精浆抗精子抗体对男性不育症患者精液参数的影响分析

目的分析男性不育症患者精浆抗精子抗体对精液相关参数的影响.方法收集男性不育症患者260例,均采用免疫珠法测定精浆抗精子抗体(AsAb,IgA或IgG型),根据结果分为AsAb阳性组(41例)和阴性组(219例).结果在这260例男性不育症患者中精浆抗精子抗体检出率为15.77%.AsAb阳性组患者的精液主要参数(精液密度、活动率、a b活动力)均低于AsAb阴性组患者,两组间比较差异具有显著性(P<0.05).结论精浆抗精子抗体对精液主要参数有明显影响,是导致男性免疫性不育的重要因素之一.     

不育男性精子膜表面抗精子抗体水平与精液主要参数及精子功能的相关性

目的探讨男性不育症患者精子膜表面抗精子抗体与精液主要参数的相关性。方法收集男性不育症患者350例,均采用免疫珠法测定精子膜表面抗精子抗体(AsAb,IgA或IgG型),根据结果分为AsAb阳性组(43例)和阴性组(307例)。结果在这350例男性不育症患者中精子膜表面抗精子抗体检出率为14.00%。AsAb阳性组患者的精液主要参数(精液密度、活动率、活动力、精液量)均低于AsAb阴性组患者,两组间比较差异具有显著性(P<0.05)。结论精子膜表面抗精子抗体与精液主要参数及精子功能下降有明显相关性,是导致男性免疫性不育的重要因素之一。     

急性附睾炎患者精液中支原体、衣原体与血清抗精子抗体的关系

目的 评价人型支原体(Mh)、解脲支原体(Uu)、衣原体(Ct)感染的急性附睾炎患者与血清抗精子抗体(AsAb)的关系.方法 对105例支原体及衣原体感染的急性附睾炎患者与30例正常男性的精液分别进行Mh、Uu 、Ct及AsAb检测.结果 急性附睾炎后血清AsAb阳性率高于正常组,差异有统计学意义(P< 0.05).结论 急性附睾炎后产生AsAb,可引起男性不育症.     

精子动态参数在男性不育精液中的定量分析

目的评价精子动态参数在男性不育症中的作用.方法选择217例男性不育及46例正常生育对照精液标本,用精子检测系统定量测定男性不育症与对照组的精子动态参数,并进行统计学处理.结果精子动态参数中曲线速度、直线速度、平均路径速度、平均移动角度、鞭打频率、直线性、摆动性、前向性等8个参数有明显统计学差异,侧摆幅度有统计学差异.结论精子的动态参数是评估男性不育的重要指标,而这些参数是传统手工目测法不能获得的.通过两组参数的对比分析,更有利于男性不育的诊断及预后观察.     

前列腺炎合并不育症患者的抗精子抗体评价

目的评价前列腺炎合并不育症患者的抗精子抗体关系.方法应用混合球蛋白试验(MAR试验)、浅盘精子凝集试验(TAT试验)和浅盘精子制动试验(SIT),对35例前列腺炎合并不育症患者(A组)的血清和精子表面抗精子抗体进行检测,随机选择35例男性不育门诊初诊者作对照(B组).结果 A组采用TAT检出血清抗精子抗体阳性5例,滴度水平在1:8～16,SIT未测出阳性,采用MAR试验检出精子表面抗体阳性8例.B组采用TAT检出血清抗体阳性4例,SIT阳性1例,采用MAR试验检出精子表面抗体阳性2例.经t检验,A组精子表面抗精子抗体阳性率显著高于B组(P＜0.01).结论前列腺炎合并不育症患者存在着精子免疫因素,且表现出精子表面抗体发生率升高,临床对这类不育患者治疗要重视前列腺炎的抗炎处理.     

不育症患者精液分析与抗精子抗体检测

目的不育症男性的精液分析与血清抗体精子抗体(AsAb)的相关性.方法用常规方法对150例男性精液标本进行精液量、pH值、精子活力、精子活率、液化时间、粘稠度及精子密度、白细胞等方面进行检查,同时用酶联免疫吸附试验(ELISA)作血清AsAb免疫学检测.结果115例不育症男性中精液异常患者的AsAb阳性率为34.8%.结论不育症男性精液异常患者与AsAb有一定的关联性,其阳性率也高于国内相关报道.     

