Ⅲ型前列腺炎患者精液参数、锌浓度及抗菌活性的变化

目的:探讨Ⅲ型前列腺炎(CP/CPPS)患者精液常规参数、锌浓度及抗菌活性的关系。方法:对60例CP/CPPS患者和20例健康男性进行精液常规参数、锌浓度及抗菌活性的检测。结果:CP/CPPS患者精液液化时间、精子活力、精浆抗菌活性及精浆锌离子浓度与对照组相比,差异有显著性(P均<0.01)。CP/CPPS患者精子活力与精浆锌离子浓度间有显著相关性(r=0.272,P=0.015)。精浆抗菌活性与精浆锌离子浓度间有显著相关性(r=0.449,P<0.01)。结论:CP/CPPS患者精液液化时间延长,精子活力下降,精浆锌浓度和抗菌活性降低。精浆抗菌活性与精浆锌浓度、精子活力间有显著相关性。     

禁欲时间对精子DNA损伤、形态及精液常规分析参数的影响

目的 探讨不同禁欲时间对精子DNA损伤、形态及精液常规分析参数的影响。方法 收集从2018年9月至2021年2月到东南大学附属中大医院生殖医学中心就诊的男性患者精液样本1 128例。采用CFT-9201型计算机辅助精子分析系统进行精液常规分析，包括精子浓度、精子活动率、前向运动精子百分率(PR)等主要参数；采用Diff-Quik染色法进行精子形态分析；采用精子染色质结构分析法(SCSA)检测精子DNA碎片指数(DFI)。结果 1 128例患者的禁欲时间为0～30天，中位数为3.0[3.0, 5.0];仅精子活动率呈正态分布(P=0.117),其余参数均呈非正态分布(P<0.01)。患者禁欲时间与精液量(r=0.21,P<0.01)、精子浓度(r=0.098,P<0.01)和精子DFI(r=0.068,P<0.05)均呈显著正相关，而与PR、精子活动率和正常形态精子百分率均呈负相关，但均无显著相关性(P>0.05)。精子DFI与精子浓度没有显著相关性(P>0.05),但与PR、精子活动率和正常形态精子百分率均呈显著负相关(P<0.01)。结论 随...     

精子DNA碎片指数与精液参数相关性的初步研究

目的研究精子DNA碎片指数(DNA fragmentation index,DFI)与精液参数的关系以及精子DFI在评价男性生育力方面的应用价值。方法收集3020例男性患者精液标本,采用吖啶橙染色配合流式细胞仪技术检测DFI,同时通过计算机辅助精液分析系统(CASA)检测精子浓度、前向运动精子百分率(PR,%)、精子总活力[PR+NP(非前向运动精子)%]、精子总数和精液量(用称量法测定精液体积)。结果精子浓度与DFI值无明显关系(r=0.003,P0.05)。精液量和DFI值有明显关系(r=0.078,P0.01),精子总活力和DFI值有明显关系(r=-0.447,P0.01)。PR和DFI值有明显关系(r=-0.444,P0.01),精子总数和DFI值有明显关系(r=0.069,P0.01),差异均具有统计学意义。结论精子DNA碎片指数与精液量、精子总数存在明显正相关,与精子总活力、前向运动精子百分率呈明显负相关。在一定程度上反映了精液参数可以为评价精子DNA完整性提供参考。     

