不育症患者精液中性α-葡糖苷酶、缺氧诱导因子-1α水平检测及临床意义

The detection and clinical significance of neutral α-glucosidase and hypoxia inducible factor-1αlevels in semen of infertility patients

目的探究不育症患者精液中性α-葡糖苷酶(NAG)、缺氧诱导因子-1α(HIF-1α)的水平及其临床意义。方法选取2022年4月至2023年4月金华市人民医院收治的200例不育症患者作为研究对象,设为研究组,并依据精液参数分为四个亚组。选择同期体检且有生育史的100例健康男性设为对照组。检测各组性激素、精液NAG、HIF-1α水平,采用Pearson相关性分析精液NAG、HIF-1α与精液参数、性激素的关系,采用受试者工作特征(ROC)曲线分析精液NAG、HIF-1α对不育症的诊断效能。结果研究组精液NAG水平显著低于对照组,HIF-1α水平显著高于对照组,差异具有统计学意义(P<0.05)。少精子组、少弱精子组精液NAG、血清睾酮(T)水平均显著低于正常组、弱精子组,且弱精子组低于正常组(P<0.05);少精子组、少弱精子组精液HIF-1α、血清卵泡刺激素(FSH)水平均显著高于正常组、弱精子组,且弱精子组高于正常组(P<0.05)。研究组精液NAG与HIF-1α、血清FSH水平呈负相关(P<0.05),与精子浓度、前向运动精子百分率(PR)、T水平呈正相关(P<0.05);精液HIF-1α与PR、血清T水平呈负相关(P<0.05)。精液NAG、HIF-1α诊断不育症的曲线下面积分别为0.885、0.807,两者联合检测为0.927。结论不育症患者精液NAG低表达,HIF-1α高表达,与相关精液参数、性激素存在一定的相关性,精液NAG、HIF-1α及联合检测诊断不育症有较好的临床价值。

Objective To investigate neutralα-glucosidase(NAG)and hypoxia inducible factor-1α(HIF-1α)levels in semen of infertility patients and their clinical significance.Methods A total of 200 infertility patients admitted to Jinhua People′s Hospital from April 2022 to April 2023 were selected as the study objects,set as study group and divided into four subgroups according to semen parameters.100 healthy males undergoing medical examination during the same period with reproductive history were selected as the control group.The levels of sex hormones,semen NAG and HIF-1αin each group were detected.Pearson correlation analysis was conducted to analyze the relationship between semen NAG and HIF-1α,semen parameters and sex hormones.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of semen NAG and HIF-1αin infertility.Results The semen NAG level in the study group was significantly lower than that in the control group,and the HIF-1αlevel was significantly higher than control group,with statistically significant differences(P<0.05).The levels of semen NAG and serum testosterone(T)in the oligospermia group and the oligoasthenozoospermia group were significantly lower than those in the normal group and the asthenospermia group,and the asthenospermia group was lower than the normal group(P<0.05).The levels of semen HIF-1αand serum follicle stimulating hormone(FSH)in the oligospermia group and the oligoasthenozoospermia group were significantly higher than those in the normal group and the asthenospermia group,and the asthenospermia group was higher than the normal group(P<0.05).In the study group,semen NAG was negatively correlated with HIF-1αand serum FSH levels(P<0.05),and positively correlated with sperm concentration,progressive motility rate(PR)and T levels(P<0.05).Semen HIF-1αwas negatively correlated with PR and serum T(P<0.05).The area under the curve of semen NAG and HIF-1αin the diagnosis of infertility were 0.885 and 0.807,respectively,and the combined diagnosis was 0.927.Conclusions The low expression of NAG and high expression of HIF-1αin semen of infertility patients are correlated with related semen parameters and sex hormones.Semen NAG,HIF-1α,and combined detection have good clinical value in the diagnosis of infertility.