男性不育患者精浆和血清中锌铅镉丙二醛含量及超氧化物歧化酶活力的研究

目的 研究男性不育患者精浆中超氧化物歧化酶(SOD)活力、丙二醛(MDA)及锌、铅、镉含量的变化与精浆抗氧化能力的关系,为男性不育症患者寻找病因及诊治方法提供依据.方法 选择精液常规检查异常的男性不育者120例,为不育组;精液常规检查正常者100例,为对照组.SOD活力采用黄嘌呤氧化酶比色法测定,MDA采用硫代巴比妥酸比色法测定,锌、铅、镉采用原子吸收分光光度计法进行测定.结果 男性不育症患者精浆中锌、铅、镉、MDA含量和SOD活力分别为(27.18±7.88)μg/L,(1.98±0.49)ng/L,(9.03±3.36) ng/L,(150±11.9) nmol/L,(210±41)U/L.对照组精浆中锌、铅、镉、MDA含量和SOD活力分别为(46.50±6.77)μg/L,(0.85±0.33)ng/L,(7.59±2.11)ng/L,(98±12)nmol/L,(361±103) U/L,其中铅和MDA含量显著高于对照组,锌含量和SOD活力显著低于对照组(P＜0.01);镉含量较对照组高,但差异无统计学意义.男性不育症患者血清中锌含量低于对照组,MDA含量高于对照组(P＜0.01);铅、镉含量和SOD活力与对照组比较无显著性差异.结论 男性不育者精浆中铅含量增高可导致精子细胞过氧化反应增强,抗氧化物锌和SOD消耗增加,脂质过氧化代谢产物MDA增多,对精子造成损伤,使精子质量降低.     

少、弱、畸形精子症患者血铅、镉浓度的测定

目的通过对男性少、弱、畸形精子症患者血铅、镉的测定,探索职业、环境、嗜好、生活习惯对男性生殖的影响。方法经检查确诊为少、弱、畸形精子症的79例患者,检测其血铅、镉含量和进行精液分析,将其结果与精液正常的34人对比,并作统计学分析。结果79例患者中,血铅(Pb)≥100μg/L或镉(Cd)≥5μg/L共53例,占总患者的67.1%;正常组中仅5例Pb>100μg/L,占14.7%,两者比较差异显著(P<0.05)。结论重金属铅、镉对精液质量影响显著。     

不育症患者和正常人精液八种元素含量的测定及锌镉比值的分析

我们对长沙地区不育症患者和正常人的精液中锌、铜、镁、钙、锰、铅、镉、镍８种元素进行了测定。其数据经统计学处理发现：不育症组精液的锌、钙、镁３种元素含量显著低于正常对照组（Ｐ＜００ｌ）；前者镉的含量高于后者（Ｐ＜０．０５），锌／镉比值低于后者；而铜、锰、铅、镍等４种元素含量在两组间均无差异。我们认为，精液中锌／镉比值可作为诊断和治疗男性不育症的参考。     

精液/精子质量与复发性流产关系的病例对照研究

目的:分析精液常规参数与复发性流产间的关系。方法:采用1∶1配对病例对照研究,比较复发性流产患者配偶与健康体检男性间的精液相关参数。结果:相对于对照组,病例组的精液量[(1.95±1.11)mlvs(2.74±1.43)ml]、精子浓度[(48.68±20.07)×106/ml vs(59.26±25.35)×106/ml]、b级精子百分率[(12.07±3.34)%vs(16.18±6.74)%]、果糖含量[(1.73±0.64)g/L vs(2.21±0.75)g/L]、顶体酶活性[(84.34±26.69)U/mg prot vs(94.20±26.35)U/mg prot]、α-葡糖苷酶(α-GLU)[(36.28±15.98)U/ml vs(44.45±12.54)U/ml]和酸性磷酸酶(ACP)[(68.55±35.45)U/ml vs(84.78±51.10)U/ml]的含量较低(P<0.05),头部畸形精子百分率[(47.36±4.59)%vs(46.50±6.32)%]、尾部畸形精子百分率[(7.56±2.27)%vs(7.28±3.10)%]和弹性硬蛋白酶[(885.64±1 272.30)ng/ml vs(661.08±764.64)ng/ml]的含量较高(P<0.05);判别分析结果显示,精液量、b级精子百分率、混合畸形精子百分率、果糖含量、α-GLU含量和ACP含量可用于复发性流产男性精液/精子质量的判断。结论:常规精液/精子质量相关检测对于评价复发性流产精液因素具有一定的意义,但需要综合分析,特异性不够;精液/精子质量相对较差与复发性流产发生相关。     

