特发性弱精子症患者精浆塑化剂含量对男性生育力的影响

Content of seminal plasma plasticizer in the patients with idiopathic asthenozoospermia and its impact on male fertility

目的:通过检测塑化剂邻苯二甲酸二(2-乙基己基)酯(DEHP)在特发性弱精子症患者精浆中的含量,探讨DEHP与男性不育症的关系。方法:选取2019年1~5月门诊就诊的男性不育患者,完善各项检查后诊断为特发性弱精子症45例为观察组,另选同期精液质量正常患者45例为对照组,分别测定两组患者精浆中DEHP的含量、精子DNA碎片指数(DFI)及活性氧(ROS)水平。两组患者年龄、生活习性等一般基线资料差异无统计学意义(P>0.05),有可比性。结果:观察组精浆DEHP含量[(0.45±0.09)μg/ml vs(0.23±0.05)μg/ml,P<0.05],ROS水平[(569.4±45.3) pmol/10^6精子vs(317.6±27.8) pmol/10^6精子,P<0.05],精子DFI[(22.1±8.3)%vs(10.5±6.7)%,P<0.05]均显著高于对照组。相关性分析结果显示,精浆DEHP含量与精子ROS水平呈正相关(r=0.77,P<0.05),与前向运动精子百分率呈负相关(r=-0.81,P<0.05),与精子DFI呈正相关(r=0.75,P<0.05)。结论:特发性弱精子症的患者精浆中DEHP含量升高,可能是导致该类患者精子活力下降及精子DFI升高的重要原因。。

Objective: To investigate the relationship between di-(2-ethyl hexyl) phthalate(DEHP) and male infertility by detecting the concentration of DEHP in the seminal plasma of the patient with idiopathic asthenozoospermia(IAS). Methods: This study included 45 infertile males with diagnosed IAS in the observation group and another 45 men with normal sperm parameters as controls. We obtained the general baseline data on the subjects, determined the concentration of DEHP in the seminal plasma, the ROS level and the sperm DNA fragmentation index(DFI), and compared them between the two groups of males. Results: There were no statistically significant differences between the two groups of subjects in age, living habits and other general in baseline data(P > 0.05). The IAS patients, in comparison with the normal controls, showed significantly increased DEHP concentration in the seminal plasma([0.45 ± 0.09] vs [0.23 ± 0.05] μg/ml, P < 0.05), ROS level([569.4 ± 45.3] vs [317.6 ± 27.8] pmol/10^6 sperm, P < 0.05) and sperm DFI([22.1 ± 8.3]% vs [10.5 ± 6.7]%, P < 0.05). The concentration of DEHP in the seminal plasma was correlated positively with the ROS level(r = 0.77, P < 0.05) and sperm DFI(r = 0.75, P < 0.05) but negatively with the percentage of progressively motile sperm(r =-0.81, P < 0.05). Conclusion: The DEHP level is escalated in the seminal plasma of the IAS patient, which may be responsible for the reduced sperm motility and increased DFI of the patient.