男性不育患者精子Na^＋-K^＋-ATP酶与抗精子抗体的关系

目的观察男性不育患者精子的Na＋-K＋-ATP酶的活性与抗精子抗体的关系。方法采用ELISA法测定男性不育组和正常生育组血清中的抗精子抗体,再分别测定40例抗精子抗体阳性的男性不育组和40例抗精子抗体阴性的正常生育组精子中Na＋-K＋-ATP酶的活性。结果抗精子抗体阳性的男性不育组精子中Na＋-K＋-ATP酶活性为12.0±6.1μmol.pi/107sperm/h,显著低于抗精子抗体阴性的正常生育组41.1±8.2μmol.pi/107sperm/h。（P〈0.05）。结论血清中抗精子抗体作为男性不育的指标之一,其可能通过降低精子的Na＋-K＋-ATP酶活性而导致男性不育。     

精浆抗精子抗体影响精子DNA完整率的临床观察

目的研究精浆抗精子抗体(AsAb)对精子DNA完整率的影响。方法实验前取配偶怀孕后半年内正常精液标本20例测定精子DNA完整率做预试验,其数值拟做疗效参考指标。选择2008年4月至2011年1月来我院生殖中心就诊的特发性弱精子症门诊患者432例。检验其精浆抗精子抗体和精子DNA完整率。结果在432例病人中抗精子抗体阳性患者有45例,占总数的10.42%。抗精子抗体阳性组与正常组比较,在液化时间、精子密度、精子存活率、DFI(%()精子DNA断裂指数)上存在差异,具有统计学意义(P<0.05)。抗精子抗体阳性组与阴性组比较,在液化时间、精子密度、和排精量上存在差异,具有统计学意义(P<0.05)。抗精子抗体阳性组与阴性组比较,在精液pH值、DFI上无明显差异,无统计学意义(P>0.05)。结论精浆抗精子抗体(AsAb)对精子DNA完整率的影响不明显。     

男性不育症患者促黄体生成素、抗精子抗体指标水平及其与精子前向运动的相关性分析

目的分析不育男性精浆促黄体生成素(LH)、抗精子抗体(AsAb)指标水平,并分析其与精子前向运动的相关性。方法选择2015年10月至2017年12月我院生殖医学科诊治的102例不育男性患者为观察组,选择同时间的42例健康育龄男性为健康对照组。观察两组对象生殖激素LH、免疫抗体AsAb指标和前向运动精子指标的差异,分析生殖激素LH、免疫抗体AsAb水平与精子前向运动的相关性。结果观察组LH水平、AsAb阳性率均高于健康对照组(P <0.05),而精子密度和前向运动精子率均低于对照组(P<0.05);不育男性患者精浆LH水平与精子密度及前向运动精子个数呈负相关(r=-0.406、-0.475;P=0.003、0.004);AsAb阳性率与精子密度及前向运动精子个数呈负相关(r=-0.518、-0.584;P=0.025、0.030)。结论不育男性患者的LH水平及AsAb阳性率较高,且与精子的前向运动密切相关,这对男性不育类型的鉴别诊断和选择治疗方案具有重要意义,应针对这种情况进行监测与干预。     

不育夫妇中男性精液的沙眼衣原体与抗精子抗体的探讨

男女性生殖道的沙眼衣原体 (Chlamydiatrachomatis,CT)感染常不表现症状 ,并且可能长时间存在。由于CT培养较困难 ,作者采用巢式聚合酶链反应 (PCR) ,检测 90对不育夫妇中男性精液的CT。同时采用ELISA检测精浆中的精子总抗体 ,用间接免疫珠试验检测女性血清中的抗精子抗体及金标法检测女性宫颈CT。现报告结果如下。资料与方法1 取 90对夫妇 ,男 (2 8～ 4 0岁 ) ,女 (2 5～ 35岁 )。结婚4～ 10年不育。2 PCR法　用纯化的CT作为阳性对照 ,取经离心沉淀精液沉渣加蛋白酶、去垢剂等处理。以 14 4bp区特异性二种寡核苷酸作为引物TaqDN…     

不育男性血清生殖激素RIA

目的 :探讨男性不育者生殖激素水平的改变情况及其临床意义。方法 :采用放射免疫分析测定患者血清FSH、LH、PRL、T等激素水平。结果 :男性不育者血清PRL值与正常男性无差异 (P >0 0 5 )。LH和FSH水平增高 (P <0 0 1)。血清T水平和T/LH比值降低 (P <0 0 1)。结论 :男性不育者除了与下丘脑 -垂体 -性腺轴功能失调有关外 ,还可能伴有睾丸间质细胞的损害。因此 ,生殖激素水平测定有助于男性不育的诊断。     

