解脲支原体感染与男性不育

用双抗体夹心ＥＬＩＳＡ法检测解脲支原体，并与经典的培养法作了比较。３９例生育男性精浆解脲支脲体ＥＬＩＳＡ法和培养法和阳性率分别为１０．３％和７．７％，１６４便不育者精浆解脲支原体两法阳性率分别为８６．５％。精子畸形率超过３０％及精子密度偏低的不育者，解脲支原体阳性率分别高达６９．２％和５６．５％，解脲支原体感染可导致精子形态与功能异常，从而引起男性不育。     

男性不育者精浆C3d和C3的测定及与AsAb的关系

用ＥＬＩＳＡ法检测精浆中的Ｃ３ｄ、Ｃ３含量，并计算Ｃ３ｄ／Ｃ３的比值。结果表明，抗精子抗体（ＡｓＡｂ）阳性的不育病人精浆Ｃ３ｄ含量及Ｃ３ｄ／Ｃ３比值明显高于生育组，而ＡｓＡｂ阴性的不育病人精浆Ｃ３ｄ、Ｃ３及Ｃ３ｄ／Ｃ３的比值与生育组间则无明显差异。以Ｃ３ｄ高于０．８ｍｇ／Ｌ为阳性，ＡｓＡｂ阴性和ＡｓＡｂ阳性的不育者Ｃ３ｄ阳性率分别为１９．２％和８１．３％，二者差异非常显著（Ｐ〈０．０１）。提示Ａｓ     

解脲支原体与男性免疫性不育关系的探讨

本文对１５０例男性不育患者进行了精浆抗精子抗体检测与解脲支原体培养，发现抗精子抗体阳性组解脲支原体检出率为６６．７％，抗精子抗体阴性组解脲支原体检出率为４０．２％，两组之间存在显著性差异（Ｐ＜０．００５）。对抗精子抗体、解脲支原体均为阳性组进行了两种治疗方法的疗效对比，结果表明，使用抗生素组抗体转阴率为７０％，未使用抗生素组抗体转阴率为３６．４％，两组疗效存在显著性差异（Ｐ＜０．０５）。提出解脲支原体可能是导致男性免疫性不育的病因之一。认为积极治疗生殖道感染有助于降低抗体滴度，阻止抗体形成，对免疫性不育的治疗有重要意义。     

ELISA法检测不育男子精浆中抗人精浆免疫抑制因子IgG和IgA

本文首次建立了抗人精浆免疫抑制因子（ＳＰＩＦ）ＩｇＧ和ＩｇＡ的ＥＬＩＳＡ测定法，用其对５０例生育男子和１００例不育男子精浆中抗ＳＰＩＦ ＩｇＧ和ＩｇＡ进行了测定。结果显示：精浆中抗ＳＰＩＦ ＩｇＧ和ＩｇＡ的阳性率在生育男子分别为６％和４％；在不育男子分别为３４％和２８％。不育组抗ＳＰＩＦ ＩｇＧ和ＩｇＡ阳性率均显著高于生育组（Ｐ＜０．０１）。本文就抗ＳＰＩＦ ＩｇＧ和ＩｇＡ在抗生育及生殖道感染方面     

不育男性精浆抗心磷脂抗体的检测与意义

应用间接ＥＬＩＳＡ法检测男性不育病人精浆的抗心磷脂抗体（ＡＣＡ），并对其与精子密度、精浆抗精子抗体及血清ＡＣＡ的关系进行了研究。结果表明，不孕、流产组精浆ＡＣＡ总检出率分别为２０．０％和１２．５％，前者较对照组显著增高（Ｐ＜０．０５），ＡＣＡ阳性率有随精子数的减少而逐渐上升趋势，但无统计学意义。精浆中ＡＣＡ与ＡｓＡｂ及与血清ＡＣＡ无关联性。     

