL)and suspected infection group(600≤SPE≤1 000 ng/mL);the discrepancies between the two groups of main semen parameters and DFI were compared statistically. Results The sperm total motility,the rate of progressively motile sperm(PR),the rate of morphologically normal sperm in abnormal group were significantly lower than those in the normal group. DFI was dramatically higher in the abnormal group than in the normal group;differences were statistically significant(P<0.05). Among the patients with abnormal SPE,the sperm total motility and PR in the confirmed infection group were observably lower than those in the suspected infection group;differences were significant(P<0.05). Moreover,among the 112 infertile men,a positive correlation shown between DFI and SPE level(r=0.33,P=0.00). Conclusion Abnormal SPE level had a significant effect on sperm motility,sperm morphology,sperm DNA integrity,and degree of damage,while no significant effect on semen pH,sperm concentration,and sperm counting. Both infected and suspected infection patients had a significant effect on sperm motility;there was no significant difference in other parameters of semen and DFI.
引文
[1]崔胜利,刘春玲,董洁.泌尿生殖道感染不育男性与精子活率、抗精子抗体的关系研究[J].中国性科学,2015,24(8):90-92.
[2]贝华锋,张晓霞,魏任雄,等.精浆弹性蛋白酶与精液常规参数及精子DNA完整性的相关性研究[J].中华男科学杂志,2014,20(10):902-906.
[3]Moretti E,Cosci I,Spreafico A,et al.Semen characteristics and inflammatory mediators in infertile men with different clinical diagnoses[J].Int J Androl,2009,32(6):637-646.
[4]Kopa Z,Wenzel J,Papp GK,et al.Role of granulocyte elastase and interleukin-6 in the diagnosis of male(下转第169页)genital tract inflammation[J].Andrologia,2005,37(5):188-194.
[5]Zorn B,Ihan A,Kopitar AN,et al.Changes in sperm apoptotic markers as related to seminal leukocytes and elastase[J].Reprod Biomde Online,2010,21(1):84-92.
[6]WHO.WHO laboratory manual for the examination and processing of huaman semen[M].5th Edition.Beijing:People′s Medical Publishing House,2011.
[7]Urbano M,Dorado J,Ortiz I,et al.Effect of cryopreservation and single layer centrifugation on canine sperm DNAfragmentation assessed by the sperm chromatin dispersion test[J].Anim Reprod Sci,2013,143(1-4):118-125.
[8]白志杰,张国辉.男性不育的相关病因小结[J].中国性科学,2016,25(3):11-14.
[9]Mania-Pramanik J,Potdar SS,Vadigoppula A,et al.Elastase:a predictive marker of inflammation and/or infection[J].J Clin Lab Anal,2004,18(3):153-158.
[10]朱文秀.精浆弹性蛋白酶在不育男性中的临床意义[J].大连:大连医科大学,2017.
[11]Zorn B,Sesek-Briski A,Osredkar J,et al.Semen polymorphonuclear neutrophil leukocyte elastase as a diagnostic and prognostic marker of genital tract inflammation-a review[J].Clin Chem Lab Med,2003,41(1):2-12.
[12]Zorn B,Virant-Klun I,Meden-Vrtovec H.Semen granulocyte elastase:its relevance for the diagnosis and prognosis of silent genital tract inflammation[J].Hum Reprod,2000,15(9):1978-1984.
[13]Eggert-Kruse W,Zimmermann K,Geissler W,et al.Clinical relevance of polymorphonuclear(PMN-)elastase determination in semen and serum during infertility investigation[J].Int J Androl,2009,32(4):317-329.
[14]何磊,万小妍,徐杰伟,等.白细胞精子症患者精液质量参数变化的初步研究[J].热带医学杂志,2015,15(3):328-330,361.
[15]Benchaib M,Braun V,Lornage J,et al.Sperm DNAfragmentation decreases the pregnancy rate in an assisted reproductive technique[J].Hum Reprod,2003,18(5):1023-1028.
[16]Ludwig M,Vidal A,Diemer T,et al.Chronic prostatitis/chronic pelvic pain pyndrome:seminal markers of inflammation[J].World J Urol,2003,21(2):82-85.
[2]贝华锋,张晓霞,魏任雄,等.精浆弹性蛋白酶与精液常规参数及精子DNA完整性的相关性研究[J].中华男科学杂志,2014,20(10):902-906.
[3]Moretti E,Cosci I,Spreafico A,et al.Semen characteristics and inflammatory mediators in infertile men with different clinical diagnoses[J].Int J Androl,2009,32(6):637-646.
[4]Kopa Z,Wenzel J,Papp GK,et al.Role of granulocyte elastase and interleukin-6 in the diagnosis of male(下转第169页)genital tract inflammation[J].Andrologia,2005,37(5):188-194.
[5]Zorn B,Ihan A,Kopitar AN,et al.Changes in sperm apoptotic markers as related to seminal leukocytes and elastase[J].Reprod Biomde Online,2010,21(1):84-92.
[6]WHO.WHO laboratory manual for the examination and processing of huaman semen[M].5th Edition.Beijing:People′s Medical Publishing House,2011.
[7]Urbano M,Dorado J,Ortiz I,et al.Effect of cryopreservation and single layer centrifugation on canine sperm DNAfragmentation assessed by the sperm chromatin dispersion test[J].Anim Reprod Sci,2013,143(1-4):118-125.
[8]白志杰,张国辉.男性不育的相关病因小结[J].中国性科学,2016,25(3):11-14.
[9]Mania-Pramanik J,Potdar SS,Vadigoppula A,et al.Elastase:a predictive marker of inflammation and/or infection[J].J Clin Lab Anal,2004,18(3):153-158.
[10]朱文秀.精浆弹性蛋白酶在不育男性中的临床意义[J].大连:大连医科大学,2017.
[11]Zorn B,Sesek-Briski A,Osredkar J,et al.Semen polymorphonuclear neutrophil leukocyte elastase as a diagnostic and prognostic marker of genital tract inflammation-a review[J].Clin Chem Lab Med,2003,41(1):2-12.
[12]Zorn B,Virant-Klun I,Meden-Vrtovec H.Semen granulocyte elastase:its relevance for the diagnosis and prognosis of silent genital tract inflammation[J].Hum Reprod,2000,15(9):1978-1984.
[13]Eggert-Kruse W,Zimmermann K,Geissler W,et al.Clinical relevance of polymorphonuclear(PMN-)elastase determination in semen and serum during infertility investigation[J].Int J Androl,2009,32(4):317-329.
[14]何磊,万小妍,徐杰伟,等.白细胞精子症患者精液质量参数变化的初步研究[J].热带医学杂志,2015,15(3):328-330,361.
[15]Benchaib M,Braun V,Lornage J,et al.Sperm DNAfragmentation decreases the pregnancy rate in an assisted reproductive technique[J].Hum Reprod,2003,18(5):1023-1028.
[16]Ludwig M,Vidal A,Diemer T,et al.Chronic prostatitis/chronic pelvic pain pyndrome:seminal markers of inflammation[J].World J Urol,2003,21(2):82-85.