精浆弹性蛋白酶、精液白细胞浓度、精子活性氧和精子DNA碎片指数间的相关性分析

Correlation analysis between seminal plasma elastase,semen leukocytes concentration,sperm reactive oxygen species and sperm DNA fragmentation indexes

目的 观察男性不育患者精浆弹性蛋白酶浓度(SPE)、精液白细胞浓度、精子活性氧(ROS)水平和精子DNA碎片指数(DFI)水平,分析各指标间的相关性。方法 选择2021年1月—2022年12月本院诊治的137例男性不育者作为观察组,同期选择30名健康志愿者作为对照组,收集所有受试者精液,测定SPE、精液白细胞浓度、ROS和DFI水平,分析各指标间的相关性。结果 对照组SPE(216.55±67.59)ng/mL、精液白细胞浓度(0.77±0.18)×10^(5)/mL、精子ROS(14.56±2.82)%、DFI(12.93±3.56)%,观察组SPE(836.28±96.60)ng/mL、精液白细胞浓度(1.49±0.35)×10^(5)/mL、精子ROS(32.24±6.38)%、DFI(25.47±8.05)%,差异均有统计学意义(P均<0.05)。137例不育患者中,27例患者DFI≤15%,76例患者DFI>15%~<30%,34例患者DFI≥30%。DFI≥30%患者SPE水平与DFI≤15%患者对比,差异有统计学意义(P<0.05);DFI>15%~<30%的患者、DFI≥30%患者精液白细胞浓度、精子ROS与DFI≤15%患者对比,差异均有统计学意义(P均<0.05),且DFI≥30%患者精液白细胞浓度、精子ROS与DFI>15%~<30%的患者对比,差异均有统计学意义(P均<0.05)。不育患者精液白细胞浓度与SPE呈正相关(P<0.01),精子ROS与SPE、精液白细胞浓度均呈正相关(P均<0.01),DFI与SPE、精液白细胞浓度、精子ROS均呈正相关(P均<0.01)。结论 男性不育患者精子DNA完整性较差,精子ROS、SPE、精液白细胞浓度水平较高,三者与精子DFI呈显著正相关,对预测精子DNA完整性和指导临床诊断具有一定的参考意义。

Objective To observe the seminal plasma elastase concentration(SPE),semen leukocyte concentration,sperm reactive oxygen species(ROS)level,and sperm DNA fragmentation index(DFI)level in male infertility patients,and to analyze the correlation between the indexes.Methods A total of 137 male infertile patients treated in Puyang Maternal and Child Health from January 2021 to December 2022 were selected as an observation group and 30 healthy volunteers were selected as a control group during the same period.All subjects’semen was collected,SPE,semen white blood cell concentration,ROS level,and DFI were measured,and the correlation between the indexes was analyzed.Results In the control group,the average SPE was(216.55±67.59)ng/mL,semen leukocytes concentration was(0.77±0.18)×10^(5)/mL,sperm ROS was(14.56±2.82)%,and DFI was(12.93±3.56%),and in the observation group,the average SPE was(836.28±96.60)ng/mL,semen leukocytes concentration was(1.49±0.35)×10^(5)/mL,sperm ROS was(32.24±6.38)%and DFI was(25.47±8.05%)%,and the differences were statistically significant(all P<0.05).Among the 137 infertile patients,27 patients had DFI≤15%,76 patients had DFI>15%-<30%,and 34 patients had DFI≥30%.The SPE level of DFI≥30%of patients compared with that of DFI≤15%of patients,there was a significant difference(P<0.05);the differences between DFI>15%-<30%of patients with DFI≥30%of patients,semen leukocytes concentration in DFI≥30%of patients,sperm ROS and DFI≤15%of patients were statistically significant(P<0.05).Moreover,the semen leukocyte cell concentration and sperm ROS of the patients with DFI≥30%compared with those of the patients with DFI>15%-<30%,the differences were statistically significant(both P<0.05).In infertility patients,the semen leukocyte concentration was positively correlated with SPE(P<0.01),sperm ROS was positively correlated with SPE,and semen leukocyte concentrations(both P<0.01),and DFI was positively correlated with SPE,semen leukocyte concentration and sperm ROS(all P<0.01).Conclusion The sperm DNA integrity of male infertile patients is poor,and the concentration of ROS,SPE,and semen leukocytes in semen is high,which are significantly positively correlated with sperm DFI,which has certain reference significance for predicting sperm DNA integrity and guiding clinical diagnosis.