不育患者血清精子蛋白17抗体的检测及临床意义

目的:检测抗精子抗体(AsAb)阳性不育患者血清中抗精子蛋白17(Sp17)的抗体,探讨该抗体在免疫性不育血清学诊断和免疫避孕方面的潜在应用价值。方法:用重组人Sp17作为抗原,ELISA法检测62例AsAb阳性血清中Sp17抗体阳性率及滴度,分析AsAb中抗Sp17的含量。结果:AsAb阳性血清中Sp17抗体阳性率为56.5%,男女之间差异无显著性。Sp17抗体占AsAb的(10.09±7.45)%,结果具有统计学意义(P<0.05)。结论:Sp17是重要的精子抗原组分,血清中Sp17抗体的检测可作为不育患者辅助诊断指标,同时也提示Sp17可能是一种免疫避孕候选抗原疫苗。     

Role of Estrogens on Human Male Reproductive System

This review focuses on estrogen role on human male physiology. Biological estrogen actions on male reproductive system are summarized with particular regard to the effects of congenital estrogen deprivation in men. The effects of estrogen on spermatogenesis, hormonal secretion and gonadotropin feedback and on sexual behavior are discussed. It is remarked that the role of estrogens in male reproduction is a very recent acquisition in reproductive endocrinology, but it promises new future fields of research to be investigated as well as the possible disclosure of new strategies in clinical practice.     

MAR与IBT2种方法检测抗精子抗体的比较研究

通过比较国产MAR AsAb试剂盒与进口IBT AsAb试剂盒 ,验证国产MAR AsAb试剂盒的真实性和可靠性。以进口IBT AsAb试剂盒为对照 ,对 42 0例不育症患者精液标本进行检测 ,比较抗精子抗体检出情况。发现 :国产MAR AsAb试剂盒与进口IBT AsAb试剂盒 ,阳性率分别为 8.8%和 8.3 % ,经配对 χ2 检验无显著差异 (P >0 .0 5 )。国产MAR AsAb试剂盒灵敏度为 94.6% ,特异度为 1 0 0 %。同一份精液标本重复检测 1 0次 ,变异系数CV =2 .5 9%。提示 :国产MAR AsAb试剂盒灵敏度高、特异性好、重复性高 ,符合临床诊断的要求。     

精浆蛋白电泳分析的临床意义

目的为了初步了解男性精浆中的蛋白电泳谱以及蛋白谱与男性生育能力的相关关系。方法通过应用SPIFE3000全自动电泳分析仪对20例对照组(生育组)与140例观察组(不育组)的精浆进行蛋白分离(琼脂糖区带电泳法),建立其精浆蛋白质的特征电泳图谱,并进行对比分析。结果精浆蛋白经酸蓝染色后,区带清晰,从阳极到阴极分为A、B、C、D、E 5条带,电泳各区带百分比含量结果经方差分析,发现不育组与生育组A、C、D、E百分比含量变化有统计学意义(P<0.01),且无精子症患者精浆的蛋白谱有特异的"双峰"特点。结论精浆蛋白区带电泳分析可作为不育症的辅助诊断指标,且将是对男性不育诊断手段的有力补充。     

少、弱精子症中精子形态缺陷类型及发生率的检查分析报告

目的 探讨在少、弱精子症中精子形态缺陷类型及其发生率.方法 对精液常规和改良巴氏染色检查的结果进行统计学分析.结果 （1）男性不育症中畸形精子症的发生率约为75%;精子头部缺陷的发生率约为70%,各种头部缺陷中空泡头畸形的发生率占首位,约为20%.（2）少精子症患者的正常形态精子百分率的中位数约为2.97%（P=0）,弱精子症患者的中位数为6.67%（P=0.003）.结论 （1）精子头部缺陷是精子畸形的主要类型;（2）少、弱精子症的畸形精子比例升高;（3）精子形态缺陷分析对选择辅助助孕方式具有应用价值.     

