男性HBV感染及不同标志物模式对常规精液参数和精浆生化指标的影响

Impact of male HBV infection and various serostatus on standard sperm parameters and seminal plasma biochemical parameters

目的探讨男性乙型肝炎病毒(HBV)感染及不同标志物模式对常规精液参数和精浆生化指标的影响。方法选取2019年1月至2021年6月在广州市番禺区妇幼保健院生殖医学科接受第一次宫腔内人工授精(IUI)治疗的男性患者557例,根据患者血清HBsAg是否阳性分为HBV感染组(n=105)和未感染组(n=452)。比较两组间的精液常规参数和精浆生化指标的差异。再根据乙肝五项检测分为12个标志物模式组,乙肝五项均为阴性或仅HBsAb阳性设为对照组,比较病例数大于10例的7个模式组与对照组间上述指标的差异。结果HBV感染组与未感染组间的精液量、精子浓度、前向运动精子百分率、前向运动精子总数和正常精子形态百分率比较差异均无统计学意义(P>0.05);HBV感染组的顶体酶活性和精浆锌含量明显低于未感染组,差异均有统计学意义(P<0.05),而两组间的中性α-葡糖苷酶含量比较差异无统计学意义(P>0.05)。不同标志物模式分析中,模式6和9组的精子浓度高于对照组,模式2和9组的前向运动精子总数高于对照组,模式7组的精子正常形态百分率高于对照组,差异均有统计学意义(P<0.05);模式1组(小三阳)和2组(大三阳)间的精浆锌含量明显低于对照组,而模式5组的精浆锌含量明显高于对照组,差异均有统计学意义(P<0.05);7个模式组与对照组间的中性α-葡糖苷酶含量比较差异均无统计学意义(P>0.05)。结论男性HBV感染及不同标志物模式对精液常规参数未产生不利影响,但是HBV感染者的精子顶体酶活性和精浆锌含量明显降低,尤其是HBV“小三阳”和“大三阳”标志物模式者的精浆锌含量明显降低,可能对男性生育产生不利影响。

Objective To investigate the impact of male hepatitis B virus(HBV)infection and various serostatus on the standard sperm parameters and seminal plasma biochemical parameters.Methods A total of 557 male patients with their first intrauterine insemination(IUI)treatment in the Department of Reproductive Medicine,Panyu Maternal and Child Care Service Centre of Guangzhou from January 2019 to June 2021 were selected.According to whether HBsAg was positive or not,the patients were divided into infected(n=105)and uninfected groups(n=452).Standard sperm parameters and seminal plasma biochemical parameters were compared between the two groups.Furtherly,according to the results of five items of hepatitis B,the patients were divided into 12 marker pattern groups,and these above parameters were compared among the 7 marker patterns with more than 10 cases and control group(HBsAb+/all seronegative).Results No statistically significant differences were observed in semen volume,sperm concentration,the percentage of progressively motile sperm(PR),total number of PR,and the percentage of normal sperm morphology between HBV infected and uninfected groups(P>0.05).And the acrosin activity and seminal plasma zinc were significantly lower in infected group than uninfected group(P<0.05),however,there was no significant difference in neutralα-glucosidase content between two groups.In addition,the sperm concentrations in marker pattern groups 6 and 9,total number of PR in marker groups 2 and 9,and the percentage of normal sperm morphology in marker group 7 were significantly higher than that in control group(P<0.05).Moreover,the seminal plasma zinc of marker pattern groups 1(HBsAg+HBeAb+HBcAb+)and 2(HBsAg+HBeAg+HBcAb+)were significantly lower than that of control group,however,the seminal plasma zinc of marker group 5 was significantly higher than that of control group(P<0.05).There was no significant difference in neutralα-glucosidase content among all marker pattern groups and control group(P>0.05).Conclusion HBV infection and different serostatus do not adversely affect the standard sperm parameters.However,HBV infection may be associated with low acrosin activity and seminal plasma zinc content,especially,the HBsAg+HBeAb+HBcAb+and HBsAg+HBeAg+HBcAb+marker patterns may be associated with low seminal plasma zinc content,which may adversely affect male fertility.