ELISA法检测不育男子精浆中抗人精浆免疫抑制因子IgG和IgA

本文首次建立了抗人精浆免疫抑制因子（ＳＰＩＦ）ＩｇＧ和ＩｇＡ的ＥＬＩＳＡ测定法，用其对５０例生育男子和１００例不育男子精浆中抗ＳＰＩＦＩｇＧ和ＩｇＡ进行了测定。结果显示：精浆中抗ＳＰＩＦＩｇＧ和ＩｇＡ的阳性率在生育男子分别为６％和４％；在不育男子分别为３４％和２８％。不育组抗ＳＰＩＦＩｇＧ和ＩｇＡ阳性率均显著高于生育组（Ｐ＜０．０１）。本文就抗ＳＰＩＦＩｇＧ和ＩｇＡ在抗生育及生殖道感染方面的可能作用进行了讨论。     

精浆超氧化物歧化酶与解脲支原体感染的关系

目的：观察解脲支原体（ＵＵ）感染与精浆超氧化物歧化酶（ＳＯＤ）活性的关系。　方法：应用精子活体染色技术和ＳＯＤ活性检测试剂盒,分别检测３６ 例正常生育男性（正常对照组）和８５例ＵＵ 感染不育男性（ＵＵ 感染组）的精子存活率与精浆ＳＯＤ活性。　结果：在正常对照组和ＵＵ 感染组中,精子存活率分别为（７８．２±７．７）％ 和（５３．６±８．４）％ ,差异极其显著（Ｐ＜ ０．０１）;精浆ＳＯＤ活性分别为（７６２．７±１３０．４）和（６４５．４±１３２．５） ＮＧ／ｍ ｌ,差异显著（Ｐ＜ ０．０５）。　结论：ＵＵ 感染可引起精浆ＳＯＤ活性降低,精子膜发生过氧化损伤,影响精子的存活率和活动力。在对ＵＵ 感染病人进行抗感染治疗的同时,辅以清除氧自由基和提高ＳＯＤ活性的物质,有利于病人恢复正常的生育能力。     

免疫印迹法分析抗SPIM抗体与临床应用

采用聚丙烯酰胺凝胶电泳和免疫印迹法分析不育症病人抗精浆免疫抑制物抗体（ＳＰＩＭ－Ａｂ）对特异抗原的免疫反应，并与ＥＬＩＳＡ法进行比较，结果表明，免疫印迹法检测血清，精浆ＳＰＩＭ－Ａｂ阳性率分别为３０．３％（３２／１０７）和２９．０％（３６／１２４）ＥＬＩＳＡ法检测分别为３３．６％（３６／１０７）和３１．５％（３９／１２４），Ｘ＾２＝１２９．５８，Ｐ〈０．０１，免疫印迹法分析的６８从不育症病人的血清     

不育男性精浆抗心磷脂抗体的检测与意义

应用间接ＥＬＩＳＡ法检测男性不育病人精浆的抗心磷脂抗体，并对其与精子密度，精浆抗精子抗体及血清ＡＣＡ的关系进行了研究。结果表明，不孕、流产组精浆ＡＣＡ总检出率分别为２０．０％和１２．５％，前者较对照组显著增高。ＡＣＡ阳性率有随精子数的减少而逐渐上升趋势，但无统计学意义。精浆中ＡＣＡ与ＡｓＡｂ及血清ＡＣＡ无关联性。     

人精子顶体酶活性及其影响因素分析

为研究人精子顶体酶活性与男性不育的关系，分别测定门诊３５６例不育男性精液（实验组）和１８例正常生育者精液（对照组）的顶体酶活性，同时测定实验组男性的精子活力、精子活率、畸形率、镜下白细胞数、精浆抗精子抗体并进行解脲支原体培养，作相关性分析。结果：实验组和对照组顶体酶活性为１０７±９２和２９７±１４３μＩＵ／１０６精子，组间比较差异有显著性（Ｐ＜０００１），顶体酶活性与镜下白细胞数、畸形率明显负相关，与精子活率、精子活力正相关，顶体酶活性与解脲支原体感染有关，但精浆抗精子抗体的存在不影响顶体酶活性。提示顶体酶活性与精子质量有关，是影响生育的重要因素     

