OHSS与肾素-血管紧张素系统

卵巢过度刺激综合征(OHSS)是辅助生殖技术中常见并发症,其发病学说和理论很多,但真正的机制仍不十分清楚.除与血管内皮生长因子、血管炎性因子等有关外,近年多量的文献认为OHSS与肾素-血管紧张素系统(RAS)相关性较大.对两者之间的关系进行综述.     

血管紧张素Ⅱ对人精子顶体反应的影响

目的 :探讨血管紧张素 (angiotensin ,Ang )对人精子顶体反应的影响及其可能机制。方法 :检测不同浓度 Ang 诱发的人精子顶体反应率和 Ang 引起的精子胞内钙离子的变化 ,以及血管紧张素受体 AT1拮抗剂 Losartan对其的抑制作用。结果 :Ang 在 1 0 nmol/L和 1 0 0 nmol/L时均可显著增加人精子顶体反应率 ,并引起精子胞内钙离子短暂快速升高 ,Losartan可以明显抑制这些过程。结论 :Ang 可以诱发人精子顶体反应 ,这一作用可能经 AT1受体介导 ,通过引起精子胞内钙离子升高而实现。     

OHSS与肾素-血管紧张素系统

卵巢过度刺激综合征(OHSS)是辅助生殖技术中常见并发症，其发病学说和理论很多，但真正的机制仍不十分清楚。除与血管内皮生长因子、血管炎性因子等有关外，近年多量的文献认为OHSS与。肾素．血管紧张素系统(RAS)相关性较大。对两者之间的关系进行综述。     

子宫内膜局部肾素-血管紧张素系统

肾素．血管紧张素系统（renin-angiotensin system,RAS）是人体重要的体液调节系统,当这一系统出现紊乱易引发多种疾病。以往研究多偏重于全身RAS系统,近年来,局部RAS成为研究热点。子宫内膜相关研究表明,局部RAS参与子宫内膜周期性变化及生殖功能调节、维持妊娠期人体子宫稳态等一系列生理过程;并参与子宫内膜异位症、功能性子宫内膜出血、子宫内膜癌等病理生理过程。     

多囊卵巢综合征患者血管紧张素转换酶基因多态性与肾素血管紧张素系统关系的探讨

目的：探讨多囊卵巢综合征（PCOS）患者血管紧张素转换酶（ACE）基因多态性与肾素血管紧张素统（RAS）的关系，了解RAS在PCOS发病中的作用。方法：采用聚合酶链反应（PCR）方法，检测PCOS患者和对照组ACE基因插入和（或）缺失多态性；采用放射免疫方法测定两组血清醛固醇（ALD）水平，比较缺失型等位基因与ALD的关系。结果：PCOS患者ALD水平显著高于对照组，PCOS患者D等位基因组ALD水平显著高于Ⅰ等位基因组，结论：PCOS患者D等位基因的存在与RAS功能亢进有关，RASR的产物血管紧张素Ⅱ（ATⅡ）可使卵泡在各阶段闭锁，导致不排卵，参与了多囊卵巢和高雄激素血症的形成。     

胎盘肾素-血管紧张素系统与妊娠

肾素-血管紧张素系统(RAS)是典型的循环内分泌系统,正常妊娠时处于激活状态,妊娠高血压综合征(PIH)时其活性保持不变或降低.局部RAS与器官生理功能调节及疾病发生的关系引起关注.妊娠特有器官--胎盘存在独立的RAS,在正常妊娠的维持中起重要作用,与PIH的发生发展有关.     

