弱精症男子与正常人精浆和精子膜尿激酶酶活性的研究

应用琼酯糖－纤维蛋白－平板法和抗人尿激酶多克隆抗体的免疫阻断法，分别测定了２０名正常生育力男子和２２例精子活力低下（弱精症）的男性不育症患者精浆中及精子膜尿激酶型纤溶酶原激活因子（ｕＰＡ）的酶活性。结果：弱精症组精浆ｕＰＡ活性为２１３４±１５８１ＩＵ／Ｌ，正常生育组精浆ｕＰＡ活性为３３６５±１８５９．５ＩＵ／Ｌ，两组间差异有显著性意义（Ｐ＜０．０５）。弱精症组精子膜ｕＰＡ活性为５．１３±３．８２ｍＵ／１０６ｃｅｌｓ，正常生育组精子膜ｕＰＡ活性为１０．１７±６．１８ｍＵ／１０６ｃｅｌｓ，两组间差异有极显著性意义（Ｐ＜０．００５）。精子膜ｕＰＡ活性值与精子活率、活力亦呈线性相关。提示精子膜ｕＰＡ酶活性与精子活力及生育力可能有一定关系。     

少弱精子症和正常生育男性精液中尿激酶及其受体含量的研究

目的:通过研究精子正常和异常男性精浆和精子中尿激酶及受体含量差异,以了解尿激酶及受体与男性生育力的关系。方法:采用双抗体夹心ELISA法测定22例正常生育男性和44例少弱精子症男性精浆和精子中尿激酶及受体的含量。结果:①正常男性精浆尿激酶平均含量为(4 803.69±602.78)mU/L,与少弱精子症组[(4 061.35±736.23)mU/L]相比,差异有显著性(P<0.01)。正常生育男性精子尿激酶平均含量为(30.29±3.16)mU/106个精子,与少弱精子症组[(20.51±4.2)mU/106个精子],差异有显著性(P<0.01)。②正常生育男性精子尿激酶受体平均含量为(12.97±3.11)mU/106个精子相比,与少弱精子症组[(6.09±1.45)mU/106个精子]相比,差异有显著性(P<0.01)。③精子和精浆中尿激酶含量和精子活率和活力呈显著正相关。结论:尿激酶和男性生育力相关,少弱精子症和正常生育男性精液中尿激酶及其受体含量存在差异。     

精浆蛋白水解酶测定及其临床意义

用酪蛋白作底物，考马斯亮蓝显色，建立了精浆蛋白水解酶的测定方法。健康人精浆蛋白水解酶活力为2145±725u／mg蛋白，不育患者（精液液化正常，n=20）精浆蛋白水解酶活力为1976±651u／mg蛋白，液化异常或粘稠度增高的不育患者精浆蛋白水解酶活力为642±78u／mg蛋白，提示精液液化异常或粘稠度增高的不育者，精浆蛋白水解酶活力显著降低。     

非阻塞性输精管滤过装置节育术的精浆中性α-糖苷酶的检测

本文采用ＷＨＯ推荐的改良精浆中性α－糖苷酶的测定方法测定输精管滤过装置节育术（ＩＶＤ组）和输精管结扎术（结扎组）的精浆中性α－糖苷酶活性。术前两组精浆均测出中性α－糖苷酶活性：ＩＶＤ组为４３．５０±２９．０１ｍＵ／每次射精（ｘ±ｓ）；结扎组为４７．８１±３１．２０（ｘ±ｓ）ｍＵ／每次射精；两组间无显著差异（Ｐ＞０．０５）。术后６、１２个月ＩＶＤ组分别有９１．５７％和７９．１７％的精浆测出中性α－糖苷酶活性；而结扎组仅有４．４８％和４．２４％的精浆测出中性α－糖苷酶活性；两组间均有非常显著的差异（Ｐ＜０．００１）。结果提示：ＩＶＤ组术后一年内其大部分受试对象的精浆中仍有附睾液存在。     

精液液化异常者精浆四种生化指标检测及其临床意义

目的：探讨精液液化异常时精浆生化指标的变化。　方法：选择１１８ 例精浆样本，其中正常生育组３６ 例，液化正常组 ５４ 例，液化异常组２８ 例，分别测定了精浆柠檬酸、酸性磷酸酶、唾液酸、果糖的含量。　结果：精液液化异常时，精浆柠檬酸和酸性磷酸酶显著下降，而精浆唾液酸、果糖无明显变化。　结论：精液生化成分的改变，是导致精液不液化的重要原因之一。     

