精浆中胱抑素C的检测及其意义

目的研究精浆中胱抑素C(CysC)的生物学特性及其检测意义,建立可供临床研究的参考数据。方法应用免疫胶体金技术对192例不育患者精浆及50例正常生育的男性精浆CysC进行对比检测,同时监测50例正常对照精浆标本在不同温度及时间段内CysC的变化情况。结果192例患者精浆标本中CysC最低值为6.53mg/L,最高值为43.56mg/L,平均值为(19.37±7.43)mg/L;50例正常对照精浆中最低CysC值为18.13mg/L,最高CysC值为28.84mg/L,平均值为(23.55±2.50)mg/L。少精子症为(15.92±4.96)mg/L、弱精子症为(15.62±2.13)mg/L、死精子症为(15.26±2.12)mg/L、无精子症为(13.88±2.38)mg/L、血精症为(15.52±5.92)mg/L、脓精症为(19.45±9.87)mg/L、精液不液化为(13.99±3.88)mg/L;患者各组间与正常对照组CysC值经统计学分析差异具有统计学意义(P<0.05)。精液中WBC数<5个/HP的CysC值最低为6.53mg/L,最高为34.82mg/L,平均值为(16.40±5.75)mg/L;精液中WBC数为5～10个/HP的CysC值最低为8.95mg/L,最高为39.54mg/L,平均值为(19.75±6.05)mg/L;精液中WBC数>10个/HP的CysC值最低为10.73mg/L,最高为43.56mg/L,平均值为(21.96±10.49)mg/L。结论少精子症、弱精子症、无精子症、死精子症、血精症、脓精症、精液不液化患者精浆CysC总体水平均明显低于正常对照组。炎症精浆中CysC值的变化提示CysC可能与其主要的细胞学来源及炎症部位相关。     

不育病人精浆前列腺特异性抗原的检测及意义

目的 :探讨不育病人精浆前列腺特异抗原 (PSA)检测的意义。　方法 :随机选择 85例不育病人 ,采用ELISA法检测不育病人精浆PSA水平 ,并分析其与精浆酸性磷酸酶 (ACP)、精子密度、活率之间的关系。　结果 :35例不液化病人、30例液化不全病人精浆PSA水平、ACP浓度、精子活率 (a +b +c级精子百分率 )均显著低于 2 0例液化正常病人 (P <0 .0 1) ;而精子密度则无差异 (P >0 .0 5 )。精浆PSA水平与精浆ACP浓度、精子活率显著正相关 (P<0 .0 1)。　结论 :精浆PSA水平与精液液化密切相关 ,其质和量的异常会使精子活率降低 ,从而导致男性生育力下降     

生殖支原体感染对不育男性精液相关参数的影响

目的:回顾分析男性不育患者伴生殖支原体(MG)感染对精液相关参数的影响,以探究MG感染与男性不育的关系。方法:2016年2月至2018年2月确诊为特发性男性不育患者420例,核酸扩增试验检测患者尿中MG RNA,计算机辅助精液分析(CASA)系统分析精液常规参数,Shorr染色分析精子形态;同时检测精浆中α-葡糖苷酶(α-Glu),果糖(Fru),锌以及γ-L-谷氨酰转肽酶(γ-GT)活性。结果:420例患者中MG阳性101例,阴性319例。MG阳性组精液体积较阴性组显著降低[3. 20±1. 30) ml vs(3. 57±1. 36) ml,P=0. 016]; MG阳性组和阴性组精子浓度[(54. 80±36. 54)×10~6/ml vs (57. 36±40. 88)×10~6/ml],前向运动精子百分率[(41. 29±18. 71)%vs (45. 33±20. 42)%]、正常形态精子百分率[(5. 67±2. 86)%vs (5. 87±2. 97)%]均无显著差异(P0. 05); MG阳性组和阴性组精浆中α-Glu [(352. 47±213. 34) U/L vs (338. 82±126. 36) U/L]、Fru [(14. 93±6. 53) mmol/L vs (15. 62±6. 35) mmol/L]、锌[(2. 82±1. 23) mmol/L vs (2. 98±1. 30) mmol/L]、γ-GT[(1925. 64±593. 41) U/L vs (1993. 98±556. 03) U/L]也无显著差异(P 0. 05)。结论:MG感染可显著降低不育男性精液体积,但对精液其他参数无明显影响。     

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,其中正常生育期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。     

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有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。     

精液质量与精浆纤维蛋白原含量关系的探讨

精浆纤维蛋白原(Fibrioogen,fis)含量与精液质量关系的研究国内尚未见报道。本文对21例正常生育男性和161例不育男性精浆fig含量进行测定,并与精子密度、活动率、正常形态精子百分率进行比较。现将结果报告如下。材料与方法一、检测对象正常生育男性21例,年龄26～35岁;不育男性为性生活正常,夫妇同居≥2年未育而又排除女方原因,共161例,年龄24～42岁。二、标本收集用手淫法收集精液于清洁干燥的玻璃瓶内,要求整份精液不遗漏,立即送检。三、检测方法精液液化后按常规方法进行精     

