人精浆中端粒酶活性测定及其临床意义

UDY ON TELOMERASE ACTIVITY IN HUMAN SEMINAL PLASMA AND ITS CLINICAL SIGNIFICANCE

目的观察精浆端粒酶活性(TA)在不同类型男性不育症患者中的变化,以及与精浆睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)浓度之间及精液中精子数量和质量之间的相互关系。方法随机选取110例男性不育症患者与30例生育者,应用酶联免疫吸附(ELISA)方法,对其精浆TA进行检测;应用放射免疫分析(RIA)方法对其精浆T、FSH、LH浓度进行检测;按WHO规定的方法,定量分析精液中的精子密度、精子活率、a+b级精子活力百分率、精液中白细胞数量。结果不育症组精浆TA和T浓度均明显低于生育组(P均<0.01);不育症组精浆FSH和LH浓度均明显高于生育组(P均<0.05)。在不育症组中,随着精液中精子数量的递减,TA水平亦呈现逐渐下降趋势;精浆中TA与T浓度之间存在明显的相关性(r=0.236,P<0.01),与FSH和LH浓度之间无相关性(P>0.05);精子活力、活率正常组精浆TA均高于不良组(P<0.01);WBC精液组精浆TA高于非WBC精液组(P<0.05)。结论精浆TA水平与精子数量和质量存在一定的相关性,同时与精子发育密切相关的睾酮浓度有协同促进作用,端粒酶在人类生殖发育中发挥着重要作用。检测精浆TA水平对于进一步了解、预防和治疗某些病理状态下所致的生殖能力低下有重要意义。

Objective To observe the changes of seminal plasma telomerase activity （TA） in patients with different types of male infertility, to observe the relationship in seminal plasma of TA, testosterone（T）, follicle stimulating hormone（FSH）, luteinizing hormone（LH）, sperm quantity and sperm quality. Methods 110 cases with different types of male infertility and 30 normal fertile males were selected randomly. The concentration of TA was determined by enzyme- linked immunosorbent assay （ELISA） ; The concentrations of T, FSH and LH were determined by radioirnmunoassay （RIA） ; Sperm density, percentage of sperm survival, percentage of a ＋ b level sperm motility and the count of white blood cells in semen were analyzed lay methods prescribed by the WHO. Results Concentrations of TA, T in seminal plasma were significantly lower in infertility group compared with fertility group （all P 〈0.01） ; Concentrations of FSH, LH in seminal plasma were significantly higher in infertility group compared with fertility group （all P 〈 0.05）. In the infertility group, TA concentration showed significant declining trend with the decreasing number of sperm in semen; TA concentration was positively correlated with T concentration in seminal plasma significantly （ P 〈0.01）, however, there was no significant correlation between TA and FSH or LH （ P 〉0. 05）. The concentrations of TA in seminal plasma were significantly higher in groups with normal sperm vitality and activity than those in groups with abnormal sperm vitality and activity （ P 〈0.01 ）. The concentrations of TA were significantly higher in WBC semen group than those in non - WBC group （ P 〈 0.05）. Conclusion There is some relationship between TA concentration, sperm quantity and quality, and at the same time, there is synergistic action between TA and T which are closely related to the sperm development. It has been proved that TA plays an important role in human reproduction and development, and the levels of TA in seminal plasma can be used for the future exploration, prevention and treatment of fertility induced by pathological status.