IL-6在慢性前列腺炎患者精浆中的表达及其临床意义

目的探讨慢性前列腺炎/慢性骨盆疼痛综合症(CP/CPPS)患者精浆中IL-6的表达及临床意义。方法采用电化学发光免疫分析法(ECLIA)对52例炎症型慢性骨盆疼痛综合征(ⅢA型)、38例非炎症型慢性骨盆疼痛综合征(ⅢB型)患者及36例健康志愿者精浆中IL-6含量进行测定分析,并将ⅢA、ⅢB型IL-6的表达与其NIH-CPSI评分进行相关性分析。结果 CP/CPPS患者ⅢA[(27.46±5.29)ng/mL]、ⅢB型[(9.83±2.09)ng/mL]精浆中IL-6含量均明显高于健康对照组[(4.94±1.55)ng/mL](P0.01)。在CP/CPPSⅢA、CP/CPPSⅢB型患者精浆中IL-6的含量有明显差异(P0.01)。CP/CPPS患者ⅢA型精浆中IL-6的含量与NIH-CPSI总评分呈正相关(r=0.590,P0.01),与疼痛评分呈正相关(r=0.436,P0.01),与排尿评分呈正相关(r=0.557,P0.01),与生活质量评分正相关(r=0.321,P0.01)。CP/CPPS患者ⅢB型精浆中IL-6的含量与NIH-CPSI总评分呈正相关(r=0.404,P0.05),与疼痛评分呈正相关(r=0.597,P0.01),与排尿评分无相关性(r=-0.262,P=0.226),与生活质量评分无相关性(r=0.290,P=0.179)。结论精浆中IL-6含量可能作为CP/CPPS分型诊断指标,精浆中IL-6含量有望作为评价CP/CPPS病情程度的分子生物学指标。     

二胎备孕男性精液质量与年龄、体质量指数以及肥胖生化指标的相关性分析

目的:探讨广州地区二胎备孕男性的年龄、体质量指数(BMI)以及肥胖生化指标对精液质量的影响。方法:对2017年8月15日至2018年7月18日在广州市妇女儿童医疗中心就诊咨询准备生育二胎的632例男性进行问卷调查,所有参与者采取静脉血进行脂代谢等相关指标检测,并按照WHO《人类精液检查与处理实验室手册》(第5版)的要求进行精液常规分析以及改良巴氏染色后精子形态分析,分析年龄、BMI、脂代谢指标、生活环境、职业等因素与精液质量的相关性。结果:年龄、BMI、取精季节、生活环境、职业等因素均可影响男性精液的质量。年龄与前向运动精子百分率呈负相关(r=-0.109,P0.05);BMI与精液量呈正相关(r=0.103,P0.05),并且与正常形态精子百分率呈负相关(r=-0.138,P0.05);高密度脂蛋白(HDL)与前向运动精子百分率呈负相关(r=-0.168,P0.01),与不活动精子百分率呈负相关(r=-0.135,P0.05);低密度脂蛋白(LDL)与精液量呈明显负相关(r=-0.124,P0.01),与前向运动精子百分率呈负相关(r=-0.127,P0.05),与不活动精子百分率呈正相关(r=0.140,P0.01),与精子浓度呈负相关(r=-0.121,P0.05),与精子总数呈明显负相关(r=-0.210,P0.01);进一步多因素回归分析显示:BMI和LDL是精液量的独立影响因素;尿酸(UA)是液化时间的独立影响因素;年龄、HDL和LDL是前向运动精子百分率的独立影响因素;年龄、HDL是不活动精子百分率的独立影响因素;LDL是精子总数的独立影响因素;而BMI和TG则是正常形态精子百分率的独立影响因素。结论:年龄、BMI、取精季节、生活环境、职业等因素均可能影响男性精液的质量。     

血清抗苗勒管激素与精液参数的相关性分析

目的:本研究旨在探讨血清抗苗勒管激素(AMH)与精液参数之间的关系。方法:收集我院2015年9月至2016年11月男性不育门诊就诊患者的资料共计726例,其中非梗阻性无精子症者72例,少精子症者123例,正常精子浓度者531例。对患者进行精液常规和血清学检测,包括精液量、精子总数、精子浓度、精子活动率、前向运动精子百分率率、正常形态精子百分率和AMH、抑制素B(Inh-B)、睾酮(T)、卵泡刺激素(FSH),整理数据进行回顾性分析。结果:血清AMH水平与精子总数(r=0.227,P0.001)、精子浓度(r=0.215,P0.001)、精子活动率(r=0.111,P=0.003)、前向运动精子百分率(r=0.120,P=0.001)、Inh-B(r=0.399,P0.001)、T(r=0.184,P=0.002)之间存在一定的正相关;与FSH(r=-0.283,P0.001)存在负相关;与年龄、禁欲时间、精液量和正常形态精子百分率之间(P0.05)均无显著相关性。非梗阻性无精子症组、少精子症组和正常组患者之间血清AMH水平有显著差异(6.33±4.26 vs 8.26±3.98 vs 9.8±5.19 ng/ml,P0.001)。结论:AMH是反映睾丸支持细胞功能的一个生物标志物;血清AMH水平与精子浓度和活动率明显相关,提示AMH可能与精子的发生和成熟有关。     