ORIGINAL ARTICLE: Sperm Antibodies,Intra‐Acrosomal Sperm Proteins,and Cytokines in Semen in Men from Infertile Couples

Problem The aim of this study was to investigate seminal sperm‐agglutinating antibodies, intra‐acrosomal proteins, sperm head abnormalities, and cytokines (IL‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70 TNF‐α, and IFN‐γ) in men from infertile couples. Method of study The direct mixed anti‐immunoglobulin reaction test for IgG, IgA, and IgE in semen, and immunocytochemical method using monoclonal antibodies and indirect immunofluorescence for the examination of intra‐acrosomal proteins in the spermatozoa were used. Cytokines in seminal plasma were determined by multiplex immunoanalytic xMAP (LUMINEX) technology. Results Sperm‐agglutinating antibodies, IgG and IgA, in seminal plasma were found to be more in asthenospermatic and oligoasthenospermatic men than in normospermatic men. Sperm head pathology and very low amounts of acrosomal proteins were frequently detected in pathologic semen samples. Cytokine levels defined as ‘high’ (based on the 75 percentile for each cytokine in all groups) were obtained especially for IL‐8, IL‐5, IL‐6, and IL‐10. The high cellularity in semen was correlated with higher IL‐5. Conclusion Immunologic cause of male infertility is a very important risk factor in the pathogenesis of sperm cells. Sperm autoantibodies and the presence of intra‐acrosomal factors must be studied together, cytokines according to accessory cellularity in the semen.     

Distinct Expression of Cytokines and Mitogenic Inhibitory Factors in Semen of Fertile and Infertile Men

PROBLEM: To assess the effect of seminal plasma (SP) of fertile and infertile men on leukocyte mitogenic response, and the capability of sperm cells to produce IL-1. METHODS: This study included four groups: fertile men (donors, normal), infertile men with azoospermia (azoo), oligo-terato-asthenozoospermia (OTA), and OTA with genital infection (OTA-inf). Mouse spleen cell proliferation in response to lipopolysaccharide (LPS) or Concanavalin-A (Con-A) was examined in the presence of SP from the above four groups. Supernatants (sup) and lysates (lys) of sperm cells from fertile and oligoteratoasthenospermic (OTA) men were evaluated for IL-1 bioactivity by specific bioassay. RESULTS: Seminal plasma (SP) of the four groups were shown to inhibit the mitogenic response of mouse spleen cells to LPS and Con-A. SP of fertile men was significantly more inhibitory than SP from infertile men. Sperm cells from fertile and OTA infertile men constitutively produced IL-1. Sperm cells of both groups produced similar levels of IL-1 as examined in the supernatants and lysates. CONCLUSIONS: Seminal plasma of fertile men had more inhibitory mitogenic activity than that of OTA. Sperm cells constitutively produce IL-1. It is possible that the factors involved in this inhibition are not only anti-proliferative immune factors. Cytokines and inhibitory factors of mitogenesis in the seminal plasma may be involved in the physiology and pathophysiology of sperm functions and thus affect male fertility.     

人精浆中微量蛋白水平与男性生育关系的探讨

目的 :观察人精浆中各种微量蛋白与男性生殖能力之间的关系。方法 :应用放射免疫分析(RIA) ,对 2 2例生育者和 1 2 5例不育者精浆中的白蛋白 (Alb)、β2 -微球蛋白 (β2 -m)、α1 -微球蛋白 (α1 -m)、TH糖蛋白 (THP)、免疫球蛋白G(IgG)、分泌型免疫球蛋白A(SIgA)、铁蛋白 (Fer)等进行了检测。 结果 :不育症组精浆中Alb、β2 -m、α1 -m、THP、IgG、SIgA均明显低于生育组 ,尤其是Alb、β2 -m、α1 -m、IgG、SIgA在生育组与不育组之间均存在显著性差异 (p <0 0 5或p <0 0 1 ) ;不育症组精浆中Fer含量明显高于生育组 (p <0 0 1 )。结论 :精浆中 β2 -m、Alb、Fer含量与精液中的精子密度均存在密切正相关。对精浆SIgA和IgG含量的观察 ,可以判断男性生殖系统局部的免疫功能状态。测定精浆中Alb、β2 -m、Fer、SIgA和IgG等微量蛋白的含量可以帮助判断男性不育者的状态 ,指导临床对其进行有效的治疗。     

