精浆肉碱测定在男性生育力评估和弱精子症疗效监测中的应用

Application of seminal carnitine assay in male fertility assessment and therapeutic monitoring of asthenospermia

目的比较正常男性与弱精子症男性精浆中肉碱含量,评估精浆肉碱水平与前向运动精子百分率(PR)之间的一致性,并外源性补充肉碱对弱精子症患者的影响。方法收集511例正常可育男性及弱精子症患者精液样本,采用精浆肉碱检测试剂盒(固定时间法)测定精浆肉碱,比较两组水平差异及与PR的一致性。另选77例弱精子症患者给予左卡尼汀(1 g/次,3次/日,30日/疗程)治疗,监测服药前后精浆肉碱及PR变化。结果弱精子症患者组精浆肉碱含量[(194.34±65.41)μmol/L]显著低于正常可育男性组[(405.43±72.12)μmol/L](P<0.01);以精浆肉碱≥325μmol/L为阈值,Kappa值为0.81,诊断符合率达93.74%;给予左卡尼汀治疗后,弱精子症组精浆肉碱浓度[(356.03±84.87)μmol/L]较之前[(183.61±79.54)μmol/L]明显上升,PR[(32.69±8.35)%]较之前[(16.56±7.74)%]显著升高(P均<0.01)。结论精浆肉碱检测试剂盒能准确高效检测大量临床样本,可用于弱精子症诊断及疗效评估。外源性补充肉碱可提高弱精子症患者精浆肉碱水平和精子活力,有助于改善其生育能力。

Objective To compare seminal carnitine levels between normal males and asthenozoospermic patients,evaluate its correlation with progressive motility(PR)of sperm,and observe the effects of exogenous carnitine supplementation on asthenozoospermic patients.Methods Semen samples were collected from 511 normal fertile males and asthenozoospermic patients.Seminal was measured using a fixed-time assay kit and the levels of carnitine were compared between the two groups.The consistency between seminal carnitine and PR was assessed.Additionally,77 asthenozoospermic patients received L-carnitine(1 g/time,3 times/day,30 days/course).The levels of seminal carnitine and PR alteration pre-and post-treatment were monitored.Results The seminal L-carnitine level in the patients with asthenospermia([194.34±65.41]μmol/L)was significantly lower than that in normal fertile males([405.43±72.12]μmol/L)(P<0.01).When the seminal L-carnitine level≥325μmol/L was set as the threshold,the statistical results showed that Kappa value was 0.81,with a diagnostic coincidence rate of 93.74%.After one course of administration of L-carnitine,the concentration of seminal L-carnitine([356.03±84.87]μmol/L)and PR([32.69±8.35]%)were significantly higher those that before treatment([183.61±79.54]μmol/L and[16.56±7.74]%,P<0.01).Conclusion The seminal carnitine assay kit could be used for accurate and high-throughput quantification of clinical samples,facilitating asthenozoospermia diagnosis and therapeutic efficacy evaluation.Exogenous carnitine supplementation may elevate seminal carnitine levels and sperm motility in asthenozoospermic patients and potentially improve their fertility.