特发性弱精子症患者血清及精浆瘦素水平与精子活动力的关系

目的 通过研究特发性弱精子症(idiopathic asthenospermia,IAS)患者以及精液参数正常人群的血清、精浆瘦素,探讨瘦素与精子运动能力的关系.方法 IAS患者54例及精液参数正常者30例作为对照.常规CASA精液分析,放射免疫法检测血清及精浆瘦素.结果 排除体重指数差异的影响,(IAS患者与精液参数正常者体重指数比较差异无统计学意义,P>0.05),IAS患者血清瘦素水平与正常对照差异无统计学意义(P>0.05),而IAS患者精浆瘦素显著高于正常对照(P<0.05);精子活动率及精子活力与血清瘦素水平之间均无显著相关性(r=-0.213,P=0.249及r=-0.167,P=0.154),IAS患者的精子活动率及活力与精浆瘦素水平显著负相关(r=-0.31,P=0.034及r=-0.47,P=0.025).结论 IAS患者精浆瘦素水平显著增高,可能对精子运动能力有调控作用.     

慢性前列腺炎患者精液参数的变化及意义

目的　了解前列腺慢性炎症对患者精液参数及生育的影响。　方法　检查 86例慢性前列腺炎患者和 32名正常生育者的精液 ,并对两组精液主要参数进行比较。　结果　慢性前列腺炎患者的精液量、精子密度、精子活动百分率及精子正常形态百分率平均分别为 2 .0 8ml、91.76× 10 6、6 5 .4 3%和 6 2 .14 %。其精液量、精子活动百分率、精子正常形态百分率显著低于正常生育者 (P =0 .0 0 3,P <0 .0 0 1和P <0 .0 0 1) ,精子密度与正常生育者比较差别无显著性意义 (P =0 .92 2 )。　结论　慢性前列腺炎患者的精液部分主要参数较正常生育者明显降低 ,未发现其对患者的生育有明显影响。     

吸烟对男性精液质量的影响

目的 探讨吸烟对男性精液质量的影响.方法 应用伟力彩色精子质量分析系统对180例不育男性(96例不育吸烟组和84例不育非吸烟者)和112例正常生育男性精液从精液量、液化时间、精子总数、精子密度、精子活力、精子活率等参数方面进行分析.结果 (1)不育吸烟组、不育非吸烟组与正常对照组比较,精子活力、精子活率等参数显著降低(P＜0.05或P＜0.01),液化时间延长(P＜0.05),而精液量、精子密度和精子总数之间无显著性差异(P＞0.05);(2)不育吸烟组与不育非吸烟组相比,精子活力、精子活率显著降低(P＜0.05或P＜O.01);(3)小烟量组和短烟龄组与不育非吸烟组相比,精液各参数之间差异无显著性(P＞O.05).大烟量组和长烟龄组与不育非吸烟组相比,精子总数、精子密度、精子活力和精子活率都显著降低(P＜O.05或P＜0.01),液化时间显著延长(P＜0.01);(4)小烟量组和短烟龄组分别与大烟量组和长烟龄组相比,精子密度、液化时间、精子活力和精子活率等均有显著性差异(P＜0.0 1).结论 (1)吸烟对男性精液质量的不良影响存在量效和时效关系.(2)大量吸烟(日吸烟量＞20支)和长期吸烟者(烟龄＞10年)可能是引起男性不育的重要原因之一.     

