男性不育患者细胞因子水平与抗精子抗体、精液参数的关系

Study on the Serum and Seminal Plasma Concentrations of Several Cytokines Antisperm Antibodies as well as Semen Parameters in Infertile Males

目的:探讨患有慢性前列腺炎(CP)的男性不育患者前列腺液(EPS)、血清、精浆中细胞因子水平及血清和精浆中抗精子抗体(AsAb)对男性生育能力的影响。方法:对60例男性不育患者和30例正常生育者进行前列腺液(EPS)常规、精液主要参数检测,采用酶联免疫吸附试验(ELISA)检测EPS、血清、精浆中IL-2、IL-6、TNF-α及血清AsAb,采用免疫珠试验(IBT)法检测精浆AsAb,分析三种细胞因子与AsAb的产生、男性不育相关因素的关系。结果:伴有CP不育患者的EPS、精浆中细胞因子(IL-2、TNF-α、IL-6)的水平明显高于对照组(P<0.001),同时AsAb的阳性率也高于正常对照(P<0.05);不育组中精浆AsAb阳性组的精子活率、a+b级精子百分率均明显低于精浆AsAb阴性组(P<0.05),精浆AsAb阳性组精浆中的TNF-α水平明显高于精浆AsAb阴性组(P<0.05),精浆TNF-α与血清AsAb阳性率存在正相关关系(r=0.312,P<0.05)。结论:慢性前列腺炎患者来自EPS中的细胞因子对精液主要参数有影响,并与血清及精浆中AsAb的产生有关,是导致男性不育的原因之一。

Objective To study the expressed seminal fluid （EPS）, serum and seminal plasma contents of several cytokines （IL-2, IL-6, TNF-α） and antisperm antibody （AsAb） in infertile males with chronic prostatis. Methods IL-2, IL-6, TNF-α （with ELISA） contents in serum, EPS and seminal plasma, AsAb in serum （with ELISA） and AsAb in Seminal fluid （with immunobead test IBT） as well as semen parameters and EPS routine were stadied in 60 infertile males with chronic prostatis and 30 controls. Results The EPS and seminal plasma contents of IL-2, IL-6 and TNF-α in infertile males were significantly higher than those in controls （P〈0.001）, the positive rate of AsAb was also significantly bigher （P〈0.05）. Among the infertile males, in those with positive seminal plasma AsAb （n=17） the semen parameters demonstrated quality inferior to that in seminal plasma AsAb negative ones （n=43） （P〈0.05）. Also, the seminal plasma contents of TNF-α in AsAb positive ones were significantly higher than those in AsAb negative ones （P〈0.05）. The seminal plasma TNF-α contents were positively correlated with the positive serum AsAb rate （r=0.312, P〈0.05）. Conclusion The increased cytokines contents in EPS in patients with chronic prostatis was detrimental to quality of sperm as demonstrated by the semen parameters and might be also related to the production of AsAb （in serun and seminal plasma）, leading to infertility.