不育男性精浆总抗氧化能力与精子运动功能的关系

目的:研究不育男性精浆总抗氧化能力(TAC)与精子运动能力和方式之间的关系,探讨精浆TAC水平在男性生育中的临床意义。方法:113例精子密度正常的不育男性,28例正常生育男性作为对照组。精液于37℃液化后采用计算机辅助精液分析(CASA)系统进行精液常规分析,采用比色法进行精浆TAC分析。结果:正常生育组精浆TAC为(19.82±6.33)U,不育男性精子密度正常组精浆TAC为(14.37±8.45)U,不育男性精子密度正常组与正常生育组比较存在显著性差异(P<0.01)。精浆TAC与a级精子百分率(r=0.208,P<0.05)和(a+b)级精子百分率(r=0.231,P<0.05)呈显著正相关,精浆TAC与精子运动参数中的前向性(r=0.200,P<0.05)、直线性(r=0.208,P<0.05)、曲线速度(r=0.189,P<0.05)、直线速度(r=0.210,P<0.05)、平均移动速度(r=0.215,P<0.05)及鞭打频率(r=-0.248,P<0.01)之间有显著的相关性,其中前向性、直线性、直线速度、曲线速度、平均移动速度与TAC呈正相关(P<0.05),而鞭打频率与TAC呈负相关(P<0.01)。精浆TAC与摆动性、侧摆幅度、平均移动角度之间无显著相关。结论:精浆中TAC水平与精子运动能力和运动方式密切相关,适宜的精浆TAC为精子运动提供了良好的外部环境,精浆中过低的TAC水平与精子运动能力下降和运动方式改变有关,可能是引起男性不育的病因之一。精浆中TAC分析可为探讨男性不育的发病机制以及临床用药提供依据。     

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。     

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。     

生育与不育者精浆中免疫球蛋白A含量检测的临床意义

为了观察分泌型免疫球蛋白Ａ(ＳＩｇＡ)在男性不育症患者精液中变化的意义 ,我们对 12 5例男性不育症患者及 2 2例正常生育者精浆中的ＳＩｇＡ的含量进行测定 ,其结果如下。　　材料与方法一、研究对象不育症组 :12 5例 ,均系婚后 2～ 19年 ,夫妻性生活正常 ,排除女方不孕原因的患者 ,年龄 2 3～ 4 2岁 ,平均 2 7.8岁的男性。为了观察精浆中ＳＩｇＡ含量与精液中精子密度之间的关系 ,根据不育患者精液分析中精子数量的多少 ,将其分为五组 ,即Ａ组 ,无精子症者 ;Ｂ组 ,精子数 <2 0× 10 9/Ｌ的少精子症者 ;Ｃ组 ,精子数在 (2 0～ 5 9)× 10 9…     

利用shotgun蛋白组学策略鉴定健康生育男性精浆蛋白质

目的:鉴定正常生育男性的精浆蛋白质。方法:3例正常健康已生育的自愿者精液标本通过Percoll分离获取精浆,等量混合后在SDS-PAGE上进行分离,切胶取条带进行胶内酶解,抽提肽段后利用shotgun蛋白组学策略鉴定蛋白质。结果:正常生育男性精浆鉴定出331种蛋白质,相对分子质量范围8000～572068,等电点范围4.36～11.05;这些蛋白质按功能和生物进程归类,大致有51个(15.4%)运输蛋白质,11个(3.32%)细胞运动蛋白,63个(19.03%)信号转导蛋白质,147个(44.4%)蛋白酶及38个(11.5%)酶调节蛋白质,21个(6.3%)细胞凋亡蛋白,12个(3.62%)结构和支撑蛋白质,59个(17.8%)分子功能未知蛋白质。结论:shotgun蛋白组学策略是鉴定蛋白质的一个较好的方法。膜联蛋白及相关蛋白、Ras相关蛋白Rab是鉴定到的信号转导蛋白中的主要成员,因此推测钙离子和G蛋白信号通路是精子胞外信号传递到胞内的最重要途径,但是这些蛋白间的相互作用还不清楚。另外,精浆中鉴定到了大量的酶类,可能与维持精子活力和代谢有密切关系。     

