精浆环氧化酶(COX)1、COX2的检测及其临床应用价值

The Clinical Application Value of COX1、COX2 in seminal plasma

目的探讨精浆环氧化酶(COX)1、COX2检测的临床应用价值。方法 172例拟生育二胎行常规孕前体检的男子,要求禁欲2~7 d,手淫取精液于无菌杯中,精液液化后,采用计算机辅助精子分析系统行精液分析,采用5-Br-PAPS法检测精浆锌含量、己糖激酶法检测精浆果糖含量、改良Cooper法检测精浆α-葡萄糖苷酶含量、固相Nα-苯甲酰-DL-精胺酸-ρ-硝酰基苯胺(BAPNA)法检测精子顶体酶含量、精子染色质扩散法检测精子DNA碎片率,采用ELISA法检测精浆COX1、COX2含量。观察COX1、COX2的ROC曲线下面积(AUC)及相应的敏感度、特异度和Cutoff值;以COX1的Cutoff值将总体分为'≥17.50'和'<17.50'2组,分析2组之间的差异性。结果精浆COX1、COX2的AUC差异均有统计学意义(P<0.05),COX1在敏感度和特异度两方面均>0.7。按COX1的Cutoff值将总体分为2组比较,精液量、精子浓度、前向运动精子比例、精浆锌、果糖及α-葡萄糖苷酶的'≥17.50'组显著高于'<17.50'组,差异有统计学意义(P<0.05);精子DNA碎片率的'≥17.50'组显著低于'<17.50'组,差异有统计学意义(P<0.05)。结论 COX1是影响男性取精状态的指标之一,可以作为取精状态指标评估男性的取精情况,进而为指导临床工作提供有效帮助。

Objective To explore the clinical application value of COX1,COX2 in seminal plasma.Methods 172 men who planned to give birth to the second baby prepared for physical examination were selected.Semen analysis was performed by computer-aided sperm analysis system after semen liquefaction and Zinc content in seminalplasma was detected by 5-Br-PAPS method,and fructose was detected by hexokinase method,andα-glycosidase was detected by improved Cooper method.Sperm acrosin content was detected by solid-phase Nalpha-benzoyl-DL-arginic acid-p-nitroaniline(BAPNA),and sperm DNA fragmentation rate was detected by sperm chromatin diffusion method after liquefaction.And then,we observed the AUC,sensitivity,specificity and cutoff value of the ROC curve of COX1,COX2,and analyzed the difference of two groups which were separated by the cutoff value of COX1.Results AUC of COX1 and COX2 in seminal plasma had statistical significance(P<0.05),and COX1 was more than 0.7 in sensitivity and specificity.According to the Cutoff value of COX1,the total number of semen,sperm concentration,forward motile sperm ratio,seminal plasma zinc,fructose and alpha-glucosidase(>17.50)group were significantly higher than(<17.50)group(P<0.05),and sperm DNA fragmentation rate(>17.50)group was significantly lower than(<17.50)group(P<0.05).Conclusion COX1 is one of the indicators affecting the state of male sperm extraction.It can be used as an indicator to evaluate the state of male sperm extraction and provide effective help for guiding clinical work.