精浆锌与精液质量关系的研究

本文对552例不育男子与207例正常男子精浆中锌的含量进行了比较研究,结果发现两组间锌含量有显著性差异(P<0.05)。在不育组中尤其以精子密度<20×10~6/ml组和精液不液化组差异显著(P<0.01和P<0.05)。无精症患者精浆锌高于正常人,但无统计学意义。输精管缺如者的锌值是正常人的3倍((?)±SD,432.9±74.5)。死精症患者精浆锌含量明显高于正常人。精子活动率低于40％时,随精子活动率的下降,锌含量有所上升(r=-0.2066,P<0.02),呈显著负相关。此外,本文还对16例输精管结扎前后的锌含量进行了比较,结果两者无差异。     

生育与不育男性精浆总抗氧化能力分析

目的:分析生育与不育男性精浆中总抗氧化能力(TAC)及其在男性生育中意义。方法:225例男性不育患者分为6组,分别为:梗阻性无精子症组(n=10),非梗阻性无精子症组(n=42),少精子症组(n=20),弱精子症组(n=78),少弱精子症组(n=57),以及正常精子症组(n=18)。28例正常生育男性作为对照(生育组)。分别采用计算机辅助精液分析(CASA)系统进行精液参数分析,采用比色法检测精浆TAC水平。结果:生育组男性精浆TAC为(19.82±6.33)U,梗阻性无精子症组(1.71±1.33)U,非梗阻性无精子症组(12.73±9.44)U,少精子症组(10.85±6.64)U,弱精子症组(13.88±8.24)U,少弱精子症组(11.20±7.02)U,正常精子症组(18.07±8.73)U;与生育组精浆TAC[(19.82±6.33)U]相比,在各不育症组中,除正常精子症组精浆TAC与生育组差异无显著性外,其余各组均显著低于生育组(P<0.01)。精浆TAC与精子密度(r=0.182,P<0.05)和a级精子(r=0.150,P<0.05)呈显著正相关。结论:精浆中TAC水平与男性不育密切相关,精浆中过低的TAC水平可能是引起男性不育的病因之一。     

精浆蛋白水解酶测定及其临床意义

用酪蛋白作底物，建立了精浆蛋白水解酶的测定方法。健康人（ｎ＝２０）精浆蛋白水解酶活力为２１４０Ｕ／ｍｇ蛋白，不育患者（精液液化正常）（ｎ＝２０）精浆蛋白水解酶活力为１９７６Ｕ／ｍｇ蛋白，液化异常或粘稠度增高的不育患者精浆蛋白水解酶活力为６４２Ｕ／ｍｇ蛋白，提示精液液化异常或粘稠度增高的不育者，精浆蛋白水解酶活力显著降低。     

生育与不育男性精浆的转铁蛋白

147例不育男性的精浆转铁蛋白(Tf)的平均含量(20.1±0.89g/ml(显著地低于115例正常生育男性的Tf的平均含量(28.2±0.7μg/ml,p<0.01)。其中无精症组、严重少精症组,中度少精症组和仅精子密度正常组的精浆Tf含量(分别为15.8±0.9,18.5±0.2,19.0±1.6和22.4±1.6μg/ml)与正常生育组比较均有显著差异(P<0.01)。血清FSH水平升高组精浆Tf含量显著低于血FSH水平正常组。本研究结果表明精浆Tf可能是反映睾丸支持细胞功能的有意义的指标。     

精浆中PSA浓度与精液粘度关系的研究

ＰＳＡ是人体前列腺上皮细胞产生的外分泌物。在精液中，ＰＳＡ直接涉及到凝固精液的液化。从１９９３年１２月～１９９５年８月，对８５例精液标本进行ＰＳＡ和粘度测定。高粘度精液的ＰＳＡ平均浓度为０．２８±０．０２ｍｇ／ｍｌ，正常粘度精液的ＰＳＡ平均浓度为０．３９±０．０２ｍｇ／ｍｌ。结果显示：精浆中ＰＳＡ水平在高粘度病人中有意义地被降低，也提示：在人类精液中ＰＳＡ浓度与精液粘度是紧密相关的。     