Y染色体微缺失不育患者精液细胞学观察

目的:对Y染色体AZF区域微缺失不育患者进行精液细胞学检查,从而评估其生精功能。方法:收集35例AZF缺失不育患者,年龄23~44岁,经3次以上精液常规分析证实,26例为非梗阻性无精子症,9例为严重少精子症。按照AZF缺失部位分为以下4组进行观察:AZFa+b+c区域缺失组5例,AZFb+c缺失(4例)及单独AZFb缺失(3例)组7例,AZFc缺失组23例。采集患者精液,待自然液化后离心,生理盐水洗涤2次,离心沉淀物经生理盐水稀释后涂于干净玻片上,瑞吉染色,光学显微镜下观察。对其中6例患者进行了睾丸组织病理学检查。结果:AZFa+b+c缺失组,精液细胞学检查均未见各级生精细胞,可见少量上皮细胞。其中1例经睾丸活组织病理学检查,生精小管中未见各级生精细胞,为唯支持细胞综合征,与精液细胞学检查结果一致。AZFb+c缺失及单独AZFb缺失组,精液细胞学检查其中6例细胞停滞在精母细胞阶段,2例睾丸活检见生精阻滞在初级精母细胞阶段。1例AZFb缺失的患者精液细胞学检查见初级精母细胞、次级精母细胞和精子细胞,但睾丸活检显示阻滞在精母细胞阶段。AZFc缺失组中,少精子症组(8例)患者生精细胞检查5例停滞在精母细胞阶段,见少量精子细胞,另3例未见各级生精细胞;无精子症组(15例)患者未见各级生精细胞,其中2例经睾丸活检,证实为唯支持细胞综合征。结论:精液细胞学检查对AZF缺失患者能有效评估生精功能,作为一项无创检查技术,容易被患者接受,推荐作为临床评估生精功能的一项方法。     

Azoospermia in two brothers with Kartagener syndrome:a family history and diagnosis

0This article describes 2 infertile brothers of asoospermia equally associated with co-existing sinusitis,bronchiectasis,and situs inversus and their family history.These two cases were diagnosed as Kartagener syndrome(KS).The patients were not offspring of kin marriages but their family members with scattered bronchi-pulmouary infections were discovered.No one manifests azoospermia,dextrocardia or situs inversus in the paternal family ex-cept two cases reported.No abnormalities were found in their mother-side family.KS should be differentiated from Young's syndrome,cystic fibrosis(CF),and other diseases such as Kallmann's syndrome in male infertility clinic.     

仙灵骨葆胶囊改善精液质量的临床研究

目的:观察仙灵骨葆胶囊改善男性不育患者精液质量的情况。方法:女方生育功能正常的男性不育患者66例,口服仙灵骨葆胶囊2~4个月,观察治疗前后精液质量并进行精子形态学分析。结果:治疗2个月后,精子密度有所提高,但无统计学差异(P>0.05);精子存活率和活动率也无明显变化(P>0.05);治疗后正常形态精子百分率明显升高,其中正常形态精子百分率≥15%者,由治疗前的25.8%(17/66)增加为57.6%(38/66)(P<0.05),而正常形态精子百分率<9%者,由治疗前的53.0%(35/66)下降为25.8%(17/66);7例少精子症者用药前精子正常形态百分率平均为5.8%,服药4个月后平均为10.9%,与服药前有明显差异(P<0.05)。治疗期间有5例患者配偶怀孕。结论:仙灵骨葆胶囊对男性精液质量有改善作用,能明显提高正常形态精子百分率,少精子症者更明显。     

A Mono-Percoll separation technique improves sperm recovery of normal and male factor specimens when compared with the swim-up technique

The purpose of this study was to determine the effects of asimplified 80% Mono-Percoll sperm separation procedure on bothnormal and male factor semen samples compared with the standardswim-up technique. The parameters examined include sperm concentration,motility and morphology, total motile functional spermatozoaand percentage recovery. Normal patients demonstrated enhancedsperm parameters with the Mono-Percoll compared with the swim-uptechnique for concentration (67x10⁶ versus 42x10⁶/ml, P <0.001), motility (66 versus 59%, P < 0.001), morphology (56versus 49%, P < 0.005) and percentage recovery (60 versus42%, P < 0.005). Male factor patients showed enhanced spermparameters with the Mono-Percoll procedure compared with theswim-up technique for motility (53 versus 42%, P < 0.05)and percentage recovery (54 versus 29%, P < 0.005), withno significant difference in concentration and morphology. Insummary, the Mono-Percoll sperm recovery procedure is significantlybetter than the swim-up technique for male factor patients andpatients with normal sperm parameters.