胎盘肾素-血管紧张素系统与妊娠

肾素-血管紧张素系统(RAS)是典型的循环内分泌系统，正常妊娠时处于激活状态，妊娠高血压综合征(PIH)时其活性保持不变或降低。局部RAS与器官生理功能调节及疾病发生的关系引起关注。妊娠特有器官——胎盘存在独立的RAS，在正常妊娠的维持中起重要作用，与PIH的发生发展有关。     

肾素-血管紧张素系统基因与妊娠高血压综合征的新进展

肾素-血管紧张素-醛固酮系统(renin-angiotensin system,RAS)基因是一种激素内分泌系统,在心血管功能调节、水盐平衡调节中起重要作用。RAS基因是妊高征主要的致病基因。AGT基因M235T多态、AT1R基因A1166C多态、ACE基因I/D缺失多态与妊高征的发病相关。     

妊娠高血压综合征和肾素-血管紧张素系统的基因研究进展

妊娠高血压综合征 (妊高征 )是一种常见的妊娠并发症 ,是导致孕产妇和围产儿死亡的主要原因之一。多年来人们对其病因及发病机理进行了大量研究 ,发现妊高征是一种多因素疾病 ,环境与遗传因素在其发病中有重要作用。临床研究表明 ,妊高征具有家族遗传倾向 ,属于单基因遗传性疾病[1] 。妊高征的基本病理生理改变是全身小动脉痉挛 ,临床主要表现为高血压、水肿、蛋白尿。肾素 血管紧张素系统(ｒｅｎｉｎ ａｎｇｉｏｔｅｎｓｉｎｓｙｓｔｅｍ ,ＲＡＳ)在血压和体液调节中具有重要作用 ,并且已发现ＲＡＳ中某些成分 ,如血管紧张素原(ａｎｇｉｏ…     

血管紧张素Ⅱ对人精子获能的影响

目的:探讨血管紧张素II(angiotensinII,AngII)对不育症精子获能的影响及其可能的作用方式。方法:不同浓度AngII与精子悬液共同孵育,以孕酮诱发顶体反应,采用FITC-PSA法测定细胞内Ca2+荧光强度来检测。结果:在未获能的精子悬液中AngII在10nmol/L和100nmol/L时均可明显加速精子获能和增强孕酮诱发的顶体反应(P<0.05),并可使细胞内Ca2+浓度升高(P<0.001),Losartan[AngII受体AT1(angiotensinIItype1receptor)拮抗剂]、EGTA可明显阻断和抑制这些过程。结论:AngII可以促进不育症精子获能,其结果可能是通过AT1受体介导,经改变精子细胞内Ca2+的浓度来实现。     

Relationship Between Human Sperm Morphology and Acrosomal Function

Purpose : In this study, we investigated the relationship between functionality of the acrosome and sperm morphology. Methods : Acrosome reaction (AR) was separately determined in live and dead sperm and in those with normal, small, and large sized acrosomes by means of the triple stain. Morphology was analyzed according to strict criteria after Papanicolaou stain. Results : AR and morphology correlated regarding detection of large and small sized acrosomes, but not for normal sized acrosomes. Spontaneous AR was significantly influenced by acrosomal size. Sperm with large (11.4%) and normal (9.2%) acrosomes exhibited a significantly higher percentage of life spontaneously acrosome-reacted sperm than those with small acrosomes (4.5%). Sperm with small acrosomes were associated with a higher percentage of cell death. Conclusion : The results indicate that sperm with small acrosomes are more susceptible to cell death and nonphysiological acrosomal loss. Acrosome size reflects the physiological capability of sperm function and therefore male fertility potential.     

哺乳动物及人精子的Ca~(2+)通道与顶体反应

在精子生理活动中 ,Ca2 +通道起重要作用。近年来 ,随着荧光探针 ,分子生物学以及电生理技术的飞速发展 ,人们更明确地认识到 Ca2 +通道的重要性 ,特别是在顶体反应中的作用 ,并对其功能性亚单位有了一定的了解。在参与精子顶体反应的众多 Ca2 +通道中 ,电压依赖性 Ca2 +通道倍受重视。同时 ,这些研究资料也可能为男性不育的治疗和避孕提供新的思路     

Sperm immobilization antibodies in infertile male sera decrease the acrosome reaction: A possible mechanism for immunologic infertility