精液中性激素水平与生殖细胞凋亡的关系

目的:探讨人精液中性激素水平与生殖细胞凋亡的关系。方法:随机选择66例不育患者及30例生育男性,采用ELISA法进行卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)和睾酮(T)水平分析,并用脱氧核苷酸末端转移酶(TdT)介导的缺口末端标记(TUNEL)法检测生殖细胞的凋亡。结果:精液中FSH、LH、PRL和T水平30例生育者分别为(1.63±0.15)U/L、(2.18±0.21)U/L、(6.34±0.30)nmol/L、(1.85±0.11)nmol/L,生殖细胞凋亡率为(4.61±1.23)%,而66例不育者4种性激素水平分别为(1.25±0.18)U/L、(1.76±0.32)U/L、(5.86±0.31)nmol/L、(1.45±0.13)nmol/L,生殖细胞凋亡率为(18.36±2.04)%。两者相比各参数差异均有显著性(P<0.01)。不育组FSH、LH、PRL、T水平与生殖细胞的凋亡率呈负相关(r分别为-0.88、-0.93、-0.90、-0.98,P均<0.01)。凋亡的生殖细胞体积缩小,核染色质致密,凝聚在核周形成新月形,或核裂解形成凋亡小体。结论:精液性激素水平与生殖细胞的凋亡有着密切关系,低水平的性激素可能导致睾丸生殖细胞凋亡率增加。     

双氢青蒿素对前列腺癌细胞PC-3M生长的影响及其机制探讨

目的:观察双氢青蒿素对雄激素非依赖性前列腺癌细胞株PC-3M细胞凋亡和血管内皮生长因子(VEGF)表达的影响。方法:不同浓度(0、25、50、100μmol/L)的双氢青蒿素分别作用于PC-3M细胞48 h,MTT法检测细胞生长活性;流式细胞仪测定细胞凋亡率;分光光度法检测细胞凋亡过程中caspase-3、caspase-8活性变化;半定量RT-PCR法检测PC-3M细胞内VEGF mRNA的表达;Western印迹法检测细胞VEGF蛋白表达。结果:双氢青蒿素能显著抑制PC-3M细胞的增殖,与对照组(0μmol/L)的细胞凋亡率(2.92±0.45)%相比,各剂量组(25、50、100μmol/L)的细胞凋亡率[(8.85±0.74)%,(12.83±0.84)%,(18.65±1.24)%]显著增加,caspase-8[(0.47±0.05)U/μg vs(1.22±0.15)U/μg,(1.76±0.07)U/μg,(2.91±0.24)U/μg]、caspase-3[(0.44±0.07)U/μg vs(0.95±0.08)U/μg,(1.48±0.14)U/μg,(2.92±0.45)U/μg]活性显著增加,呈剂量依赖性(P<0.01)。PC-3M细胞内VEGF mRNA的表达和蛋白表达呈剂量依赖性降低。结论:双氢青蒿素能显著抑制体外PC-3M细胞的生长,并促进其凋亡,机制可能与增加凋亡蛋白酶和抑制VEGF表达有关。     

