精浆蛋白酶的筛查试验在无症状性生殖道炎症诊断中意义

The significance of protease screening test in seminal plasma for diagnosing silent genital tract inflammation

目的研究男性不育患者精浆中弹性蛋白酶的含量变化和临床意义,探讨其在诊断无症状性生殖道炎症中的作用。方法收集140例不育症门诊患者的精浆标本(实验组),其中80例按WHO标准诊断为弱精子症,60例为精液常规正常的不育症男性。所有患者都没有生殖道感染的症状,3个月前无抗菌治疗史。所有患者都是自愿参加本研究的。采用ELISA双抗体夹心酶联免疫吸附法检测患者精浆弹性蛋白酶水平,20例生育男性作对照。结果(1)140例不育男性患者精浆中的弹性蛋白酶明显高于生育男性(P<0.01);(2)弹性蛋白酶浓度与患者年龄(r=0.255,P<0.01)及精液中白细胞数(r=0.569,P<0.01)有正相关关系;(3)弹性蛋白酶浓度与精液量(r=-0.537,P<0.01)呈负相关关系。结论精浆中弹性蛋白酶检测对诊断无症状性生殖道炎症是一种可靠的筛查试验。

Objective To study the clinical significance and the change of neutrophil elastase concentration in seminal plasma of infertile patients, in oder to investigate the role of elastase for diagnosis and prognosis of silent genital tract inflammation. Methods 140 seminal plasma samples of out-patient （study group） with infertility were collected, including 80 cases of asthenospermia men and 60 cases of normozoospermic men. None of the patients had clinical signs or symptoms of a genital tract infection. None had been treated by antibiotics within 3 months before enrolment into the study. All patients had given their informed consent for participation. Elastase concentration in seminal plasma was measured by ELISA method. The control group consisted of 20 fertile men who fathered children spontaneously within the study period. Results （1） The prevalence of increased seminal elastase in 140 infertile men was significantly higher as compared with that observed in 20 fertile men （P〈0.01）. （2）A significant positive correlation was found between elastase concentration and patients, age （r=0.255, P〈0.01） and the number of leukocytes （r=0.569, P〈0.01）. （3） A negative correlation was found between elastase concentration and semen volume （r=-0.537, P〈0.01）. Conclusion Seminal granulocyte elastase is a reliable screening test for silent genital tract inflammation of the couple.