精子尾部卷曲试验及影响因素的探讨

本文介绍了精子尾部卷曲试验及影响因素（时间、温度、ｐＨ）。３０例正常生育男性和４３例不育男性的精液分析表明，精子尾部卷曲率与精子活率具有高度的相关性（ｒ＝０．９６２５），与精子密度无相关性（ｒ＝０．１６２）；男性生育组与不育组之间的精子尾部卷曲率具有显著性差异（ｘ±ｓ，百分率分别为７５．２１±２０．０１和５９．４３±２０．５４，Ｐ＜０．０５）。     

神经肽催产素与男性不育关系的研究

目的:分析特发性男性不育患者催产素(oxytocin,OT)水平及其受体的表达。方法:选取特发性少精子症(oligozoospermia group,OG)(含无精子)、弱精子症(asthenozoospermia group,AG)及少精子合并弱精子症(oligoasthenozoospermia group,OAG)男性不育患者共65例,年龄20～45岁;对照组(control group,CG)选取有自然生育史的健康男性志愿者20例(精液参数正常),年龄20～45岁。检测各组血清黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle-stimulating hormone,FSH)、睾酮(testosterone,T)及OT含量,进一步通过检测催产素受体启动子功能序列(oxytocin receptor promotor fuctional sequence,OTRP)、催产素受体羧基端部分mRNA序列(OTRmR-NA)以及OTR蛋白构象、组成来分析OTR表达情况。OTR蛋白印迹分析结果经灰度软件处理后转化为计数资料;统计方法采用单因素方差分析。结果:①男性生殖内分泌激素含量分析:OT:各病例组均高于CG[(79.30±3.83)pg/ml],具有统计学意义(F0.05/2(2,82)=8.29,P<0.001);LH:AG[(4.26±0.31)IU/L]及OAG[(4.55±0.40)IU/L]均低于OG[(6.77±0.57)IU/L]和CG[(7.19±0.50)IU/L](F0.05/2(2,82)=11.64,P<0.01);FSH:AG[(5.02±0.39)IU/L]低于CG[(8.91±0.91)IU/L]、OG[(11.86±1.76)IU/L]及OAG[(8.82±1.03)IU/L](F0.05/2(2,82)=7.22,P<0.01);T:各组间无统计学差异(F0.05/2(2,82)=0.42,P=0.739)。②OTR基因转录分析:OTR启动子功能序列和OTR成熟mRNA序列未发现明显的变异。③OTR构象分析:人OTR以单体和寡聚体同时存在,以寡聚体为主,常见为四聚体和六聚体;AG(0.41±0.03)和OAG(0.13±0.01)的单体明显多于OG(0.05±0.004)和CG(0.05±0.003)(F0.05/2(2,82)=115.50,P<0.01);AG中20%病例存在寡聚体明显减少现象。结论:男性不育患者血清OT含量及OTR表达的差异提示OT与男性不育间存在一定的联系,OTR单体表达升高及寡聚体表达降低为进一步探索OT与男性不育间的关系提供了新的方向。     

Soluble Fibrinogen-like protein 2 plays a role in varicocele induced male infertility

Varicocele is the most common cause of male infertility. Several theories have been proposed to explain how varicocele induces infertility. The role of epididymis in male infertility is not fully well established. Fibrinogen-like protein 2 is one of serine proteases and is a potent coagulant in membranous form and immune-modulator in soluble form (sFGL-2) and expressed in the epididymis. There are no previous reports about its possible role in varicocele. This case-controlled study aimed to evaluate the seminal level of sFGL-2 in infertile men with varicocele and in men with idiopathic infertility. This study included 85 participants divided into three groups; 25 normal fertile men, 30 infertile men with varicocele and 30 infertile men of idiopathic cause. Clinical examination, Doppler ultrasound, semen analysis and measurement of seminal level of sFGL-2 were done to all participants. Seminal level of sFGL-2 was significantly elevated in infertile than normal fertile men. Seminal level of sFGL-2 showed negative correlations with sperm concentration, motility and normal morphology. Seminal level of sFGL-2 had a positive correlation with seminal liquefaction time. This study concluded that seminal level of sFGL-2 is increased in infertile men with idiopathic cause and with varicocele induced infertility and affects seminal liquefaction.     