红细胞停跳液的心肌保护作用及对心肌微血管通透性的影响

目的制作一种新的停跳液--红细胞停跳液(EC),并观察它的心肌保护作用以及同全血停跳液(BC)和去白细胞停跳液(DC)的差异.方法用滤器去除大鼠(24只)血液中的白细胞和血小板,配制红细胞停跳液,并应用Langendorff离体心模型,测定心率(HR)、左心室收缩压(LVSP)、左心室舒张末压(LVEDP)、心肌最大收缩速度(Dp/Dtmax)、冠状动脉流量(CF);灌流流出液中的肌酸激酶(CK)、乳酸、葡萄糖含量以及心肌组织内的伊文思蓝(EB)的含量和湿干比值.结果红细胞停跳液组HR、LVSP的恢复率[BC(64.0±14.1)%、DC(55.4±11.9)%、EC(75.3±14.2)%];CF的恢复率[BC(62.49±14.69)%,DC(66.63±7.54)%,EC(79 15±12.18)%]、乳酸、葡萄糖、伊文思蓝的含量[EC(80.11±21.13)μg/g,DC(129.80±39.4)μg/g,BC(186.03±11.89)μg/g]和湿干比值(BC5.91±1.30,DC4.96±0.24,EC4.58±0.36)与对照组间比较差异有显著性(P＜0.05).结论红细胞停跳液较全血停跳液和去白细胞停跳液具有更好的心肌保护作用.     

前列腺癌患者血清中锌、镉含量变化及其临床意义

目的:研究血清锌、镉与前列腺癌(PCa)的关系,以探讨其在PCa诊断及防治中的价值。方法:选择PCa患者85例(PCa组)和健康体检者90例(对照组),抽取外周静脉血4ml,分离血清。采用原子吸收分光光度法测定血清中锌、镉含量。结果:PCa组血清锌为(63.92±19.10)μg/dl,显著低于对照组(103.61±32.43)μg/dl;而PCa组血清镉为(13.58±3.64)μg/dl,显著高于对照组(7.45±2.31)μg/dl(P0.05)。PCa组血清锌与前列腺特异抗原(PSA)之间呈明显负相关(P0.05),相关系数r=-0.74;血清镉与PSA之间呈明显正相关(P0.05),相关系数r=0.65。结论:血清锌降低及血清镉升高可能与PCa的发生密切相关;检测血清锌、镉可能对PCa的早期诊断具有重要价值。     

几种离子及微量元素与人类精子运动相关性研究

本文应用浊度法和原子吸收光谱法,分别测定了精液中快速运动相精子的平均速度(VRM)和精浆中Na~+,K~+,Ca~(++),Mg~(++),Fe,Cu,Zn,Mn的含量。通过统计发现:1.正常有生育力者Na~+为2.5913±0.1399mg/mL,K~+1.2297±0.4189mg/mL,Mg~(++)0.1438±0.054mg/mL,Ca~(++)0.3089±0.1236mg/mL,Fe0.4087±0.1462μg/mL,Cu0.3383±0.1449μg/mL,Zn179.9±98μg/mL,Ma0.0446±0.043μg/mL。2.精子活动力差的不育患者,精浆中Mg~(++),Ca~(++),Cu及VRM均低于正常有生育力者。P<0.05。3.正常有生育力者VRM与精浆内Na~+含量有相关性。精子活动力差的不育患者VRM与精浆内Ca~(++),Cu含量有相关性。由此可见,VRM与精浆内多种成分有关,以与Na~+关系最为密切,其次是Ca~(++)和Cu。     

抗生素及非甾体类消炎药对ⅢA型前列腺炎血清PSA及游离PSA的影响

目的:探讨炎症性慢性骨盆疼痛综合征(ⅢA)患者经过抗生素及非甾体类消炎药治疗的血清前列腺特异性抗原(PSA)水平及游离PSA百分率(F-PSAR)的变化。方法:ⅢA型前列腺炎患者228例,应用抗生素及非甾体类消炎药治疗4周,测定患者治疗前、治疗结束后4周及8周的血PSA水平及F-PSAR,分析治疗前后血PSA水平及F-PSAR的变化。结果:在228例ⅢA型前列腺炎患者中,血PSA治疗前为(3.51±3.03)μg/L,治疗后第4周为(2.75±2.84)μg/L,较治疗前显著下降(P<0.05);而F-PSAR由治疗前0.25±0.05升至0.27±0.03。其中PSA≥4μg/L的患者占28.5%(65/228),在PSA≥4μg/L的患者中,PSA由治疗前(6.24±1.93)μg/L降至治疗结束后第4周(4.58±2.99)μg/L(P<0.05),PSA下降的幅度为(32.9±36.1)%;治疗后PSA<4μg/L患者占27.7%(18/65),F-PSAR由治疗前(16±9)%升至治疗结束后第4周(22±11)%(P<0.05),F-PSAR上升幅度为(51.4±25.8)%。上述指标在治疗后4周和治疗后8周差异无显著性(P>0.05)。结论:慢性前列腺炎亦是血PSA升高的原因之一。在明确前列腺炎的诊断后,可以给予有效的抗感染及抗炎治疗,能显著降低血PSA水平及提高F-PSAR。     

