白细胞精子症与精浆白介素-6、肿瘤坏死因子-α水平的相关性研究

The correlation between leukocytospermia and IL-6 and TNF-α in semen

目的探讨男性白细胞精子症与白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平之间的关系。方法选取2018年7月至2019年6月连云港市妇幼保健院诊治的100例成年男性患者作为研究对象。按照病史及精液检查结果分为四组:有白细胞精子症,但其他精液参数正常的患者纳入A组(n=25);同时有白细胞精子症和精液参数异常(即少精子症和/或弱精子症和/或畸形精子症)的患者纳入B组(n=25);精液参数异常,但无白细胞精子症的患者纳入C组(n=25);精液参数正常且无白细胞精子症的患者纳入D组(n=25)。检查精液参数,包括精液体积、精子浓度、精子数量、前向运动百分率(PR)指标,检测精浆中IL-6和TNF-α水平。结果四组间精子数量、精子浓度、PR、白细胞计数比较,差异具有统计学意义(P<0.05);四组间精液量比较,差异无统计学意义(P>0.05)。根据光镜下对精液涂片进行白细胞计数,将研究对象分为白细胞计数<5个/HP组和≥5个/HP组,其精子总数、精子浓度、PR、IL-6、TNF-α水平比较,差异具有统计学意义(P<0.05)。A、B组的IL-6、TNF-α水平显著高于C、D组,差异具有统计学意义(P<0.05);但A组和B组比较,差异无统计学意义(P>0.05);C组明显高于D组,差异具有统计学意义(P<0.05)。结论白细胞精子症与精子计数、精子活力及精浆IL-6和TNF-α水平存在相关性,精液中白细胞的增多可能是导致精子计数、精子活力下降及精浆IL-6和TNF-α水平升高的原因。

Objective To investigate the relationship between the levels of interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) in male leukocytospermia. Methods 100 adult male patients treated in Lianyungang Maternal and Child Health Hospital from July 2018 to June 2019 were selected as the study subjects. According to the medical history and semen examination results, the patients with leukocytospermia but normal semen parameters were included in group A(n=25);Patients with both leukocytospermia and abnormal semen parameters(i.e. oligozoospermia and/or asthenospermia and/or teratoospermia) were included in group B(n=25);Patients with abnormal semen parameters but no leucospermia were included in group C(n=25);Patients with normal semen parameters and no leucospermia were included in group D(n=25). Semen parameters were examined, including semen volume, sperm concentration, sperm count, forward motility percentage(PR), and plasma IL-6 and TNF-α levels. Results There were statistically significant differences in sperm number, sperm concentration, PR and white blood cell count among the four groups(P<0.05). There was no significant difference in semen volume between the four groups(P>0.05). According to the white blood cell technique of semen smear under light microscope, the subjects were divided into two groups with white blood cell count < 5/HP and ≥5/HP, and there were statistically significant differences in total sperm count, sperm concentration, PR, IL-6 and TNF-α levels(P<0.05). The levels of IL-6 and TNF-α in A and B group were significantly higher than those in C and D group, the differences were statistically significant(P<0.05). However, there was no statistically significant difference between group A and group B(P>0.05), and group C was significantly higher than group D(P<0.05). Conclusions Leukocytospermia is associated with sperm count, sperm motility and the levels of IL-6 and TNF-α in seminal plasma. The increase of white blood cells in semen may be responsible for the decrease of sperm count and sperm motility and the increase of IL-6 and TNF-α in seminal plasma.