Antioxidant activity in the semen of fertile and infertile men

OBJECTIVES: To evaluate catalase- and superoxide dismutase (SOD)-like activities in the seminal plasma of fertile and infertile men. METHODS: Semen samples were obtained from consecutive men presenting for vasectomy (n = 12) and infertility evaluation (n = 105) at our institution. Catalase-like activity was measured by the decrease in hydrogen peroxide after incubation with seminal plasma. SOD-like activity was measured as the inhibition of nitroblue tetrazolium reduction due to superoxide anion generation by xanthine plus xanthine oxidase. RESULTS: Mean seminal catalase-like activity (+/-SEM) in fertile men was not significantly different from that of infertile men (369 +/- 49 versus 326 +/- 17 U/mL, respectively). Mean SOD-like activity in the semen of infertile men was significantly greater than in the semen of fertile controls (46.7 +/- 1.5 versus 37.0 +/- 2.8 U/mL, respectively, P <0.05). CONCLUSIONS: Our data show that infertile men do not have deficient seminal plasma SOD- and/or catalase-like activity (two key antioxidants). These findings suggest that the high semen ROS levels in some infertile men are likely due to excessive generation of ROS rather than deficient ROS scavenging activity in semen.     

Ureaplasma urealyticum infection related to seminal plasma immunosuppressive factors, semen pH and liquefaction duration

In this study, semen samples from fertile and unexplained infertile men were explored for relationships between seminal plasma immunosuppressive factors (SPIFs), semen pH, liquefaction duration and infection of ureaplasma urealyticum (Uu). SPIFs activity was measured by way of counteracting complement. PH was detected by exact pH test paper. Liquefaction duration was observed at 37 degrees C. The results showed that Uu infection ratios of semen samples with abnormal SPIFs, pH or liquefaction duration were markedly higher than those of normal semen samples. It is suggested that Uu infection decreases the level of SPIFs, changes the pH in semen and prolongs the semen liquefaction so as to cause spermatic quality decline. The enhancement of SPIFs level may change the male body against Uu infection.     

精浆中分子物质与男性不育

本文报告男性不育患者精浆、血浆中分子物质测定结果。３４例生育男性精浆中分子物质平均含量为１５３８．５Ｕ／ｄｌ；３６例睾丸生精障碍男性精浆中分子物质平均含量为１４６９Ｕ／ｄｌ；６２例不明原因不育男性精浆中分子物质平均含量为１３２５．３／ｄｌ。生育与不明原因不育男性精浆中分子物质含量比较差异有显著性（Ｐ＜０．０１），生育和不育男性血浆中分子物质无显著性差异（Ｐ＞０．０５），睾丸生精障碍男性与生育男性精浆中分子物质含量相比无统计学意义（Ｐ＞０．０５）。提示精浆中分子物质主要来自附睾、前列腺、精囊等附属性腺。     

Association of asymptomatic Chlamydia trachomatis infection with male infertility and the effect of antibiotic therapy in improvement of semen quality in infected infertile men

The role of asymptomatic infections caused by Chlamydia trachomatis in male infertility and the efficacy of antibiotics in the treatment of this condition are not yet definitely determined. A total of 165 infertile males having abnormal semen parameters (study group) as well as 165 healthy fertile men (control group) were included. Semen samples were taken from all participants and after analysing for semen parameters, undergone real‐time PCR, and reactive oxygen species (ROS) as well as total antioxidant capacity (TAC) assays. Infected individuals of study group were treated with antibiotic. One month after the treatment completion, second semen samples were taken and undergone all the tests mentioned. The frequency of C. trachomatis was significantly higher in the infertile men compared with the fertile ones (4.2% vs 0.6%). Most of the semen parameters were improved and reached their normal range, the level of TAC elevated and ROS level as well as ROS/TAC ratio reduced after antibiotic treatment. Moreover, wives of three infected infertile men (42.9%) became pregnant 4 months after the treatment completion. Our data suggest that asymptomatic infection caused by C. trachomatis is correlated with male infertility and antibiotic therapy can improve the semen quality and fairly treat the male infertility.     

尿激酶对弱精症患者精子活力影响的研究

对２８例弱精症男子精液中加入不同浓度的尿激酶后，分别在３０、６０、９０和１２０分钟观察精子的活率和前向运动能力。并对１４例患者体内给予尿激酶１０天后，比较用药前后精子活率和有前向运动力精子数目的变化。结果：２８例精液标本体外加入尿激酶后，３０、６０、９０和１２０分钟时精子的活率均有提高；前向运动精子的数目亦有增加。体内给药前，１４例精子平均活率为４４．６４±１１．７９，用药１０天后，精子平均活率为６４．７１±１３．０１，二者比较有极显著差异（Ｐ＜０．０１）。尿激酶的这一作用可能与它降低精液的粘稠度有关。