慢性非细菌性前列腺炎/慢性盆底疼痛综合征患者症状与白细胞计数的关系

目的探讨慢性非细菌性前列腺炎/慢性盆底疼痛综合征患者(CAP/CPPS)症状与前列腺液、按摩后尿液、精液中白细胞计数间的关系.方法以前列腺炎症状评分(NIH-CPS1)评估CAP/CPPS患者症状情况,按四杯法留取尿液,对患者前列腺液、按摩后尿液、精液行白细胞计数,并对样本行细菌培养.将228例CAP/CPPS患者分型,对患者症状与实验室结果间行相关分析.结果CAP/CPPS患者中,依据EPS、VB3或精液中WBC数目而分型的Ⅲ a型与Ⅲ b患者间的CPSI中的疼痛、排尿不适、生活质量及总分无显著性差异(P值分别为0.97、0.75、0.08、0.55).CAP/CPPS患者EPS、VB3或精液中WBC数目与CPSI中的疼痛、排尿不适、生活质量及总分无显著相关性(P值＞0.05).结论CAP/CPPS患者Ⅲ a型与Ⅲ b型间症状严重程度无显著性差异,白细胞计数与CAP/CPPS患者症状的严重程度无明显相关性,提示还有其他引起CPPS症状的因素存在.     

Significance of inflammation on standard semen analysis in chronic prostatitis/chronic pelvic pain syndrome

The impact of defined urogenital inflammations on standard ejaculate parameters is still a matter of controversial debate. Basic spermiogram parameters has been analysed in patients with inflammatory and noninflammatory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS-NIH IIIA/IIIB) with regard to indicators of inflammation in prostatic secretions and/or the ejaculate. A total of 112 consecutive patients symptomatic for chronic pelvic pain were included in the study. All of them underwent a 'four glass-test' including leukocyte determination in expressed prostatic secretions followed by ejaculate analysis according to WHO. The analysis included pH, volume, total sperm count, sperm density, motility, morphology (Shorr stain), vitality (eosin stain), and counting of peroxidase positive leukocytes (PPL). Patients were first subgrouped according to elevated leukocyte counts in prostatic secretions, and then according to the number of PPL in semen. Leukocytes neither in the prostatic secretions nor in the ejaculate were associated with reduced standard semen parameters. Our data supports previous results that elevated leukocyte counts in prostatic secretions and in ejaculate, as indicators of inflammation have no negative impact on total sperm count, sperm density, motility, morphology, and sperm vitality in patients with CP/CPPS.     

Impact of prostatitis NIH IIIB (prostatodynia) on ejaculate parameters

OBJECTIVES: Prostatitis NIH IIIB is defined by chronic pelvic pain without evidence of inflammation in prostate secretions or ejaculate. The relations between chronic prostatitis and fertility are discussed controversially. In this context, we analysed fertility data of a well defined collective of patients with prostatitis NIH IIIB. METHODS: We analysed prospective fertility data of a group of 30 patients with chronic prostatitis NIH IIIB and compared these data with the duration of symptoms as well as with an age-matched control group. RESULTS: The prostatitis group and the control group differed significantly in terms of ejaculate volume, motility and fructose concentration. The remaining parameters did not differ significantly. An azoospermia was present in 3 patients of the prostatitis group versus none of the control group. The duration of symptoms did not correlate with the sperm parameters (sperm density, motility and morphology). CONCLUSIONS: Patients with prostatitis NIH IIIB have changes in their ejaculate with a reduction of motility and a reduced fructose concentration. This supports a somatic aetiology of the chronic pelvic pain syndrome.     

慢性前列腺炎/慢性骨盆疼痛综合征对男性健康的影响

目的:探讨慢性前列腺炎/慢性骨盆疼痛综合征(CP/CPPS)对男性健康的影响。方法:在650例门诊CP/CPPS患者中随机选择200例,年龄20～59岁,无记名填写调查表,内容包括年龄、身高、体重、病程、治疗情况、前列腺按摩液(EPS)及精液检测结果、国际前列腺炎症状评分指数表(NIH-CPSI)、勃起功能国际指数问卷(IIEF-5)及症状自评量表(SCL-90)。结果:200例CP/CPPS患者中,回收有效问卷198份,回收率99.0%。CPSI评分轻度56例(28.3%),中度98例(49.5%),重度44例(22.2%)。精液中精子密度及活动率降低者分别为38例(19.2%)和47例(23.7%)。IIEF-5评分显示ED者41例(20.7%),其中58.5%为轻度ED;94例(47.5%)患者出现心理异常包括抑郁、焦虑、敏感等。患者前列腺炎症状与心理异常、ED发生率存在正相关性(r=0.25,P<0.05;r=0.12,P<0.05),与精子密度及活动率降低无明显相关性(P>0.05)。结论:CP/CPPS对男性健康的影响主要是对心理产生明显的负面影响,对勃起功能影响轻微,对精液检测结果的影响不明显,治疗方法应是病理和心理的综合治疗为主。     