Comparison of zinc concentrations in blood and seminal plasma and the various sperm parameters between fertile and infertile men

The aim of the study was to examine the relationships between concentrations of zinc in blood and seminal plasma and sperm quality among infertile and fertile men. One hundred seven male (infertile group) partners of couples who were undergoing investigation for infertility with no known cause for the infertility and 103 men (fertile group) whose wives were pregnant at the time of the study were recruited. The subjects' blood and seminal plasma concentration of zinc were determined by atomic absorption spectroscopy. Except for semen volume, all the other semen parameters for the infertile men were significantly lower than those for the fertile group. The geometric means of the seminal plasma zinc concentration were significantly lower in the infertile group compared with those in the fertile group; 183.6 mg/L (range, 63-499) versus 274.6 mg/L (range, 55-420). There were no significant differences in the geometric means of the blood zinc concentration between the 2 groups. Seminal plasma zinc concentration was significantly correlated with sperm density (r = 0.341, P < .0001), motility (r = 0.253, P < .0001), and viability (r = 0.286, P < .0001). On the basis of the findings of this study and those of other reports, zinc may contribute to fertility through its positive effect on spermatogenesis.     

Cadmium, lead, selenium, and zinc in semen of occupationally unexposed men

Summary. Concentrations of cadmium, lead, selenium, and zinc were determined in semen and seminal plasma of 22 volunteers by atomic absorption spectrometry. Additionally conventional semen parameters and, by means of computer videomicrography, motion parameters of spermatozoa were evaluated. Concentrations of Cd, Pb, and Zn determined in semen were not significantly different from those measured in seminal plasma. However, selenium levels were significantly higher in semen (53.8 ± 22.9 μg 1⁻¹) than in seminal plasma (40.4 ± 15.5 μg 1⁻¹, P <0.01). The investigated semen samples on average contained low levels of Cd (0.4 ± 0.23 μg 1⁻¹) and Pb (9.8 ± 6.5 μg 1⁻¹). Studies on the intra-individual variability revealed the following average coefficients of variation (%) for element concentrations: Pb (70), Cd (53), Se (27), and Zn (23); and for semen parameters: total sperm count (46), sperm concentration (37), motility (22), ejaculate volume (21), linearity (19), linear velocity (11), curvilinear velocity (10), and percentage of normally formed sperm (9). Significant positive correlations were detected between semen selenium levels and sperm concentration ( r =0.51, P <0.05), and percentage of normally formed sperm ( r =0.46, P <0.05), respectively. Sperm motility ( r =0.53, P <0.02), linear ( r = 0.76, P <0.001) and curvilinear velocity ( r = 0.64, P < 0.002) were significantly correlated with semen cadmium levels.     

少弱精子冷冻保存在宫腔内人工授精中的应用

目的:探讨精液冷冻保存在少弱精子症患者行宫腔内人工授精(IUI)周期中的应用效果。方法:2008年3月至2009年6月103对原发性不孕夫妇,共计152个IUI治疗周期,其中精液正常者53个周期(组1),少弱精子者52个周期(组2),少弱精子经精液冷冻保存后结合新鲜精液者47个周期(组3)。检测治疗前后精液常规、精液处理后前向活动精子总数,随访3组患者治疗期间配偶妊娠结局。结果:精液处理前组3精液体积、精子活率、a级精子均低于组2,差异极显著(P<0.01);组3处理后前向活动精子总数高于组2,但差异无显著性(P>0.05)。3组间生化妊娠率和临床妊娠率均无显著性差异。结论:精液冷冻保存可以增加少弱精子症患者前向活动精子总数,精液冷冻保存技术可以在一定程度上提高其IUI妊娠率。精液冷冻保存与IUI相结合,可能是治疗少弱精子症一种较为理想的方法。     

Chromatin decondensation of human sperm in vitro and its relation to fertilization rate after ICSI