精索静脉曲张对精液质量和血清、精浆中抑制素B水平的影响

目的:探讨精索静脉曲张(VC)患者精索静脉曲张程度对精液参数和血清、精浆中抑制素B(inhibin B)水平的影响。方法:收集95例不育伴VC患者,55例有正常生育力的男性作为对照组,均通过CASA进行精液常规检查,改良巴氏染色进行精子形态检查;通过ELISA法检测外周血、精浆中抑制素B的水平。结果:VC患者正常形态精子百分率[Ⅰ度:(6.3±6.5)%,Ⅱ度:(2.6±3.0)%,Ⅲ度:(1.0±0.7)%]和前向运动精子百分率[Ⅰ度:(33.3±20.8)%,Ⅱ度:(28.9±19.8)%,Ⅲ度:(13.5±8.4)%]明显低于对照组[(7.5±5.2)%,(43.9±22.7)%](P0.05),精子畸形以头部畸形为主;VC患者外周血和精浆中抑制素B水平[Ⅰ度:(160.9±48.9)pg/ml,(208.3±28.1)pg/ml;Ⅱ度:(150.6±44.7)pg/ml,(201.5±83.5)pg/ml;Ⅲ度:(132.6±41.5)pg/ml,(150.2±51.6)pg/ml]均低于对照组[(201.0±38.1)pg/ml,(225.3±82.5)pg/ml]。结论:VC可导致精子活力降低,畸形率升高,外周血和精浆抑制素B水平下降,从而导致男性生育力受损。     

安特尔治疗NIH-Ⅲa型前列腺炎合并精液液化延迟患者临床分析

目的 探讨安特尔治疗NIH-Ⅲa型前列腺炎合并精液液化延迟的疗效及安全性.方法 选取NIH-Ⅲa型前列腺炎合并精液液化延迟患者62例随机分为两组,对照组口服左氧氟沙星0.5mg每天,治疗组加用安特尔40mg每天,疗程1个月.比较治疗前后两组相关指标的变化.结果 治疗前两组各项指标无显著差异.治疗后精浆PSA治疗组与对照组分别为1.21±0.46mg/mL和0.83±0.43mg/mL（P=0.002）,血清PSA分别为1.79±0.86ng/mL和1.68±0.72ng/mL（P=0.615）,血清总睾酮分别为474.83±105.74ng/dl和428.86±106.49ng/dl（P=0.095）,NIH-CPSI总分分别为15.76±5.22和16.04±6.22（P=0.853）,有效率分别为70.59％和45.83％（P=0.02）.结论 短期内小剂量安特尔治疗有助于提高精浆PSA水平,促进精液液化,对前列腺炎症状无显著影响.     

少精子症患者血清、精浆中游离睾酮水平的测定及意义

目的 :通过测定少精子症患者血清、精浆中游离睾酮 (FT)水平 ,分析血清、精浆FT与少精子症的关系。　方法 :正常对照组 (n =4 4 )、少精子症组 (n =4 4 )男性于上午 8:0 0～ 10 :0 0留取血标本 ;正常对照组 (n =30 )、少精子症组 (n =37)同时留取精液。男性精液常规分析判断精子密度 ,放射免疫分析法测定血清、精浆中FT水平。　结果 :少精子症患者血清中FT浓度为 [(94 .88± 4 2 .0 4 )pmol/L],与正常对照组 [(97.5 0± 4 6 .96 )pmol/L]相比差异无显著性 (P >0 .0 5 ) ,但少精子症患者精浆中FT浓度 [(0 .5 2± 0 .4 4 ) pmol/L]显著低于正常对照组 [(2 .0 1±0 .32 )pmol/L],P <0 .0 1。　结论 :精浆中FT的测定较早反映睾丸的功能 ,有利于少精子症患者的早期诊断和治疗。     

精液液化异常与溶脲脲原体、沙眼衣原体感染以及抗精子抗体相关性研究

目的研究精液液化异常与生殖道溶脲脲原体、沙眼衣原体感染以及精浆抗精子抗体的关系。方法男性不育患者350例,根据液化时间分为精液不液化组、液化不全组和液化正常组,观察精液液化状态与UU、CT感染率和精浆AsAb阳性率之间的关系。结果精液不液化组、液化不全组的UU、CT感染率和AsAb阳性率均明显高于液化正常组;而液化不全组和不液化组的UU、CT感染率和AsAb阳性率无明显差异(P>0.05)。结论精液液化异常与生殖道UU、CT感染以及精浆AsAb有关。     

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.     