The effect of chymotrypsin on the determination of total alpha-glucosidase activity in seminal plasma and the correlation between alpha-glucosidase level and semen parameters

To evaluate the effect of chymotrypsin on the examination of alpha-glucosidase activity in seminal plasma, thirty-nine samples of fresh liquefied semen with or without chymotrypsin and forty-eight samples of fresh un-liquefied semen with chymotrypsin were determined for the total alpha-glucosidase activity in seminal plasma. The total alpha-glucosidase level of each sample was assayed by the method of glucose oxidase. The correlations between alpha-glucosidase level and semen parameters, including semen volume, pH, sperm concentration, grade a and b motility and total motility, were analyzed with SPSS 11.0 software. The results showed that chymotrypsin had no effect on seminal alpha-glucosidase activity determination. Chymotrypsin could improve the liquefaction for un-liquefied semen, and there was no significant difference of alpha-glucosidase activity between liquefied and un-liquefied semen samples. There were significantly positive correlations between seminal alpha-glucosidase activity (U/ml) and sperm concentration (r = 0.338, p = 0.015) and between total alpha-glucosidase activity (U/ejaculate) and semen volume (r = 0.677, p = 0.000). However, there was no significant correlation between alpha-glucosidase level (U/ml) and semen volume, pH, sperm motility or grade a and b motility (r = -0.234 approximately 0.077, p = 0.099 approximately 0.993). The data indicated that chymotrypsin could be added into the un-liquefied semen samples for alpha-glucosidase activity determination, and there were different correlations between seminal alpha-glucosidase level and various semen parameters.     

吲哚美辛栓联合曲唑酮治疗Ⅲ型前列腺炎的临床研究

目的探讨慢性非细菌性前列腺炎/慢性盆底疼痛综合征(CAP/CPPS)的治疗方法。方法对60例诊断为CAP/CPPS的患者使用非甾体类抗炎药直肠栓剂吲哚美辛栓及三唑吡啶类抗抑郁药曲唑酮进行8周的联合治疗。在治疗前、治疗后4周及8周对所有患者进行NIH-CPSI症状评分和EPS-WBC计数,对其中伴精液参数异常和性功能下降的患者分别进行精液参数测定和性功能评价。观察疗效及不良反应情况。结果60例患者在治疗后4周及8周NIH-CPSI评分和EPS-WBC较治疗前明显降低(P<0.001);伴精液参数异常和性功能下降的患者的射精潜伏期及IIEF-5评分较治疗前有明显改善(P<0.01);不良反应发生率较低。结论吲哚美辛栓联合曲唑酮的治疗方案安全有效,可以明显缓解CAP/CPPS患者症状,对患者精液质量及性功能亦有明显改善。     

慢性前列腺炎伴不孕不育患者精液结果及精浆PSA和果糖的分析研究

目的：探讨慢性前列腺炎（CP）伴不孕不育患者精液质量及果糖和PSA的变化。方法：研究对象均为男性CP患者。根据精液液化时间是否大于60min分为两组：精液液化正常组22例,精液延迟液化组20例;另选择正常对照组15例。分析各组精液理化指标,并测定各组精浆中果糖和PSA的含量。结果：精液液化正常组、精液延迟液化组在精子密度、精子活率、活动A级和活动A＋B级较正常对照组差异有统计学意义（P〈0．01）;PSA浓度较正常对照组差异有统计学意义（P〈0．01）。精液延迟液化组果糖含量较正常对照组差异有统计学意义（P〉0．05）。结论：CP可以引起精子质量降低和化学组分的改变,有可能影响精液的液化过程,导致男性不育。     

