人精浆抗精子抗体与顶体酶活性关系的探讨

目的 :研究精浆抗精子抗体 (AsAb)对精子顶体酶活力的影响。　方法 :用间接血凝法测定 34 32例不育男性和 6 5例生育男性精浆的AsAb ,并对其中的 2 882例不育男性精子用比色法进行了顶体酶活性的测定。　结果 :34 32例不育者精浆AsAb阳性率为 10 .2 0 %,2 882例进行了顶体酶活性测定的不育者精浆AsAb阳性率为 9.37%,对照组精子顶体酶活性明显高于各不育组 (P <0 .0 0 1)。不育组AsAb阳性组与AsAb阴性组比较顶体酶活性没有明显差异 (P >0 .0 5 ) ,顶体酶活性正常与异常组AsAb阳性率比较差异无显著性 (P >0 .0 5 )。　结论 :精浆AsAb对精子顶体酶活性没有影响。     

抗精子抗体对精子顶体酶活性的影响

本文旨在观察抗精子抗体对精子顶体酶活性的影响。选择男性不育者50例与正常生育者20例，采用固相酶染色法测抗精子抗体，以固定明胶薄膜法测精子顶体酶活性。结果发现50例不育者抗精子抗体阳性率为52％。不育者精子顶体酶活性明显低于生育者；抗精子抗体阳性者须体酶活性明显低于阴性者，表明抗精子抗体可降低精子顶体酶活性。     

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     

不育患者精浆α-1,4糖苷酶活性与精液参数的关系

目的　探讨精浆 α-1 ,4糖苷酶活性与精液参数之间的关系。　方法　分光光度比色法测定精浆 α-1 ,4糖苷酶活性及进行精液常规分析。　结果　 2 90 2例男性不育者精浆α-1 ,4糖苷酶活性异常率为 3 8.87%。该酶活性与精子密度、精子活率、a,b级精子活力和顶体酶活性呈显著正相关 ( r分别为 0 .460、0 .1 2 2、0 .0 86和 0 .2 3 0 ,P均 <0 .0 0 1 ) ,而与精液量、精液 p H、液化时间和畸形精子率无显著相关 ( P>0 .0 5)。 α-1 ,4糖苷酶活性正常组精子密度、活率、a,b级精子活力和精子顶体酶活性均明显高于 α-1 ,4糖苷酶活性异常组 ( P<0 .0 0 1 )。以常规精液分析法 ( RSA)主要参数正常与否分成的两组间α-1 ,4糖苷酶活性差异有显著性 ( P<0 .0 0 1 )。　结论　α-1 ,4糖苷酶活性对精子密度、活率、a,b级精子活力和顶体酶活性均有明显影响 ,对精液量、精液 p H、液化时间和畸形精子率无显著影响     

不育男性精子染色质结构与精液常规参数的关系

目的 研究不育男性精子染色质结构参数与精液常规参数的关系.方法 采集36例男性不育患者和18例健康对照者的精液标本,用TUNEL法检测精子DNA碎片化,CMA3染色法检测精子染色质包装质量,按照世界卫生组织标准(1999)检测精液常规参数.结果 不育组的精子TUNEL阳性率和CMA3阳性率均显著高于健康对照组,差异具有统计学意义(P＜0.05),精液常规参数正常的不育男性精子TUNEL阳性率和CMA3阳性率也显著高于健康对照组,差异具有统计学意义(P＜0.05),精子TUNEL阳性率和CMA3阳性率与精液常规参数之间具有显著的相关性(P＜0.05).结论 不育男性的精子染色质结构检测结果与健康男性存在显著差异,精子染色质结构检测可提供反映男性生育能力的信息.     

