男性年龄与精子质量和精浆生化的关系

Relationship between ages and sperm quality and seminal plasma biochemical indexes

目的探讨不同年龄段男性精子质量与精浆弹性硬蛋白酶和精浆中性α-葡萄糖苷酶的关系。方法回顾性分析在嘉兴市妇幼保健院门诊检测精子质量和精浆生化(精浆弹性硬蛋白酶、精浆中性α-葡萄糖苷酶)的3 262例患者的临床资料。根据年龄分为5组:<25岁组、25~29岁组、30~34岁组、35~39岁组和≥40岁组;并按精子质量分为少弱精子症(301例)、少精子症(193例)、弱精子症(1 335例)及正常精子组(1 433例)。统计分析不同精子质量不同年龄段男性的精浆弹性硬蛋白酶、精浆中性α-葡萄糖苷酶资料。结果 (1)3 262例精液分析,精浆中性α-葡萄糖苷酶异常发生率7.14%,精浆弹性硬蛋白酶水平确诊感染率29.25%;(2)各年龄组总体精浆中性α-葡萄糖苷酶异常发生率相似(P>0.05),生殖道感染发生率随年龄增加有增高趋势(P<0.05);(3)不同精子质量各组总体精浆中性α-葡萄糖苷酶异常发生率不同(P<0.05),其中少精子症和少弱精子症组均显著高于弱精子症组及精子正常组(P<0.05),但生殖道感染发生率相似(P>0.05);(4)随着年龄增加,不同精子质量各组精浆中性α-葡萄糖苷酶异常发生率相似(P>0.05),而精浆弹性硬蛋白酶异常发生率有增高趋势(P<0.05),其中少弱精子症、少精子症患者各年龄组间比较均有统计学差异(P<0.05);(5)各精子质量组精浆弹性硬蛋白酶测定值均随着年龄增加呈增高趋势,且正常精子组的精浆弹性硬蛋白酶测定值在35~39岁组及≥40岁组均显著高于<25岁组(P<0.05)。结论男科门诊患者中生殖道感染具有普遍性;伴随难以自愈的生殖道感染的少弱精子症、少精子症和弱精子症可能与男性患者年龄增加有关,亦可能与附性腺病变严重程度、病程进展所处不同阶段有关。

Objective：To investigate the relationship between age and sperm quality and biochemical indexes of seminal plasma.Methods：The clinical data of 3 262 patients with sperm quality and seminal plasma biochemistry indicators（seminal plasma elastase ＆α-glycosidase）in Jiaxing Maternal ＆ Child Health Hospital were analyzed retrospectively.The patients were divided into 5groups according to the age：〈25year group,25-29 year group,30-34 years group,35-39 years group and≥40years group.In addition,the patients were divided into oligoasthenospermia（n=301）,oligozoospermia（n=193）and asthenospermia（n=1335）and normal sperm group（n=1433）according to sperm quality.The correlation between the age or sperm quality and seminal plasma elastase ＆α-glycosidase was analyzed.Results：The abnormal rate of seminal plasmaα-glycosidase was 7.14%,and the infection rate confirmed by seminal plasma elastase level was 29.25%in 3 262 patients.The abnormal rate ofα-glycosidasewas similar among the different age groups（P〉0.05）.The infection rate was significantly increased with age（P〈0.05）.The abnormal rate ofα-glycosidase was significantly different among the different sperm quality groups（P〈0.05）.The abnormal rate ofα-glycosidase in oligoasthenospermia or oligozoospermia was significantly higher than that of asthenospermia or normal sperm group（P〈0.05）,while the infection rate was similar（P〉0.05）.The abnormal rate ofα-glycosidase was similar in different sperm quality group with the increase of age（P〉0.05）,while the abnormal rate of seminal plasma elastase was significantly increased with age（P〈0.05）,which also was significant different in the patients with oligoasthenospermia or oligozoospermia among the different age group（all P〈0.05）.The tendency of the seminal plasma elastase levels was increased with age in different sperm quality groups.Compared with〈25years old group,the seminal plasma elastase levels of normal sperm group with 35-39 years old and≥40years old was significantly increased（P〈0.05）.Conclusions：Reproductive tract infection in male clinic patients is universality.Oligoasthenospermia,oligozoospermia,and asthenospermia in patients with difficult to self-healing of reproductive tract infections may be related the patients’ age and the severity and advancement of infertile patients’ accessory sex gland lesions.