存活素在正常及不育男性精浆中的检测及其意义

【目的】探讨健康生育男性及不育男性患者精液中存活素蛋白（一种凋亡抑制剂）的含量水平及临床意义。【方法】采用酶联免疫吸附试验检测23例健康生育男性志愿者、22例少弱精子症患者、39例非梗阻性无精症患者及12例梗阻性无精症患者精浆中的存活素含量。对梗阻性无精症患者和非梗阻性少精症患者进行睾丸活检，同时行组织病理学检查及睾丸穿刺抽吸术。【结果】精浆存活素水平在有生育能力的健康对照组中含量最高，其次为少弱精子症患者，而在非梗阻性无精症患者中含量少，差异有显著性（P〈0．05）。梗阻性无精症患者精浆存活素缺如，精浆中存活素的含量与精子发生及产量呈正相关，而与精液中异常形态精子的百分比呈负相关。在睾丸穿刺抽吸术成功的非梗阻性无精症患者精液中可检测到存活素，而在睾丸穿刺抽吸术不成功的患者中无法检出。【结论】精浆存活素是睾丸源性的，它与精子发生及活力有关。在非梗阻性无精症患者中，睾丸穿刺抽吸术检测是否存有精子与存活素相关。

Detection of Seminal Plasma Survivin in Fertile and Infertile Males

Objective] To explore the level of survivin protein （an inhibitor of apoptosis） in the seminal plasma of infertile and fertile males. MethodslSeminal plasma survivin was estimated by enzyme-linked immunosorbent assay in 25 healthy fertile volunteers, 22 men with oligoasthenozoospermia, 39 with non-obstruc tive azoospermia and 12 with obstructive azoosperrnia. Histopathology and testicular sperm extraction were done in testicular tissue biopsies from obstructive azoospermia and non-obstructive azoospermia cases. Results] Mean seminal survivin was highest in fertile controls, less in oligoasthenozoospermic cases and low in non-obstructive azoospermia cases, and there were significant differences among three groups（ P 〈0.05）. In obstructive azoosperrnia cases, seminal plasma survivin was absent. Seminal survivin positively correlated with sperm concentration and total sperm motility, and negatively correlated with the percent of sperm abnormal forms. Seminal survivin was detectable in non obstructive azoospermia cases in which testicular sperm extraction was successful but absent in such cases when testicular sperm extraction was unsuccessful. Conclusion]Seminal survivin is testicular in origin. It is related to spermatogenesis and sperm motility processes. Seminal survivin is related to successful testicular sperm extraction in non-obstructive azoospermia cases.