无症状不育病人精液抗沙眼衣原体IgG、IgM类别抗体的检测

目的 :探讨无症状不育病人精液抗沙眼衣原体 (Chlamydiatrachomatis,CT) IgG、 IgM抗体检测的临床意义。　方法 :随机选择 116例无生殖道感染症状的不育病人及 18例生育男性 ,作精液常规参数分析 ,然后分离精浆 ,测定其抗CT IgG、 IgM抗体。 　结果 :①不育病人精浆抗CT IgG、 IgM抗体阳性率分别为13 .8% ( 16/ 116)和3 .4% ( 4/ 116) ,而生育男性分别为 11.1% ( 2 / 18)和 0 ,两组相比差异均无显著性 (P均 >0 .0 5 )。② 116例不育病人中有 2 2例为无精子症。其余 94例病人中 ,精子密度异常组的精浆抗CT IgG、 IgM抗体阳性率分别为2 1.4% ( 6/2 8)和 7.1% ( 2 / 2 8) ,精子密度正常组则较低 ,分别为 12 .1% ( 8/ 66)和 3 .0 % ( 2 / 66) ,但差异均无显著性 (P均 >0 .0 5 ) ;精子活率正常组和异常组之间的精浆抗CT IgG、 IgM抗体阳性率也无明显差异 (P均 >0 .0 5 )。③ 116例不育病人中 3 0例CT阳性 ( 2 5 .9% )。　结论 :无症状不育病人的精浆抗CT IgG、 IgM抗体阳性率与生育男性相似 ,与其精液参数改变无关 ,不能作为CT感染的辅助指标     

应用化学发光法检测男性不育人群精液活性氧水平

目的 探讨化学发光法检测男性不育人群中精液ROS水平的意义.方法 使用化学发光法检测1018例不育男性和50例已育志愿者精液活性氧水平.不育男性精液分为弱精子组(400例)、少精子组(19例)、少弱精子组(21 2例),少弱畸精子组(3 5例),精液指标正常组(3 52例).结果 男性不育人群精液活性氧水平旱偏峰分布,中位数为40 RLU/s;男性不育各组与志愿者ROS水平差异有统计学意义,不育组各组之间差异也有统计学意义.结论 用化学发光法检测精液ROS水平能够较好地评价男性生育功能,ROS能够作为一个独立的指标指导男性不育的诊断.     

精子诱发顶体反应与精子顶体酶活性测定关系的研究

目的 通过对精液常规正常的不育男子检测人类精子诱发顶体反应和测定精子顶体酶活性,探讨两种检测结果 的相关性.方法 40例精子密度≥20×106/ml、活动力(a+b)级精子≥50%的不育男子精液,采用离子载体A23187诱导精子顶体反应(AR),用FITC-PSA荧光染色法分析AR,并计算顶体反应发生率;用分光光度比色法(Kennedy法)测定精子顶体酶活性.用组间方差分析方法 比较精子顶体反应发生率与精子顶体酶活性之间关系.结果 两种检测结果 没有明显相关性(r=0.292,P>0.05).结论 两种检测联合应用可作为临床分析男性不育病因的检测手段.     

抗精子抗体对精子顶体酶活性的影响

目的：观察抗精子抗体对精子顶体酶活性的影响。方法：选择男性不育者５０例，与正常生育者２０例。采用固相酶染色法测抗精子抗体，固定明胶薄膜法测精子顶体酶活性。结果：５０例不育者抗精子抗体阳性率为５２％。不育者精子顶体酶活性明显低于生育者；抗精子抗体阳性者顶体酶活性低于阴性者。结论：抗精子抗体可降低精子顶体酶活性。     

抗精子抗体对精子顶体酶活性的影响

本文旨在观察抗精子抗体对精子顶体酶活性的影响。选择男性不育者５０例与正常生育者２０例，采用固相酶染色法测抗精子抗体，以固定明胶薄膜法测精子顶体酶活性。结果发现５０例不育者抗精子抗体阳性率为５２％，不育者精子顶体酶活性明显低于生育者；抗精子抗体阳性者顶体酶活性明显低于阴性者，表明抗精子抗体可降低精子顶体酶活性。     

Assessment of hyperactivation, acrosome reaction and motility characteristics of spermatozoa from semen of men of proven fertility and unexplained infertility

