男性不育患者精浆弹性蛋白酶与精子活性氧及精液参数的相关性研究

Correlation of seminal plasma elastase with sperm reactive oxygen species and semen parameters in infertile men

目的:探究男性不育患者的精浆弹性蛋白酶与精子活性氧(ROS)和精液相关参数之间的关系。方法:选取2021年7月~12月来院就诊,年龄为20~51岁的男性不育患者145例。精浆弹性蛋白酶浓度≥290 ng/ml的患者设为炎症组(48例),<290 ng/ml的患者设为非炎症组(97例)。分析精浆弹性蛋白酶浓度对精液白细胞浓度、精子ROS水平、精液量、精子浓度、精子活动率、前向运动精子百分率、正常形态精子百分率和DFI的关系。结果:炎症组的精液白细胞浓度、精子ROS水平和DFI显著高于非炎症组(P<0.05),而精液量、精子浓度、精子活动率、前向运动精子百分率、正常形态精子百分率和精子畸形指数(SDI)无明显差异(P>0.05)。Spearman相关性分析结果显示,精浆弹性蛋白酶浓度与精液白细胞浓度(r=0.658,P<0.01)、精子ROS水平(r=0.229,P=0.006)、DFI(r=0.192,P=0.021)呈正相关,与精液量、精子浓度、精子活动率、前向运动精子百分率、正常形态精子百分率和SDI无明显相关性(P>0.05)。结论:精浆弹性蛋白酶浓度与精液白细胞浓度、精子ROS水平和DFI相关,在男性不育的诊断中有一定的参考意义。

Objective: To investigate the relationship of seminal plasma elastase(SPE) with sperm reactive oxygen species(ROS) and semen parameters in infertile men. Methods: Between July 2021 and December 2021, a total of 145 subjects aged 20-51 years with male infertility were enrolled. SPE, seminal leukocytes, sperm ROS, DNA fragmentation index(DFI) and other semen parameters were detected. We divided patients into an inflammation group(SPE ≥ 290 ng/ml, n = 48) and a non-inflammation group(SPE < 290 ng/ml, n = 97), analyzed the relationship of SPE with seminal leukocytes, sperm ROS, semen volume, sperm concentration, total sperm motility, the percentages of progressively motile sperm(PMS), morphologically normal sperm(MNS), and DFI. Results: The concentration of seminal leukocytes, sperm ROS level and DFI were significantly higher in inflammation group than in non-inflammation group(P < 0.05). No statistically significant differences were observed in semen volume, sperm concentration, total sperm motility, PMS, MNS or sperm deformity index(SDI) between two groups of patients(P > 0.05). Spearman correlation analysis showed that the SPE level was correlated positively with the concentration of seminal leukocytes(r = 0.658, P < 0.01), sperm ROS level(r = 0.229, P = 0.006) and DFI(r = 0.192, P = 0.021), but not correlated with semen volume, sperm concentration, total sperm motility, PMS, MNS or SDI(P > 0.05). Conclusion: The level of seminal plasma elastase is related with the concentration of seminal leukocytes, sperm ROS level and DFI, and has some reference value in the diagnosis of male infertility.