Objective: To study the effect of sperm-immobilizing antibodies from male sera on spontaneous and A23187-induced acrosome reactions (AR). Design: Swim-up spermatozoa obtained from three fertile donors were incubated with 13 sera with sperm-immobilizing antibodies obtained from infertile men and three control sera obtained from healthy fertile males. Sperm acrosomes were examined by staining with pisum sativum agglutinin labeled with fluorescein isothiocyanate (30 µg/ml; Sigma Chemical Co., St. Louis, MO) as spontaneous and A23187 (used at a final concentration of 10 µM; Sigma Chemical Co.) induced. Results: The incidence of spontaneous AR of spermatozoa incubated with antisperm antibody positive male sera (6.2±0.7) was significantly (P<0.001) lower than that of spermatozoa incubated with control sera (10.7±0.5). And the incidence of A23187-induced and -inducible (incidence of induced minus spontaneous) ARs of spermatozoa incubated with sperm antibody-positive male sera (12.4±1.9 and 6.2±1.9) was significantly lower (P<0.001) than that of spermatozoa incubated with control sera (31.0±0.5 and 20.3±0.9). Sperm-immobilizing antibody-positive sera decreased spontaneous, A23187-induced, and inducible ARs. Conclusions: Sperm-immobilizing antibodies from male sera interfere with fertilization by inhibiting the AR.     

Physiological Induction of the Acrosome Reaction in Human Sperm: Validation of a Microassay Using Minimal Volumes of Solubilized, Homologous Zona Pellucida

Purpose: To develop a method that could accommodatemicrovolumes of solubilized human zona pellucida (ZP) andsperm for assessing the induction of the acrosome reaction. Methods: A microassay using 1 l of 2.5, 1.25, 0.6, 0.3,and 0.125 ZP/l incubated with 1 l of a highly motilesperm suspension for 60 min. As a control and parallelto the microassay a standard acrosome reaction techniquewas performed. Results: No significant differences were observed betweenthe percentage acrosome reacted sperm reported by the twoassays under basal conditions (spontaneous) or after inductionwith a Ca²⁺ ionophore or solubilized ZP. At a ZPconcentration of 0.6 ZP/l, the percentages of acrosome-reactedspermatozoa in both techniques were significantlyhigher compared to the spontaneous acrosome reactionresults, namely, 18% and 17%, compared to 10% and 10%,respectively. An approximately 30% level of acrosomal exocytosiswas induced with 2.5 ZP/l in both methods. Conclusions: This newly devised microtechnique is easy andrapid to perform, is repeatable and facilitates the use ofminimal volumes of solubilized human ZP (even a single ZP)for assessment of the inducibility of the acrosome reaction ofa homologous sperm population.     

Physiology: Physiological Induction of the Acrosome Reaction in Human Sperm: Validation of a Microassay Using Minimal Volumes of Solubilized, Homologous Zona Pellucida

Purpose: The objective was to develop a method that couldaccommodate microvolumes of solubilized human (ZP) andsperm for assessing the induction of the acrosome reaction. Methods: A microassay using 1 l of 2.5, 1.25, 0.6, 0.3,and 0.125 ZP/l incubated with 1 l of a highly motilesperm suspension for 60 min. As a control and parallelto the microassay a standard acrosome reaction techniquewas performed. Results: No significant differences were observed betweenthe percentage acrosome-reacted sperm reported by the twoassays under basal conditions (spontaneous) or after inductionwith a Ca2⁺ ionophore or solubilized ZP. At a ZPconcentration of 0.6 ZP/l, the percentages ofacrosome-reacted spermatozoa in both techniques were significantlyhigher compared to the spontaneous acrosome reactionresults, namely 18% and 17%, compared to 10% and 10%,respectively. Approximately a 30% level of acrosomal exocytosis was induced with 2.5 ZP/l in both methods. Conclusions: This newly devised microtechnique is easy andrapid to perform, is repeatable, and facilitates the use ofminimal volumes of solubilized human ZP (even a single ZP)for assessment of the inducibility of the acrosome reaction ofa homologous sperm population.     