解脲支原体感染与男性不育

用高度纯化的人解脲支原体免疫家兔,获得兔抗人解脲支原体抗血清,以此抗血清(一抗)及羊抗兔 IgG 荧光抗体(二抗),分别处理20例正常生育男性和20例精液解脲支原体培养阳性的不明原因不育男性的精子,并在荧光显微镜下观察。结果显示:在不育男性部分精子的头部和(或)尾部有特异性的较强荧光结合,表明有解脲支原体吸附,并有大量畸形精子,多数为卷尾畸形。此外,用比浊法检测了正常生育男性与上述不育男性精液中快速运动相精子的百分含量(FRM)及平均速度(VRM)。不育男性组比生育组的 FRM 及 VRM 都显著降低(分别为 P<0.01和 P<0.001)。本研究首次用特异性方法证实解脲支原体吸附于不育男性精子表面,提示解脲支原体感染可能通过影响精子的形态、精子的运动和精卵识别过程而导致男性不育。     

生殖道支原体感染与精索静脉曲张不育关系的探讨

为研究精索静脉曲张男性不育症中生殖道感染因素，对５９０例患精索静脉曲张（曲张组）和３３５例无精索静脉曲张（对照组）的男性不育患者进行了精液解脲支原体（ＵＵ）的培养研究。结果表明：ＵＵ总感染率为４８．２２％。曲张组中生殖道ＵＵ感染率高达５５．７６％，而对照组ＵＵ感染率为３４．９３％，两组间有高度显著性差异（Ｐ〈０．００５）。曲张组精子活力低下者明显增多，而精液分析正常者明显减少。认为精索静脉曲张的存     

Interleukin-6 (IL-6) in seminal plasma of infertile men, and lipid peroxidation of their sperm

Concentrations of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in seminal fluid, as well as levels of sperm lipid membrane peroxidation, were investigated in fertile and infertile men. Semen samples, obtained by masturbation from 37 infertile and 14 fertile men, were examined for the presence of TNF-alpha and IL-6. The level of lipid peroxidation of the sperm membrane was measured by determining malondialdehyde (MDA) formation. The correlation between the IL-6 and the TNF-alpha concentrations in seminal plasma with the levels of lipid peroxidation of the sperm membranes was statistically evaluated. The IL-6 concentration in seminal plasma of infertile men was significantly higher than that of fertile men (p < .05). Similarly, the level of membrane lipid peroxidation was higher for the semen of infertile men than that of fertile men (p < .001). A significant positive correlation was found between IL-6 levels in seminal plasma and membrane sperm lipid peroxidation (p < .002), but not between this parameter and TNF-alpha levels in seminal plasma. These findings suggest a possible association between IL-6 seminal plasma levels and lipid peroxidation of sperm membrane. Stimulation of reactive species production by human sperm and leucocytes, induced by the high levels of IL-6, could explain these results.     

Seminal plasma oxytocin and oxidative stress levels in infertile men with varicocele

This study aimed to assess seminal plasma oxytocin (OT) and oxidative stress (OS) levels in infertile men with varicocele (Vx). A total of 131 men were divided into fertile men (n = 20), fertile men with Vx (n = 17), infertile men without Vx (n = 40) and infertile men with Vx (n = 54). OT, malondialdehyde (MDA) and glutathione peroxidase (GPx) were estimated in seminal plasma. Mean levels of seminal OT, MDA were significantly decreased, and the mean level of GPx was significantly increased in fertile men with/without Vx compared with infertile men with/without Vx. Mean levels of OT, MDA were increased, and mean level of GPx was significantly decreased in Vx grade III cases compared with Vx grades I, II cases and in bilateral Vx cases compared with unilateral Vx. There was significant negative correlation between seminal OT with sperm count, sperm motility, seminal GPx and significant positive correlation with sperm abnormal forms, seminal MDA. It is concluded that seminal OT is significantly decreased in fertile men with/without Vx compared with infertile men with/without Vx. Seminal OT demonstrated significant negative correlation with sperm count, sperm motility, seminal GPx and significant positive correlation with sperm abnormal forms, seminal MDA. Seminal OT is associated with Vx grade and its bilaterality.     