人精浆中EGF与NPY测定的临床价值初探

目的:观察生育者与不育症者精浆中表皮生长因子(EGF)和神经肽Y(NPY)等多肽类物质水平及其对精子数量和功能的影响。方法:应用放射免疫分析(RIA)对110例不同原因引起的不育男性精浆中EGF和NPY等进行综合性测定和分析,同时与精液中精子的功能指标进行相关分析。结果:不育症组精浆EGF和NPY含量均明显高于生育组(P<0.01)。在不育症组中,随精子密度的减少,NPY浓度依次呈不断增高的趋势;在精子活动力与活动率正常组、非WBC精液组精浆EGF含量均低于不正常(或下降)组(P<0.05);NPY含量在精子活动率正常组、非WBC精液组均低于不正常(或下降)组(P<0.05)。结论:精浆中EGF和NPY含量增高或降低反映生殖系统局部的免疫状态和感染情况,其增高产生的毒性作用可影响精子的产生和精子的正常功能。检测精浆中EGF和NPY等含量可以反映男性不育症患者的状态,有利于帮助临床进行有针对性的治疗。     

Immunobiologic implication of RANTES in seminal plasma of fertile, infertile and immunoinfertile men

PROBLEM: To investigate the presence of Regulated on Activation, Normal T Expressed and Secreted (RANTES) in the seminal plasma of fertile, infertile, and immunoinfertile men in order to determine whether it has any role in fertility/infertility and in the modulation of immunogenicity of the sperm cell. METHOD OF STUDY: The enzyme-linked immunosorbent assay was performed by using a commercially available immunoassay kit to measure RANTES levels in seminal plasma of fertile (n = 28), male-factor infertile (n = 35), and immunoinfertile (n = 21) men. The levels were correlated with various seminal parameters. RESULTS: RANTES was detected in the seminal plasma of fertile, male-factor infertile, and immunoinfertile men. Its levels differed significantly (P<0.05) between the fertile and immunoinfertile groups, with the immunoinfertile group showing an overall decrease of 19.9% in mean values. When RANTES levels were correlated with sperm concentration, total sperm number, and motility, only the total number of the immunoinfertile group correlated (r = 0.86) significantly (P = 0.03) with the RANTES levels, and none of the other seminal parameters of any other group correlated (r = -0.37-0.30) significantly (P>0.05). CONCLUSIONS: The findings of this study indicate that RANTES may have a role in immunomodulation of antigenicity of sperm cells in the male genital tract before ejaculation, and perhaps also in the female genital tract after intercourse. The exact physiologic, pathophysiologic, and molecular mechanism(s) involved in these processes require further study.     

不孕及反复自然流产患者血清抗精子抗体分析

目的：探讨不孕及反复自然流产与抗精子抗体（AsAb）的关系。方法：用金标法检测有反复自然流产史患者245例（流产组）、原发或继发不孕患者164例（不孕组）及正常妇女40例（对照组）血清中的AsAb。结果：不孕组AsAb总阳性率52.44%,流产组总阳性率48.57%,与对照组比较差异均有统计学意义（P〈0.05）。结论：AsAb与不孕及反复自然流产有着密切关系。     

Elevated Nitric Oxide Concentration in the Seminal Plasma of Infertile Males: Nitric Oxide Inhibits Sperm Motility

PROBLEM: To evaluate the “effect of nitric oxide in the seminal plasma on sperm motility. METHOD: Seminal plasma concentrations of NO₂^—, a stable end product of nitric oxide, of 108 males of infertile couples and 15 proven fertile donors were measured and compared with spermatogram parameters. Motile sperm was incubated with a nitric oxide-generating drug, sodium nitroprusside, for 6 hr in the absence or presence of oxyhemoglobin, an inhibitor of nitric oxide. RESULTS: The NO₂^— concentration in the seminal plasma was 6.58±0.56 μM in 26 infertile males with leukocytospermia, 5.51±0.25 μM in 82 infertile males without leukocytospermia, and 3.91±0.16 μM in 15 controls. There was a significant correlation between the NO₂^— concentration and sperm motility. Sodium nitroprusside reduced the sperm motility in a dose- and time-dependent manner and its reduction was completely inhibited by the addition of oxyhemoglobin. CONCLUSION: These findings indicate that nitric oxide concentration in the seminal plasma of infertile males is elevated and that nitric oxide is an inhibitor of sperm motion.