精浆雌二醇对不育症精液参数的预测价值

Application value of estradiol in seminal plasma in predicting semen parameters of male infertile patients

目的研究男性不育患者精浆雌二醇(E2)与精液参数的关系,探讨精浆E2对精子质量的预测价值。方法2018年1012月至本院生殖中心就诊的男性不育患者随机选取86名,根据WHO标准对各项精液参数进行分析,采用化学发光法测定精浆E2。根据精液参数分为4组:少精子症组(1组,n=12)、弱精子症组(2组,n=24)、少弱精子组(3组,n=24)、正常精子组(4组,n=26)。结果1~4组精浆E2分别为(56.97±10.55)pg/ml、(52.30±8.64)pg/ml、(54.02±11.63)pg/ml和(45.79±5.87)pg/ml,差异有统计学意义(P<0.01);精浆E2与浓度和PR呈明显负相关,与正常形态率和顶体酶不相关;应用ROC曲线分析精浆E2对精子数量活力异常的诊断价值,截值42.50 pg/ml,其敏感性为90.00%,特异性为69.23%,AUC值为0.737(P<0.01),95%CI(0.634,0.840)。结论精浆E2高于42.50 pg/ml提示精子数量活力异常。因此,精浆E2有一定的预测价值,可作为男性不育患者诊断及治疗的评估指标。

Objective To research the correlation between estradiol in seminal plasma and semen parameters of male infertile patients and to explore the value of seminal estradiol in predicting sperm quality.Methods A total of 86 infertility men who visited the reproductive center of our hospital from October to December 2018 were randomly selected and were measured semen parameters according to the WHO laboratory standard.We also tested seminal plasma estradiol by chemiluminescence.The patients were divided into four groups according to the seminal parameters:oligozoospermia(group 1,n=12),asthenospermia(group 2,n=24),oligoasthenozoospermia(group 3,n=24),normozoospermia(group 4,n=26).Results The level of estradiol in seminal plasma in group 1 to 4 were respectively(56.97±10.55)pg/ml,(52.30±8.64)pg/ml,(54.02±11.63)pg/ml,and(45.79±5.87)pg/ml,with statistically significant difference(P<0.01).The correlation analysis showed that the seminal plasma estradiol was negatively correlated with sperm concentration and sperm progressive motility,was not correlated with sperm normal morphology and sperm acrosin activity.The ROC curve of estradiol was drawn for the diagnosis of abnormal sperm.The cut off value of curve was 42.50 pg/ml,the sensitivity was 90.00%,the specificity 69.23%,the area under the curve was 0.737(P<0.01),and the 95%confidence interval was(0.634,0.840).Conclusion Seminal plasma E2 more than 42.50 pg/ml may be connected with abnormal sperm counts and vitality.Therefore,seminal plasma estradiol has certain forecastable value,which can be used as evaluation index of the diagnosis and treatment of male infertility patients.