男性不育患者精浆尿酸的检测及临床意义初探

目的 :检测男性不育患者精浆尿酸的含量 ,并探讨其与不育的关系。　方法 :2 0 0 3年 2～ 8月就诊的男性不育患者 1 6 3例 ,分为 4组 :梗阻性无精子症组 ,1 5例 ;非梗阻性无精子症组 ,36例 ;少精子症组 ,4 3例 ;弱精子症组 ,6 9例。 2 0例正常生育男性为正常对照组。上述各组均作精液参数分析及精浆尿酸含量的测定。　结果 :正常对照组精浆尿酸含量为 (396 .9± 5 3.1 ) μmol/L ,显著高于梗阻性无精子症组 [(79.5± 1 8.1 ) μmol/L]、非梗阻性无精子症组[(2 4 5 .8± 76 .5 ) μmol/L]、少精子症组 [(2 6 2 .2± 79.2 ) μmol/L]和弱精子症组 [(2 5 1 .4± 75 .4 ) μmol/L](P均 <0 .0 1 )。其中 ,梗阻性无精子症组精浆尿酸含量又显著低于其他各不育症组 (P均 <0 .0 1 ) ,其余各不育症组间精浆尿酸含量差异无显著性 (P >0 .0 5 )。　结论 :精浆中尿酸作为生殖系统中的一种重要抗氧化物 ,可能在男性生殖中具有一定意义。     

男性不育患者生殖道溶脲脲原体感染对精液质量影响的研究

目的:了解男性不育患者生殖道溶脲脲原体感染情况,探讨男性不育患者生殖道溶脲脲原体感染对精液质量、附属性腺功能的影响及可能机制。方法:本研究对202例确诊的男性不育患者的精液标本进行溶脲脲原体培养,对精液参数及精浆α-葡萄糖苷酶、酸性磷酸酶和果糖进行检测,分析生殖道溶脲脲原体感染对精液参数及精浆生化指标的影响。结果:男性不育患者生殖道溶脲脲原体感染率为33.7%;生殖道溶脲脲原体感染阳性组和阴性组间精液量相差不显著[(2.93±1.32)mlvs(2.86±1.52)ml,P=0.774];阳性组精子密度较阴性组患者明显偏低[(84.37±52.92)×106/mlvs(101.90±43.90)×106/ml,P=0.025];阳性组精子活率较阴性组患者明显偏低[(44.62±22.13)%vs(51.83±19.88)%,P=0.036];阳性组患者精子活力明显低于阴性患者[(38.40±15.61)%vs(44.45±15.47)%,P=0.020];两组精液pH值均在正常值范围内,但阳性组明显高于阴性组(7.32±0.10vs7.19±0.29,P=0.003);阳性组与阴性组除侧摆幅度、向前运动、直线运动和摆动性等4项指标相差不显著外,对曲线运动性、直线速度、平均路径速度、平均移动角度)和鞭打频率等5项指标均有影响;阳性组精浆α-葡萄糖苷酶较阴性组明显降低[(40.0±18.7)U/mlvs(47.9±21.0)U/ml,P=0.026],Uu感染阳性组α-葡萄糖苷酶降低的相对危险性是阴性组的2.12倍;两组间精浆酸性磷酸酶和果糖水平无统计学差异(P均>0.05)。结论:在男性不育患者中,生殖道溶脲脲原体感染是精液质量下降的重要危险因素;生殖道溶脲脲原体感染可导致附睾分泌α-葡萄糖苷酶下降,但对前列腺酸性磷酸酶及果糖无明显影响,而这种感染对前列腺和精囊危害相对有限。     

Transferrin in Seminal Plasma of Fertile and Infertile Men

The levels of transferrin in seminal plasma of a large sample of infertile men (n = 287) were measured by radioimmunoassay. A group of recently pregnancy-proven fertile men (n = 20) was used as control and a small group (n = 6) of vasectomized men was studied to determine the origin of seminal transferrin. Infertile men had lower transferrin values than fertile men, although the difference was not significant in the case of normozoospermic infertile men (0,05 less than p less than 0,1); in the case of oligozoospermic infertile men the difference was highly significant (p less than 0,001). The values of transferrin in severely oligozoospermic, azoospermic and vasectomized subjects suggested that 60% of seminal transferrin could be of testicular origin. In infertile patients transferrin fall along with sperm count; there is a strong correlation between transferrin and sperm density. FSH levels were measured in a group of severely oligozoospermic and azoospermic patients (n = 41); although the patients with elevated FSH had lower transferrin levels than the patients with FSH within the normal range, the difference was not significant. The results of this study show that transferrin could be a useful marker of seminiferous tubular function but more work is needed to assess its relevance for clinical practice.     

