男性不育伴慢性病毒性肝炎患者血清和精液氧化应激水平及相关参数分析

Oxidative stress and semen parameters in the serum and seminal plasma of infertile men with chronic viral hepatitis

目的:探讨男性不育伴慢性病毒性肝炎患者血清和精液丙二醛(MDA)、对氧磷酶-1(PON-1)水平及对精液相关参数的影响。方法:选择有生育力的男性健康对照组50例,男性不育组42例,男性不育伴慢性病毒性肝炎组45例,采用分光光度法测定血清和精浆MDA水平、PON-1活性,采用吖啶橙荧光染色法测定精子DNA碎片化指数(DFI)。结果:不育伴肝炎组血清和精浆MDA水平明显高于对照组和不育组(P<0.01和P<0.05),而PON-1活性明显低于对照组和不育组(P<0.01和P<0.05)。不育伴肝炎组精子活动率、精子存活率均明显低于对照组和不育组(P<0.01和P<0.05),而精子DFI明显高于对照组和不育组(P<0.01和P<0.05)。三组精子浓度无显著性差异(P>0.05);不育组与不育伴肝炎组精液WBC显著高于对照组(P<0.05)。男性不育伴慢性病毒性肝炎组精浆中的MDA水平、PON-1活性分别与血清中的MDA和PON-1呈显著正相关(r=0.57和0.48,P<0.01)。结论:病毒引起慢性活动性肝炎会使生殖系统氧化应激加强,加重对精子的损害,影响精子质量。

Objective： To investigate the malondialdehyde（ MDA） level and paraoxonase-1（ PON-1） activity in the serum and seminal plasma of infertile men with chronic viral hepatitis and their influence on the semen parameters of the patients. Methods： We collected serum and semen samples from 42 infertile men,45 infertile males with chronic viral hepatitis,and 50 healthy fertile men as controls. We measured the MDA level in the serum and seminal plasma by spectrophotometry,detected the PON-1 activity by spectrophotometry,and determined the sperm DNA fragmentation index（ DFI） by acridine orange fluorescence staining. Results： The MDA level was significantly higher but the PON-1 activity remarkably lower in the serum and seminal plasma of the infertile males with chronic viral hepatitis than in the healthy controls and infertile patients（ P 〈 0. 01 or P 〈 0. 05）. Total sperm motility and sperm survival rate were significantly lower while the sperm DFI markedly higher in the former than in the latter two groups（ P 〈 0. 01 or P 〈0. 05）. No statistically significant difference was found among the three groups in sperm concentration（ P 〉 0. 05）. The WBC counts in the semen of the infertile and infertile with chronic viral hepatitis groups were significantly higher than that in the health controls（ P〈 0. 05）. The MDA level and PON-1 activity in the seminal plasma were positively correlated with those in the serum in the infertile males with chronic viral hepatitis（ r = 0. 57 or 0. 48,P 〈 0. 01）. Conclusion： Virus-induced chronic active hepatitis enhances oxidative stress in the reproductive system,aggravates sperm damage,and affects sperm quality parameters.