非梗阻性无精子症患者附性腺标志物变化分析

Analysis of biochemical markers of accessory sex glands in patients with non-obstructive azoospermia

目的通过对正常生育男性和非梗阻性无精子症患者精液常规分析与精浆附性腺标志物的检测,探讨非梗阻性无精子症患者附性腺生化标志物的变化。方法选取2018年3~8月于广东省计划生育专科医院门诊就诊的38例非梗阻性无精子症患者作为非梗阻性无精子症组,另选取同期于广东省计划生育专科医院进行生殖健康体检合格的有正常生育力的30例男性志愿者作为正常对照组。禁欲2~7 d后均手淫取精,精液完全液化后,常规检测精液量、精浆附性腺标志物(包括精浆果糖、精浆中性α-葡糖苷酶和精浆锌含量)。结果非梗阻性无精子症组患者的精液量[2.6(0.2,5.9)ml]低于正常对照组[3.8(2.2,6.3)ml],差异有统计学意义(P<0.05)。非梗阻性无精子症组患者的精浆果糖含量[36.0(0.1,141.5)μmol/一次射精]低于正常对照组[75.9(22.4,154.4)μmol/一次射精],差异有统计学意义(P<0.05)。非梗阻性无精子症组患者的精浆中性α-葡糖苷酶活性[26.8(0.4,95.7)mU/一次射精]低于正常对照组[61.1(7.8,193.9)mU/一次射精],差异有统计学意义(P<0.05)。两组的精浆锌含量比较,差异无统计学意义(P>0.05)。结论非梗阻性无精子症患者与正常生育男性相比,除生精功能障碍外,还同时存在不同程度的附睾和精囊腺功能下降。

Objective To investigate the changes of biochemical markers of accessory sex gland in non-obstructive azoospermia patients by routine analysis of semen and detection of accessory sex gland markers in seminal plasma of normal fertile men and non-obstructive azoospermia patients.Methods A total of 38 patients with non-obstructive azoospermia were selected as the non-obstructive azoospermia group,and 30 male volunteers with normal fertility who passed the reproductive health examination were selected as the normal control group from March to August 2018 in the Outpatient Clinic of Guangdong Family Planning Specialty Hospital.After abstinence for 2 to 7 days,the semen sample were obtained by masturbation.After complete liquefaction of semen,semen volume and semen accessory gland markers(including seminal fructose,seminal neutralα-glucosidase and seminal zinc),were routinely measured.Results The semen volume of the non-obstructive azoospermia group(2.6[0.2,5.9]ml)was lower than that of the normal control group(3.8[2.2,6.3]ml),and the difference was statistically significant(P<0.05).The content of seminal fructose in the non-obstructive azoospermia group(36.0[0.1,141.5]μmol/ejaculation)was lower than that in the normal control group(75.9[22.4,154.4]μmol/ejaculation),the difference was statistically significant(P<0.05).The activity of seminal neutralα-glucosidase in the non-obstructive azoospermia group(26.8[0.4,95.7]m U/ejaculation)was lower than that in the normal control group(61.1[7.8,193.9]mU/ejaculation),the difference was statistically significant(P<0.05).There was no significant difference in seminal zinc content between the two groups(P>0.05).Conclusion Compared with normal fertile men,non-obstructive azoospermia patients have not only spermatogenic dysfunction,but also decreased epididymis and seminal vesicle gland function in varying degrees.