The inability of sperm chromatin to decondense has been implicated in the failure of fertilization, This study was undertaken to identify the relationship between sperm chromatin decondensation in vitro after incubation with follicular fluid at various points in time and fertilization or pregnancy rates after intracytoplasmic sperm injection. Moreover, an attempt was made to determine whether this test could be used as a predictive test for the outcome of ICSI. Thirty-two infertile couples undergoing ICSI therapy were included in this prospective study. One milliter of semen from each sample was mixed with 1 mL of follicular fluid obtained from ICSI patients at the time of oocyte retrieval and incubated for 24 h. Many smears were made directly after semen liquefaction at the following time intervals: 30, 60, and 120 min and 24 h. Chromatin decondensation was evaluated with acridine orange staining. The mean percentage of uncondensed chromatin of spermatozoa in the native semen samples was 25 +/- 18.3%, which increased within 24 h to 91 +/- 9.5%. On the other hand, the fertilization and ongoing pregnancy rates were 64 +/- 21.7% and 20%, respectively. However, no correlations were found between chromatin decondensation at various point of time (30, 60, and 120 min and 24 h) and fertilization rate. No correlation was shown between the chromatin decondensation and sperm counts in the ejaculate. morphology, or the percentage of condensed chromatin. In light of this study, chromatin decondensation in vitro cannot be recommended for predicting the fertilization potential of spermatozoa and pregnancy rates in the ICSI program. Further research is necessary, especially in cases where ICSI is being considered as a therapeutic option.     

Blood concentrations of lead, cadmium, mercury, zinc, and copper and human semen parameters.

The study consisted of 35 male subjects attending an andrology clinic. The subjects all had poor sperm parameters that could not be attributed to any known medical cause. The objective was to evaluate the relation between various seminal characteristics (volume, total sperm count, sperm viability, proportion of progressively motile sperm, and different sperm morphology) and the blood concentrations of lead, cadmium, mercury, copper, and zinc. The mean blood concentrations of lead, mercury, copper, and zinc were within the normal values; cadmium concentration (1.35 micrograms/L) was much higher than the norms. Asthenozoospermic subjects had significantly (p less than .025) higher blood cadmium levels than normozoospermic subjects. No significant differences were noted between the two groups for mean concentration of mercury, zinc, and copper in blood. Significant correlations were observed between blood cadmium levels and volume of semen, midpiece defects, and immature forms of spermatozoa. High blood cadmium levels may have an effect on spermatogenesis. Possible reasons for the high blood cadmium levels among the subjects are discussed.     

Correlation between lead and cadmium concentration and semen quality

There are contrary reports of association of lead and cadmium with the decline in semen quality. This study evaluates whether seminal lead (Pb) and cadmium (Cd) at environmental concentration are associated with altered semen quality. We conducted a study of healthy fertile and infertile men 20–43 years of age attending the Andrology Laboratory of Reproductive Biology Department for semen analysis. The semen analysis was carried out according to the WHO 2010 guidelines. Seminal lead and cadmium were estimated by ICP‐AES. The lead and cadmium values were significantly higher in infertile subjects. A negative association between seminal lead or cadmium concentration and sperm concentration, sperm motility and per cent abnormal spermatozoa was found. This study shows that exposure to Pb (5.29–7.25 μg dl^?1) and cadmium (4.07–5.92 μg dl^?1) might affect semen profile in men. Age, diet, smoking and tobacco chewing habits may have an influence on the increase in exposure to Pb and Cd in the individual subjects.     

Male serum Chlamydia trachomatis IgA and IgG, but not heat shock protein 60 IgG, correlates with negatively affected semen characteristics and lower pregnancy rates in the infertile couple

