精索静脉曲张不育患者氧化应激水平和精子DNA完整性及精液参数的相关性分析

Correlation of oxidative stress with sperm DNA integrity and semen parameters in infertile men with varicocele

目的:分析精索静脉曲张(VC)不育患者氧化应激同DNA完整性及精液参数的关系。方法:采用前瞻性研究,纳入98例患者,根据活性氧水平(ROS)将VC不育患者分为ROS低水平组(54例)及高水平组(44例),分析两组精子DNA碎片指数(DFI)、精子活力、形态等参数的差异,并分析它们之间的相关性。结果:ROS高水平组DFI显著高于ROS低水平组[(34.49±6.05)%vs(27.38±8.10)%,P=0.039]。与ROS低水平组比较,ROS高水平组精子活力[(25.21±18.22)%vs(36.16±22.83)%,P=0.017]、前向运动精子百分率[(16.34±9.22)%vs(23.34±11.53)%,P=0.041]、曲线速率[(20.62±4.38)%vs(27.03±6.21)%,P=0.013]及直线性率[(18.30±7.93)%vs(29.75±8.24)%,P=0.024]均显著降低,而精液白细胞数显著升高[(0.86±0.41)×106/ml vs(0.65±0.15)×106/ml,P=0.022]。Spearman相关性分析表明ROS水平同精液白细胞数(r=0.41,P<0.01)及DFI(r=0.21,P=0.006)呈显著正相关,同曲线速率(r=-0.24,P=0.017)、直线性率(r=-0.24,P=0.021)、精子活力(r=-0.31,P=0.002)及前向运动精子百分率(r=-0.41,P=0.012)呈显著负相关。DFI同精子活力(r=-0.29,P<0.01)、前向运动精子百分率(r=-0.34,P<0.01)呈显著负相关。结论:精浆ROS水平同VC不育患者DFI显著正相关。氧化应激及DNA完整性可影响患者的精子参数。

Objective： To investigate the relationship of oxidative stress with DNA integrity and semen parameters in infertile men with varicocele（ VC）. Methods： This prospective study included 98 infertile males with VC. According to the levels of reactive oxygen species（ ROS） in the semen,we divided the patients into a high ROS group（ n = 44） and a low ROS group（ n = 54）,determined the sperm DNA fragmentation index（ DFI）,motility and morphology,and analyzed their correlation with ROS in the two groups of patients. Results： Compared with the patients of the low ROS group,those of the high ROS group showed a significantly higher DFI（27. 38 ± 8. 10 vs 34. 49 ± 6. 05,P = 0. 039） and a higher concentration of seminal leukocytes（[0. 65 ± 0. 15] × 10^6/ ml vs[0. 86 ± 0. 41]× 10^6/ ml,P = 0. 022）,but lower sperm motility（[36. 16 ± 22. 83]% vs [18. 22 ± 25. 21]%,P = 0. 017）,percentage of progressively motile sperm（[23. 34 ± 11. 53]% vs [16. 34 ± 9. 22]%,P = 0. 041）,sperm curvilinear velocity（[27. 03 ±6. 21] vs [20. 62 ± 4. 38] μm / s,P = 0. 013）,and sperm linearity（[29. 75 ± 8. 24]% vs [18. 30 ± 7. 93]%,P = 0. 024）.Spearman correlation analysis indicated that the ROS level was correlated positively with the concentration of seminal leukocytes（ r =0. 41,P〈0. 01） and DFI（ r = 0. 21,P = 0. 006）,but negatively with sperm curvilinear velocity（ r =- 0. 24,P = 0. 017）,linearity（r =- 0. 24,P = 0. 021）,motility（r =- 0. 31,P = 0. 002）,and the percentage of progressively motile sperm（r =- 0. 41,P =0. 012）. Additionally,the sperm DFI manifested a significant negative correlation with sperm motility（ r =- 0. 29,P〈0. 01） and the percentage of progressively motile sperm（ r =- 0. 34,P〈0. 01）. Conclusion： The level of seminal ROS is positively correlated with the sperm DFI in infertile men with varicocele,and both the ROS level and DNA integrity are associated with semen parameters.