男性不育症患者精浆中miR-145 的表达水平及其临床意义

目的　探讨男性不育症患者精浆中miR-145 的表达水平及其临床意义。方法　招募2017 年1 月~ 2018 年9 月 男性不育症患者130 例和同期体检正常的生育男性50 例为正常对照组。采用实时荧光定量PCR 检测精浆中miR-145 的 表达水平，精液常规参数采用WLJY-9000 伟力彩色精子检测系统进行分析。应用ROC 曲线分析miR-145 对男性不育症 的诊断价值，采用Pearson 相关分析精浆中miR-145 表达水平与精液参数的相关性。结果　男性不育症组精浆中miR- 145 表达水平明显高于对照组（3.92±0.86 vs 1.16±0.35），而男性不育症组精子浓度（70.24±28.60 vs 112.50±46.35） ×106/mL、精子存活率（38.40±7.60 vs 73.84±5.82）%、前向运动精子百分率（17.52±9.73 vs 46.20±5.30）% 及正常 精子形态百分率（2.60±1.42 vs 9.25±1.70）% 明显低于对照组，差异均有统计学意义（t=4.852~11.238，均P<0.01）。 ROC 曲线分析显示，精浆中miR-145 表达水平诊断男性不育症的曲线下面积（AUC）为0.864（95%CI:0.807~0.925）， 其最佳诊断截断值为2.15，敏感度和特异度分别为92.8% 和75.0%。相关分析显示，男性不育症患者精浆中miR-145 表 达水平与精子浓度、精子存活率、前向运动精子百分率均呈正相关（r=0.427，0.604，0.538，均P<0.01）。结论　精浆 中miR-145 表达水平在男性不育症患者中明显上调，且精子浓度、精子存活率、前向运动精子百分率呈正相关，有望 作为男性不育症的辅助诊断指标。

Expression of miR-145 in Seminal Plasma of Male Infertility Patients and Its Clinical Significance

Objective　To investigate the expression of miR-145 in seminal plasma of male infertility patients and its clinical significance. Methods　130 male infertility patients and 50 fertile males with normal physical examination as normal control group from January 2017 to September 2018 were recruited. Real-time fluorescence quantitative PCR was used to detect the expression of miR-145 in seminal plasma. The conventional parameters of semen were analyzed by WLJY-9000 Weili color sperm detection system. ROC curve was used to analyze the diagnostic value of miR-145 in male infertility. Pearson correlation was used to analyze the correlation between miR-145 expression level in seminal plasma and semen parameters. Results　The expression level of miR- 145 in seminal plasma of male infertility group was significantly higher than that of control group（3.92±0.86 vs 1.16±0.35）. The sperm concentration （70.24±28.60 vs 112.50±46.35）×106/ml, sperm survival rate （38.40±7.60 vs 73.84±5.82）%, forward motility sperm percentage （17.52±9.73 vs 46.20±5.30）% and normal sperm morphology percentage （2.60±1.42 vs 9.25±1.70）% in male infertility group were significantly lower than those in control group, the differences were not stantisically significant (t=4.852~11.238, all P<0.01). ROC curve analysis showed that the area under the curve (AUC) of seminal plasma miR-145 expression level in diagnosis of male infertility was 0.864 (95% CI: 0.807~ 0.925). The best diagnostic truncation value was 2.15, and the sensitivity and specificity were 92.8% and 75.0%, respectively. The correlation analysis showed that the expression level of miR-145 in seminal plasma of male infertility patients was positively correlated with sperm concentration, sperm survival rate and forward motile sperm percentage（r=0.427, 0.604, 0.538, all P<0.01）. Conclusion　The expression of miR-145 in seminal plasma was significantly up-regulated in male infertility patients, and there was a positive correlation among sperm concentration, sperm survival rate and percentage of forward motile sperm, which was expected to be used as an auxiliary diagnostic index for male infertility.