BACKGROUND: The objective of this study was to evaluate whether serum Chlamydia trachomatis immunoglobulin-A (IgA), IgM and C. trachomatis heat shock protein 60 (CHSP60) IgG are of additional value to C. trachomatis IgG regarding the impact on fecundity in infertile couples, and to relate C. trachomatis serum antibodies to semen characteristics, diagnoses and pregnancy outcome. METHODS: A total of 226 infertile couples, previously tested for C. trachomatis IgG, were tested for C. trachomatis IgA, IgM and CHSP60 IgG, and semen samples from all men were analysed. RESULTS: Chlamydia trachomatis serum IgA in men (but not in women) correlated with reduced chances of achieving pregnancy [p = 0.021, relative risk (RR) =0.65, 95% confidence interval (CI) 0.42-1.005] and in combination with C. trachomatis IgG the chance was further reduced (p =0.001, RR = 0.35, 95% CI 0.15-0.84). Chlamydia trachomatis serum IgA was also significantly correlated with reduced motility of the spermatozoa (-8.7%, p = 0.023), increased number of dead spermatozoa (+10.5%, p = 0.014) and higher prevalence of leucocytes in semen (+122%, p = 0.005), and in combination with C. trachomatis IgG positivity, there was also a decrease in sperm concentration (-35%, p = 0.033), the number of progressive spermatozoa (-14.8%, p = 0.029) and a rise in the teratozoospermia index (+4.4%, p = 0.010). CHSP60 IgG correlated with reduced motility (-5.6%, p = 0.033), and in the women to tubal factor infertility (p = 0.033), but no correlations of C. trachomatis serum IgM or CHSP60 IgG with pregnancy rates were found. CONCLUSIONS: Chlamydia trachomatis serum IgA in the male partner of the infertile couple has an additive value to IgG in predicting pregnancy chances, and serum IgA and IgG are associated with subtle negative changes in semen characteristics.     

Classification of the Semen of the Male Partners of Infertile Nigerian Couples

Semen samples from 500 Nigerian male partners of infertile couples were classified according to their sperm counts and progressive motility. 74.15% of these men were normozoospermic while 16.19, 5.57 and 4.09% were azoospermic, necrozoospermic and asthenozoospermic, respectively. The degree of oligozoospermia was mild (35.88%), severe (23.22%) or very severe (40.90%). The classifications of two consecutive samples per patient collected two weeks apart were highly correlated. Results show that in over 70% of these infertile couples, infertility was due to a female factor, the absence of which therefore has to be established before semen analysis. Some socioeconomic factors in infertility were also implied.     

生育与不育男性精子核DNA成熟度的比较研究

通过对１９对生育夫妇和７２对不育夫妇丈夫精液中绿色吖淀橙（ＡＯ）荧光精子（成熟精子）比率分布情况的比较分析，探讨了绿色ＡＯ荧光精子百分率与精液参数及精子授精能力之间的关系。在１～３年随访中，通过人工授精、其他治疗或在非治疗期，５４对绿色ＡＯ荧光精子≥５０％的夫妇有１８对怀孕，而１８对绿色ＡＯ荧光精子＜５０％的夫妇无１例怀孕。结果还显示了绿色ＡＯ荧光精子百分率与精液参数无关。认为该项指标从精子核ＤＮＡ成熟状态角度反映了单凭精液分析所不能反映的男性生育力。精液中绿色ＡＯ荧光精子＜５０％，是低生育力精液的评估界限     

The effect of doxycycline in infertile couples with male accessory gland infection: a double blind prospective study

Male accessory gland infection (MAGI, epididymo-prostato-vesiculitis) with abnormal semen quality was rarely the only abnormality in infertile couples since it occurred in no more than 1.6% of 2871 couples evaluated in 7 centres during a 3-year period. Both partners of 33 infertile couples with no other demonstrable abnormality than abnormal semen and MAGI consented to participate in a double blind trial and were treated with either doxycycline, 100 mg/day for 1 month (20 couples) or placebo (13 couples). Follow-up during a total of 175 couple-months included semen analysis and the recording of pregnancy. Pregnancy occurred in 2 of the doxycycline-treated couples (10%) and in 1 of the placebo treated couples (8%), corresponding with conception rates per month of 1.9% and 1.5%, respectively. Sperm motility and, to a lesser extent, morphology showed improvement in both groups. Evidence of infection, namely increased numbers of white blood cells and positive sperm culture, disappeared in both the doxycycline-treated and placebo group. It is concluded that features of MAGI in semen may regress spontaneously and are not influenced by the doxycycline treatment. The concomitant improvement of sperm motility and morphology still does not seem to enhance the probability of conception.