Summary. Semen from men of proven fertility was compared with that of men with unexplained infertility to determine differences in spermatozoal functions such as hyperactivation and acrosome reaction and spermatozoal motility characteristics. The hyperactivated spermatozoa in both groups could be visualised on the monitor of the Computer Assisted Semen Analyser and they exhibited 'circling', 'thrashing', 'starspin' and 'helical' motility patterns and the mean hyperactivation rates were not significantly different. However, 20% of the men with unexplained infertility did not exhibit hyperactivation compared to only 4% in the fertile group. Furthermore, the semen from infertile men when evaluated for hyperactivation could be categorised into two groups with those having lower hyperactivation (<10% or <6% after 4 and 6 h of incubation respectively), forming the first group, and those having a higher hyperactivation rate constituting the second group. In the fertile men such distinct groups were not visible and the percentage hyperactivation ranged from 1 to 16%. No significant differences were observed in the rate of acrosome reaction of fertile and unexplained infertile men.
The non-hyperactivated spermatozoa from unexplained infertile men showed a significant increase in path velocity (VAP), curvilinear velocity (VCL) and amplitude of lateral head displacement (ALH) and a decrease in linearity (LIN) and straightness (STR) compared to spermatozoa from fertile men. Furthermore, the hyperactivated spermatozoa from infertile men also showed an increase in progressive velocity (VSL) (only after 2 h of incubation) and LIN and decrease in ALH and beat cross frequency (BCF) compared to spermatozoa from fertile men. The results are discussed in the light of the importance of the above spermatozoal functions and spermatozoal parameters in fertilization.     

The importance of the hypoosmotic swelling test and acrosin activity assay for identifying subpopulations of idiopathic infertile men.

Semen samples collected from fertile donors (n = 13) and pooled samples from idiopathic infertile men (n = 19) were used in this study. Measurements of the total sperm acrosin activity and the hypoosmotic swelling test (HOST) were performed in all the samples. The percentage of swollen spermatozoa and acrosin profiles were significantly lower in the infertile men than in the fertile donors. Considering the lowest values of the outcome of the HOST and the acrosin activity assay in the group of fertile men as the lowest normal values, it was proven that HOST and acrosin activity assay could identify subpopulations of infertile men of 37 and 26%, respectively. The results tend to support the employment of the HOST and the acrosin activity assay in the evaluation of idiopathic infertile men.     

Problems in evaluating male fertility: valuable factors in evaluating male fertility and normal values of seminal parameters

To determine the valuable factor for evaluating male fertility, a comparative study was done as to various seminal parameters between fertile and infertile groups. The fertile group consists of 57 proven fertile males and the infertile group consists of randomly chosen 67 infertile patients. Seminal parameters assessed were sperm concentration, motility, mean velocity, total sperm output, total motile sperm output, sperm morphology, acrosin activity and sperm penetration rate on zona-free hamster egg penetration assay (SPA). The infertile group was significantly different from the fertile group in every parameter except acrosin activity. However, the range of each parameter in the two groups overlapped each other. The diagnostic rate of each parameter, which is the percentage of an infertile male correctly diagnosed as infertile, was calculated by using 95% specificity threshold value of fertile males. The 95% specificity threshold values of sperm concentration, motility and % normal shaped sperm were 24.9 x 10(6)/ml, 34.9% and 55%, respectively, and they could be acceptable for the normal limit of seminal parameters. The diagnostic rate was highest in penetration rate (72.4%). In other words, penetration rate is the most valuable factor in various parameters for making a distinction between fertile and infertile males. Sperm motility and mean velocity showed the next highest diagnostic rate. On the other hand, sperm concentration showed a poor diagnostic rate (36.8%). In addition, there was no significant correlation between penetration rate and any other seminal parameters. These results suggest that the SPA will be an essential test for evaluating male fertility and penetration rate may be a marker of male fertility in the treatment of male infertility.     

Oestrogen receptor alpha gene polymorphisms relationship with semen variables in infertile men

This study aimed to assess the association of oestrogen receptor alpha (ER‐α) gene polymorphisms and semen variables in infertile oligoasthenoteratozoospermic (OAT) men. In all, 141 men were grouped into fertile men (n = 60) and infertile OAT men (n = 81). They were subjected to assessment of semen analysis, acrosin activity, serum reproductive hormones and genotyping of ER‐α gene. Frequencies of p and x alleles in ER‐α gene PvuII and XbaI polymorphisms were more prevalent among fertile men compared with infertile OAT men. Presence of P and X alleles was associated with increased incidence of male infertility for genotypes PP, XX compared with genotypes pp and xx (OR = 2.8; 95% CI: 2.36–6.97; P = 0.001 and OR = 4.1, 95% CI: 1.49–11.39; P = 0.001, respectively). The mean of semen variables and sperm acrosin activity were significantly higher in cases associated with pp than PP and in xx than XX genotypes of ER‐α gene. Mean levels of all serum reproductive hormones demonstrated nonsignificant differences in different ER‐α genotypes except oestrogen that was elevated in PP and XX ER‐α gene genotypes. It is concluded that as oestrogen is concerned in male gamete maturation, ER‐α gene polymorphisms might play a role in the pathophysiology of male infertility.     