精子DNA碎片与体外受精结局的关系

目的:探讨精子DNA碎片与体外受精(in vitro fertilization,IVF)结局的关系。方法:采用染色质扩散实验(sperm chromatin dispersion,SCD)对242例接受IVF的男方进行精子DNA碎片率(DNAfragmentation index,DFI)检测,按照WHO标准进行精液常规分析,将精子DFI、精液常规参数和IVF受精率、卵裂率、可移植胚胎率、优质胚胎率进行Spearman相关分析,将精子DFI、精液常规参数对生化妊娠、临床妊娠的影响进行Logistic回归分析。结果:精子DFI与精子前向活动率呈负相关(r=-0.355,P<0.001);密度梯度法处理前、后精子DFI均与IVF受精率呈负相关(r=-0.223,P<0.001)(r=-0.136,P<0.05);精子DFI、精液常规参数与卵裂率、可移植胚胎率、优质胚胎率无相关性;精子DFI与生化妊娠、临床妊娠结局无相关性。结论:精子DFI影响精子活力与IVF受精率,精子DFI检测对预测IVF受精率有一定的临床意义。     

溶脲脲原体感染与精子密度关系的研究

目的:探讨溶脲脲原体(UU)感染与精子密度之间的关系。方法:在上海同济医院和仁济医院男科两研究中心就医,年龄在20-45岁的对象共346例,分为UU阳性和阴性两组,比较两组对象精子密度,应用混合线性模型-协方差分析,调整中心和禁欲时间计算修正均数;并构建多元线性回归模型控制混杂因素影响。结果:UU阳性对象精子密度均值为47.97×106/ml,而阴性对象为61.49×106/ml,差异有统计学意义(P<0.01)。在控制禁欲时间、研究中心、居沪年限、年龄、独用卫生间、饮酒史等因素的多元线性回归模型显示,UU感染对象的精子密度仍然较低(P<0.05)。结论:UU感染与精子密度下降有关。     

人精子甘露糖受体的表达与精卵融合的关系

目的:研究人精子甘露糖受体(MR)的表达与精卵融合的关系。方法:正常人活精子获能培养后与去透明带金黄地鼠卵行精子穿透试验(SPA)监测精卵相互作用,同时用异硫氰酸荧光素偶联的甘露糖化牛血清白蛋白(FITC-DMA)检测精子甘露糖受体的表达并分析SPA各项指标与精子甘露糖受体表达的关系。结果:SPA指标中穿透指数、结合指数均与精子MR表达率呈正相关。结论:人精子MR与精-卵膜融合密切相关,可能起某种介导作用。     

梗阻性无精子症患者精子顶体完整性与卵胞质单精子注射治疗结局之间的关系

目的:探讨梗阻性无精子症(OA)患者精子的顶体完整性及其与卵胞质单精子注射(ICSI)治疗临床结局之间的关系。方法:选取梗阻性无精子症患者共37例为试验组,同期进行体外受精治疗且精液常规参数正常的男性33例为对照组,应用荧光标记的豌豆凝集素法(PSA-FITC)检测精子顶体完整性,巴氏染色法分析精子形态,比较试验组与对照组的顶体完整率(AIR)、正常形态率(NFR)、受精率(FR)、卵裂率(CR)及优质胚胎率(OER),并将AIR与FR、NFR与FR进行相关性分析。结果:试验组的AIR、NFR、FR显著低于对照组(P<0.01),CR、OER试验组与对照组相比无统计学差异(P>0.05)。试验组AIR与FR呈显著正相关(r=0.595,P<0.01),NFR与FR显著正相关(r=0.463,P<0.01);对照组AIR与FR显著正相关(r=0.683,P<0.01),NFR与FR呈显著正相关(r=0.205,P<0.01)。结论:梗阻性无精子症患者的精子AIR较低。行皮下附睾抽吸术(PESA)-ICSI的梗阻性无精子症患者精子其AIR高则受精率也会高。