生育与不育男性血清和精浆褪黑素检测及其意义

目的 :检测生育与不育男性精浆褪黑素 (MLT)浓度并探讨在男性生育中的意义。　方法 :年龄为 2 6～ 36岁的生育男性 (18例 )和年龄为 2 3～ 36岁的不育男性 (99例 ) ,其中 ,后者又分为正常精子症组 (13例 )、少精子症组(2 7例 )、弱精子症组 (31例 )、少弱精子症组 (17例 )和少弱畸精子症组 (11例 )。分别采集静脉血和精液 ,采用酶联免疫吸附实验 (ELISA)检测血清和精浆中MLT浓度。　结果 :血清MLT浓度在生育与不育男性之间无显著性差异 ,各组精浆MLT浓度均低于相应的血清值。生育组精浆MLT浓度与各不育组相比无显著性差异 ,而少弱精子症组和少弱畸精子症组MLT浓度下降较为明显 ,但尚未达到统计学意义 (P >0 .0 5 )。　结论 :本研究结果表明 ,精浆MLT可能对精子功能具有一定作用 ,其具体作用机制尚需进一步深入的研究。     

解脲支原体引起男性不育的机理研究——Ⅰ.精子形态学观察

本文对精液解脲支原体(Ureaplasma urealyticum)培养阳性的不明原因不育男性及正常生育男性的精子分别进行扫描电镜及免疫金电镜观察。结果发现在不育男性组;部分精子上有较多解脲支原体吸附;精子畸形率明显增加,主要为严重的卷尾畸形和头尾-成角畸形,此外尚有较多尖头畸形及多精子凝集现象;在解脲支原体附着的部位,精子膜缺损乃至严重破坏;精子的活力也较正常生育组明显下降;部分脱落的生精细胞胞浆内发现解脲支原体样结构,生精细胞胞质崩解。提示解脲支原体感染是男性不育的因素之一,而其对精子形态学的影响是造成男性不育的重要机制。     

溶脲脲原体引起男性不育的机理研究——Ⅱ.对精子运动的影响

本研究观察了正常生育男性与精液溶脲脲原体培养阳性的不育男性的精子运动。用比浊法比较了两组男性精液中快速运动精子的百分率与其平均速度。此外,用血清型4溶脲脲原体人工感染正常生育男性的精子。结果表明,不育男性快速运动精子的百分率与平均速度均显著低于正常生育男性;而正常生育男性的精子受血清型4溶脲脲原体感染后,精子的活率及活力的下降。提示溶脲脲原体(血清型4)对人精子的运动具有抑制作用,可能是造成男性不育的一个因素。     

Seminal arginase activity in infertility

Arginase (Arg) activity in seminal plasma and sperm cells from infertile men and healthy fertile donors was measured. There were no statistically meaningful differences in seminal plasma Arg activity between the two groups whereas sperm cells from oligospermic infertile men had a higher Arg activity compared with the controls. Some important correlations were established between sperm count and Arg activity (negative values) and sperm motility and Arg activity (positive values) in both sperm cells and plasma samples from infertile men. Results suggest that the arginine-nitric oxide pathway within sperm cells from oligospermic infertile men is disturbed by enhanced Arg activity. We think that this may play a part in sperm dysfunction and male infertility. Received: 22 October 1998 / Accepted: 1 October 1999     

Heterologous ovum penetration test and seminal parameters in fertile and infertile men

Sperm penetration rates in the heterologous ovum penetration test were correlated with results of routine semen analysis in 30 fertile and 50 infertile men. There was no difference in penetration rates when comparing infertile men with normal and abnormal seminal parameters, nor was any difference seen between fertile (15-83%) and infertile men (8-83%). Of the 22 infertile men with normal seminal characteristics, seven had partners with no discernible reproductive dysfunction. The penetration rates of these men (38-81%) did not differ from those of fertile men. Stepwise regression analysis of seminal characteristics, with penetration as the dependent variable, indicated that sperm count and morphology are the most important seminal parameters for fertility assessment. Discrimination analysis revealed that sperm numbers and morphologic variables provide significant information for discriminating between fertile men and infertile men with normal or abnormal seminal characteristics. Sperm penetration and motility were not indicated as important factors. The present data suggest that, in unselected male patients seeking reproductive evaluation, the sperm penetration assay did not yield any additional information on the cause of infertility.