Über Beziehungen zwischen der Spermienmotilität und dem Gehalt an ungesättigten Fettsäuren sowie dem osmotischen Verhalten der menschlichen Spermienzelle

The relations between sperm motility and the content of lipids and fatty acids in sperm cells were investigated. In addition the osmotic volume changes of sperm cells were studied, by determination of progressive sperm motility, measurement of relative concentration of lipid-peroxy radicals in seminal plasma using chemoluminescence technique, gas-chromatographic determination of fatty acid pattern in sperm cells and in seminal plasma and by electronic measurement of the sperm cell volume. The impulse installment of chemoluminescence increased during the time of storage of the ejaculate. In contrast, this phenomenon was not observed in pure seminal plasma prepared by centrifugation immediately after liquefaction. The pattern of phospholipids and free fatty acids changed during storage of the ejaculate both in sperm cells and in seminal plasma. Sperm cells showed a significant increase of volume under hypotonic stress. The increase of volume is more distinct in spermatozoa with high progressive motility as in spermatozoa with low progressive motility. The determination of initial and late progressive motility enables the differentiation of two groups of sperm populations: one group with a medium initial motility and a normal decrease of motility during the following time and another group with excellent initial motility and an extreme decrease of motility following. The second group is characterized by an especially distinct increase of volume under hypotonic conditions.     

Studies on gamma-glutamyl transpeptidase (gamma-GTP) in seminal plasma

The significance of gamma-GTP (gamma-glutamyl transpeptidase) in seminal plasma was examined by measuring the gamma-GTP activity in ejaculate, seminal plasma, prostatic secretion, testis, epididymis, vas deferens, prostate and sperm. The gamma-GTP activity was measured spectrophotometrically (405 nm) using L-gamma-glutamyl-p-nitroanilide as a substrate. One unit of enzyme activity was defined as the amount liberating 1 mumol of p-nitroaniline per min. The mean gamma-GTP activity was 9,094 +/- 4,351 mU/ml in ejaculate and 7,487 +/- 4,286 mU/ml in seminal plasma of 76 men visiting the infertility clinic. There is a positive correlation between gamma-GTP activity in ejaculate and in seminal plasma. The gamma-GTP activity was 15,044 +/- 6,422 mU/ml in prostatic secretion and twice as high as the activity in seminal plasma. There was no significant correlation between gamma-GTP activity in seminal plasma and volume of ejaculate, sperm density or sperm motility. The gamma-GTP activity in testicular tissues was 72 +/- 25 mU/mg protein except for two cases in which its activity was not detected (3 years old; retentio testis, 71 years old; prostatic carcinoma, was administered with hormonal medicine). The gamma-GTP activity in prostatic tissues was 133 +/- 68 mU/mg protein. The relationship between the gamma-GTP activity in testicular tissues and Johnsen's mean score count. Judging from the present results together with the previous reports of Rosalki et al (1977) and Simon et al (1978) the prostate seemed to be the major source of gamma-GTP in human semen.     

Studies on relationship between semen viscosity and other semen parameters, Ureaplasma urealyticum infection and seminal plasma antisperm antibody

Objective: To study the relationship between semen viscosity and other semen parameters, Ureaplasma urealyticum (UU) infection and seminal plasma antisperm antibody (AsAb) in male infertiles. Methods: Semen parameters, Ureaplasma urealyticum (UU) infection and antisperm antibody (AsAb) were measured and analyzed in 4337 infertile men. Results: The seminal viscosity was higherr than normal in 65.02 % of 4337 male infertiles. The sperm motility and grade (a, b) motile sperm were significantly lower in the high viscosity group than in the normal viscosity group (P<0.05-0.01). The rate of abnormal morphology sperm was higher and duration of semen liquefaction was longer in the high viscosity than in the normal viscosity group (P<0.01). The seminal volume, sperm concentration and semen pH were not significantly different between the two groups. The semen viscosity is significantly higher in subjects with higher seminal WBC (>5/ HP) than in those with lower WBC (<5/HP). The positive AsAb and UU infection rates