不育男性精浆弹性蛋白酶水平与精液主要参数及精子DNA完整性的关系分析

Correlation of seminal plasma elastase level with major semen parameters and sperm DNA integrity in infertile men

目的探讨不育男性精浆弹性蛋白酶(SPE)水平与精液主要参数及精子DNA完整性的关系。方法回顾分析2016年12月-2017年4月于广东省中医院就诊的112例不育患者的临床资料,根据SPE水平分为异常组(SPE≥600 ng/mL)和正常组(SPE<600 ng/mL),比较两组精液主要参数及精子DNA碎片指数(DFI)的差异;异常组患者细分为确认感染组(SPE>1 000 ng/mL)与疑似感染组(600≤SPE≤1 000 ng/mL),比较两组精液主要参数及DFI的差异。结果异常组精子总活力、前向运动精子百分率、正常形态精子百分率与正常组相比明显降低,异常组精子DFI明显高于正常组,差异均有统计学意义(P<0.05)。SPE异常患者中,确认感染组精子总活力、前向精子运动百分率明显低于疑似感染组,差异均有统计学意义(P<0.05)。112例不育男性SPE水平与DFI呈正相关(r=0.33,P=0.00)。结论 SPE水平异常对精子活力、精子形态、精子DNA完整性及损伤程度影响显著,对精液pH值、精子浓度、精子总数无明显影响;不论隐性感染还是疑似感染都对精子活力影响显著,对精液其他参数及DFI的影响无显著差异。

Objective To discuss the correlation of seminal plasma elastase(SPE)level with main semen parameters and sperm DNA integrity in infertile men.Methods The clinical data of 112 infertility patients from December 2016 to April2017 in Guangdong Provincial Hospital of Traditional Chinese Medicine were analyzed retrospectively.According to SPE level,they were divided into abnormal group(SPE≥600 ng/mL)and normal group(SPE<600 ng/mL);main semen parameters and sperm DNA fragment index(DFI)between two groups were compared.Patients in abnormal group were subdivided into confirmed infection group(SPE>1 000 ng/mL)and suspected infection group(600≤SPE≤1 000 ng/mL);the discrepancies between the two groups of main semen parameters and DFI were compared statistically.Results The sperm total motility,the rate of progressively motile sperm(PR),the rate of morphologically normal sperm in abnormal group were significantly lower than those in the normal group.DFI was dramatically higher in the abnormal group than in the normal group;differences were statistically significant(P<0.05).Among the patients with abnormal SPE,the sperm total motility and PR in the confirmed infection group were observably lower than those in the suspected infection group;differences were significant(P<0.05).Moreover,among the 112 infertile men,a positive correlation shown between DFI and SPE level(r=0.33,P=0.00).Conclusion Abnormal SPE level had a significant effect on sperm motility,sperm morphology,sperm DNA integrity,and degree of damage,while no significant effect on semen pH,sperm concentration,and sperm counting.Both infected and suspected infection patients had a significant effect on sperm motility;there was no significant difference in other parameters of semen and DFI.