男性不育患者精浆对氧磷酶-1活性测定的临床价值

摘要：目的探讨精浆对氧磷酶-1(PON-1)活性在男性不育症患者中的变化及在男性不育症诊断中的临床价值。方法选择有生
育力的男性健康对照组50例，男性不育症组270例，采用分光光度法和计算机辅助精液分析系统分别测定精浆PON-1活性和精
液常规参数。结果参数正常男性不育组和参数异常男性不育组精浆PON-1活性（U/L)分别为1.22±0.76和0.64±0.54，均明显
低于健康对照组精浆PON-1活性为（3.17±0.89），差异有显著统计学意义(P<0.01)；男性不育各精子活力组精浆PON-1活性均明
显低于健康对照组（P<0.01)；在各弱精子症组中，随着精子活力降低，精浆PON-1活性依次降低；在轻度弱精子症组、中度弱精
子症组和重度弱精子症组，组间差异有统计学意义(P<0.05)；精浆PON-1活性与精子存活率间存在正相关关系（P<0.01）,而精浆
PON-1活性与精子畸形率存在负相关关系（P<0.01）；根据制定的ROC曲线，PON-1活性曲线下面积为0.907，有显著统计学意
义(P<0.01)。结论精浆PON-1活性测定为男性不育症实验室诊断提供参考依据。

Clinical value of seminal paraoxonase-1 activity evaluation in the diagnosis of male infertility

Objective To investigate the changes in seminal paraoxonase-1(PON-1) activity in infertile male patients and assess the clinical value of seminal PON-1 examination in the diagnosis of male infertility.Methods Seminal PON-1 activity was detected by spectrophotometric method in the semen samples from 270 infertile male patients and 50 health fertile males(control),and the semen parameters were analyzed using a computer-assisted semen analysis system.Results In the male infertility group,seminal PON-1 activity was 1.22±0.76 U/L in the patients with normal semen parameters and 0.64±0.54 in the patients with abnormal semen parameters,both significantly lower than that of the control group(3.17±0.89 U/L,P<0.01).In patients with asthenospermia,the declined sperm motility was associated with decreased seminal PON-1 activity,which showed significant differences between patients with mild,moderate,and severe asthenospermia.Seminal PON-1 activity was positively correlated with the percentage of sperm viability(P<0.01),but inversely with the percentage of morphologically abnormal sperm(P<0.01).According to ROC curves,the area of seminal PON-1 activity under the curve was 0.907,showing a statistical significance(P<0.01).Conclusion The detection of seminal PON-1 activity can provide a laboratory evidence for the diagnosis of male infertility.