Heme oxygenase enzyme activity in seminal plasma of oligoasthenoteratozoospermic males with varicocele

This work aimed to assess seminal plasma heme oxygenase (HO) enzyme activity in oligoasthenoteratozoospermia (OAT) males with varicocele. Ninety‐three men were divided according to their sperm count and clinical examination into: healthy fertile controls (n = 34), OAT without varicocele (n = 37) and OAT associated with varicocele (n = 22). They were subjected to semen analysis and estimation of seminal plasma HO enzyme activity in the form of bilirubin concentration. Seminal plasma HO enzyme activity decreased significantly in OAT cases compared with controls. Seminal plasma HO in OAT cases associated with varicocele decreased significantly compared with OAT cases without varicocele and healthy controls (mean ± SD; 109.2 ± 29.5, 283.6 ± 88.4, 669.5 ± 236.1 nMol bilirubin/mg ptn/min, P < 0.001). There was positive correlation between seminal plasma HO enzyme activity and sperm concentration, per cent of motile spermatozoa, number of motile spermatozoas ml^?1 and significant negative correlation with sperm abnormal forms per cent. It is concluded that varicocele has a negative impact on seminal HO enzyme activity. Therefore, improved seminal picture after correcting varicocele repair might be related, in part, to improved HO action(s).     

超高效液相色谱法测定男性精浆中生物胺含量的研究

目的:建立一种超高效液相色谱测定人精浆中腐胺、亚精胺、精胺3种生物胺含量的方法. 方法:精浆样品用5％三氯乙酸提取,丹磺酰氯柱前衍生化,采用C18(2.1×50mm,1.7 μm)色谱柱,以水-乙腈为流动相梯度洗脱,流速为0.3 ml/min,检测波长为245 nm,柱温:35℃;进样量3.0μl.测定了捐精志愿者52...     

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。     

精液不同体外处理技术对宫腔内人工授精的临床疗效分析

目的　探讨精液的不同体外处理技术对宫腔内人工授精 (IUI)的疗效。　方法　A组为因女方因素引起的不育 ,采用上游法优选精子。B组为因男性性交和射精障碍 ,精液液化不良 ,免疫学异常 ,精液中有核细胞数目 >5× 10 9/L ,单纯精浆异常等引起的不育 ,采用高速离心法处理精子。C组为少、弱、畸精子症等引起的不育 ,采用双层梯度法处理精子。　结果　妊娠成功率A组 5 0 .5 % ,B组为 4 1.4 % ,C组为 32 .4 %。　结论　对不同的病因采用不同的精液体外处理技术 ,能提高IUI的成功率。     

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     

Paraoxonase-1 activity in subfertile men and relationship to sperm parameters

Oxidative stress has been implicated in the pathogenesis of male infertility. Paraoxonase-1 (PON-1) is a high-density lipoprotein-associated antioxidant enzyme that prevents oxidative modification of low-density lipoprotein. Our aims in the study were to investigate 1) seminal PON-1 activity in subfertile men and 2) whether seminal PON-1 activity had any relationship to semen parameters. The study included 28 men with idiopathic subfertility, 32 subfertile men with abnormal semen parameters, and 30 fertile male volunteers. Seminal PON-1 activity was measured spectrophotometrically. Seminal total antioxidant status (TAS) and total oxidant status (TOS) were determined by using colorimetric methods. Oxidative stress index (OSI) was calculated as ([TOS/TAS] x 100). TOS and OSI were significantly higher and PON-1 activity and TAS were significantly lower in subfertile men with abnormal semen parameters than in men with idiopathic subfertility and fertile donors. PON-1 activity was also strongly correlated with sperm concentration (r = .68, P < .0001), motility (r = .58, P < .0001), and morphology (r = .62, P < .0001) in the overall group. The receiver operating characteristic curve analysis revealed a high diagnostic value for PON-1 activity with respect to male-factor subfertility, with an area under curve of .95 (95% confidence interval = 0.89-1.01), sensitivity = 97%, and specificity = 88%. Men with abnormal semen parameters have decreased levels of PON-1 activity in their seminal plasma. This may play an important role in the pathogenesis of male-factor subfertility.     

Altered malondialdehyde, protein carbonyl and sialic acid levels in seminal plasma of microscopically abnormal semen

Microscopically abnormal (n = 26) semen showed significantly higher levels of malondialdehyde (MDA), protein carbonyl (PC) and protein-bound sialic acid (SA) in seminal plasma as compared with normal semen (n = 24). The percentage of nonmotile spermatozoa showed significant (P < 0.01) positive correlation with MDA (r = 0.5) and PC (r = 0.49). Sperm counts showed a significant negative correlation with MDA (r = -0.63, P < 0.001) level of seminal plasma. SA correlated (r = 0.56, P < 0.01) with MDA. The receiver operating characteristic (ROC) curve of MDA and SA showed that MDA of 3.15 micromol l(-1) and SA of 3.85 micromol l(-1) were optimum cut-off limits to discriminate abnormal semen from normal. In conclusion, high SA might be a protective response against prevailed oxidative stress in abnormal semen. Seminal plasma MDA and SA may act as potential markers of abnormal semen.