Metenkephalin in Seminal Plasma of Infertile Men

Background: Enkephalin is one of the opioids, which is expressed widely in reproductive organs. However, the function of enkephalin in male reproduction is not completely understood. The effect of metenkephalin on sperm motility remains especially controversial. In this study we examined the level of metenkephalin in seminal plasma from men with normal sperm production and patients with asthenospermia, oligospermia, and azoospermia to investigate the role of metenkephalin in seminal plasma on sperm function. We also investigated the effect of metenkephalin on sperm motility in vitro.
Methods: Sixty nine infertile patients (31 oligospermic, 21 asthenospermic, and 17 azoospermic) were included in this study. The level of metenkephalin in seminal plasma of these men was measured and the effect of the peptide on the motility of human sperm was examined in vitro. Seventeen men with normal seminograms were a control group.
Results: The level of metenkephalin in the seminal plasma of semen from asthenospermic men was significantly lower than that from the controls ( P < 0.05). No significant correlations between the level of metenkephalin and the mean pathing or progressive velocity of sperm, or serum hormone levels were observed. In the in vitro study, which used semen from the controls, treatment of sperm with metenkephalin (50–200 pg/mL) maintained sperm motility for 4 hours. On the other hand, motility of sperm incubated without metenkephalin began to decrease at 3 hours. Metenkephalin levels of 50 pg/mL in seminal plasma is considered to be necessary for maintaining sperm motility.
Conclusion: These results suggest that metenkephalin in seminal plasma is an important clue in the investigation of decreased sperm motility.     

Seminal Plasma Isoenzyme LDH X in Infertile Men

Isoenzym LDH X im Seminalplasma infertiler Männer
Bei 55 Proben von Patienten mit Azoo-bzw. Oligozoospermie wurde das Isoenzym LDH X im Seminalplasma sowie das Hormonprofil bestimmt.
Die zwischen den LDH X-Werten und den Gonadotropinen gefundene Korrelation kann als Indikator für die Keimzellendifferenzierung benutzt werden. Auffallend hohe LDH X-Werte, die bei Patienten mit hochgradiger Oligozoospermie gefunden wurden, könnten darauf hindeuten, daß diese Patienten eine normale Spermatogenese haben und möglicherweise auf eine Hormontherapie ansprechen.     

Concentration of Calcitonin in Seminal Plasma of Infertile Men/Calcitonin-Konzentration im Spermaplasma von unfruchtbaren Männern

Calcitonin levels in peripheral plasma (8 cases) and seminal fluid (30 cases) were measured by direct Radioimmunoassay (RIA). Their relationship with seminal characteristics, calcium and swelling test were evaluated. Seminal plasma calcitonin averaged 7530 pg/ml which amounts to 142 times higher than that of serum averaging 53 pg/ml. There was no significant difference in the mean seminal plasma concentration of immunoreactive calcitonin (iCT) among normozoospermic, oligozoospermic and azoo-spermic groups. However, there was a significant difference (p less than 0.05) in the seminal plasma mean concentration between high and low motility groups. A significant correlation was found between iCT seminal plasma concentration and percent of motility (p less than 0.05), yet, no correlation was detected between iCT and other seminal characteristics including swelling test (p greater than 0.05). Seminal plasma calcium averaged 175.3 +/- 29.9 mg/L which was 1.75 times higher than that of the serum averaging 100.32 +/- 5 mg/L. No significant difference (p less than 0.05) was obtained between high and low motility groups as regard their calcium seminal plasma levels. A significant correlation was found between seminal plasma concentration of calcium and calcitonin (p less than 0.05), but not with the percent of motility (p less than 0.05). Calcitonin (CT) was present in seminal plasma in higher concentrations than those of serum, indicating its active secretion within the male accessory sex glands. The role of CT in human reproduction needs further elucidation, especially regarding sperm motility.     

严重少精子症患者与正常生育男性精浆蛋白质群比较分析

目的:探讨严重少精子症和正常生育男性精浆蛋白质群的差异性。方法:11例正常健康已生育的自愿者(正常组)和6例严重少精子症男性精液标本通过Percoll分离获取精浆。采用SELDI-TOF-MS,经CM10芯片捕获蛋白质并用TOF-MS对蛋白质进行检测,获得各样本的蛋白质指纹图谱,经过归一化处理后进行组间比较。结果:严重少精子症组与正常组比较仅有2种低丰度蛋白质表达存在差异,与非梗阻性无精子症组比较差异蛋白质达15种。蛋白质荷比(m/z)分别为7196.058、7547.610、5780.493、7059.844、7409.589、5379.173、10778.810的7种蛋白质是严重少精子症、正常组与非梗阻性无精子症组的共同差异蛋白质,除后两者在非梗阻性无精子症中含量升高外,其余含量均降低。结论:严重少精子症的精浆蛋白质群与正常组差异较小,即两者的精浆蛋白质组成较为相似,但二者均与非梗阻性无精子症存在显著差异。提示严重少精子症和非梗阻性无精子症的发生机制不同,并非仅是遗传因素量的累加。