精浆弹性蛋白酶水平与精液主要参数和精子功能的相关性分析

目的:探讨精浆弹性蛋白酶与精液主要参数和指标的关系。方法:用酶联免疫吸附法(ELISA)检测精浆中的弹性蛋白酶,按照WHO人类精液实验室手册要求进行精液常规分析、精子形态分析,检测精子顶体酶活性、精浆抗体(AsAb)、解脲支原体等,分析弹性蛋白酶与男性不育相关因素的关系。结果:209例男性不育患者中,43例患者精浆弹性蛋白酶≥290ng/ml,设为炎症组;166例患者精浆弹性蛋白酶<290ng/ml,设为非炎症组。炎症组的精子密度、精子活动率、a+b级活力精子率、精子顶体酶阳性率均低于非炎症组(P<0.05);而精子畸形率、精浆抗体(AsAb)、解脲支原体阳性率均高于非炎症组(P<0.05)。两组的精液量、PH值和液化时间差异无统计学意义。结论:精浆弹性蛋白酶水平与精液质量有密切的关系,生殖道感染是导致男性不育的重要原因。     

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。     

孕酮对正常生育和不明原因不育男性精子细胞内游离Ca~(2+)浓度的影响

目的:比较正常生育男性和不明原因不育男性患者精子细胞内游离Ca2+浓度([Ca2+]i)对孕酮(P)的反应性。方法:选择10例不明原因不育男性患者和9例正常生育男性,用上游法分离活力良好的精子并于体外获能2 h,将获能后精子与8.85μmol/L钙荧光探针Fluo-3/AM避光孵育40 min负载,将负载后的精子悬液与等量20%明胶混匀以制动精子,然后在激光扫描共聚焦显微镜下动态观察单个精子头部的[Ca2+]i基础水平以及10μmol/L P刺激对[Ca2+]i的影响。结果:不育组获能2 h后精子的[Ca2+]i基础水平显著低于生育组(P<0.01)。生育组精子经10μmol/L P刺激后,产生快速而短暂的[Ca2+]i升高,[Ca2+]i峰值水平显著高于其基础水平(P<0.05);而不育组精子经P刺激后,[Ca2+]i仅有微弱增加,其峰值水平与基础水平相比无统计学差异(P>0.05)。生育组由P激发的精子[Ca2+]i峰值水平以及[Ca2+]i升高幅度(峰值水平与基础水平之差)均显著高于不育组(P<0.01)。结论:不明原因不育男性患者精子[Ca2+]i对P的反应性降低,提示这些患者精子膜上负责Ca2+内流的非基因型孕激素受体可能存在功能障碍。     

Acrosin activity in patients with idiopathic infertility

Acrosin is a sperm acrosomal enzyme that is involved in the acrosome reaction, the binding of spermatozoa to the zona pellucida, and fertilization. This study was designed to determine whether sperm acrosin measurements can identify subpopulations of infertile or subfertile patients that are not recognized by routine semen analyses. We measured the total acrosin activity of ejaculates in a group of 19 men (15 suspected subfertile patients and 4 fertile donors). The acrosin activity was measured in liquefied semen specimens using the methodology described by Kennedy et al. [1989) J Urol 10:221-231). Ten patients in the suspected subfertile group had a mean acrosin value of 7.8 microIU acrosin/million sperm, which is clearly in the abnormal range (less than 14 microIU/10(6) sperm). Three patients had a mean acrosin value of 20.1 microIU/10(6) sperm, which is in the indeterminate range. Two other patients and four proven fertile donors had acrosin values in the normal range (greater than 25 microIU/10(6) sperm) (Agarwal A, Loughlin KR (1990): 2d International Meeting of Andrology, Como, Italy; Abstr 22). The normal fertile controls had a mean acrosin value of 32.5 microIU/10(6) sperm.