男性年龄与精子质量和精浆生化的关系

目的探讨不同年龄段男性精子质量与精浆弹性硬蛋白酶和精浆中性α-葡萄糖苷酶的关系。方法回顾性分析在嘉兴市妇幼保健院门诊检测精子质量和精浆生化(精浆弹性硬蛋白酶、精浆中性α-葡萄糖苷酶)的3 262例患者的临床资料。根据年龄分为5组:25岁组、25~29岁组、30~34岁组、35~39岁组和≥40岁组;并按精子质量分为少弱精子症(301例)、少精子症(193例)、弱精子症(1 335例)及正常精子组(1 433例)。统计分析不同精子质量不同年龄段男性的精浆弹性硬蛋白酶、精浆中性α-葡萄糖苷酶资料。结果 (1)3 262例精液分析,精浆中性α-葡萄糖苷酶异常发生率7.14%,精浆弹性硬蛋白酶水平确诊感染率29.25%;(2)各年龄组总体精浆中性α-葡萄糖苷酶异常发生率相似(P0.05),生殖道感染发生率随年龄增加有增高趋势(P0.05);(3)不同精子质量各组总体精浆中性α-葡萄糖苷酶异常发生率不同(P0.05),其中少精子症和少弱精子症组均显著高于弱精子症组及精子正常组(P0.05),但生殖道感染发生率相似(P0.05);(4)随着年龄增加,不同精子质量各组精浆中性α-葡萄糖苷酶异常发生率相似(P0.05),而精浆弹性硬蛋白酶异常发生率有增高趋势(P0.05),其中少弱精子症、少精子症患者各年龄组间比较均有统计学差异(P0.05);(5)各精子质量组精浆弹性硬蛋白酶测定值均随着年龄增加呈增高趋势,且正常精子组的精浆弹性硬蛋白酶测定值在35~39岁组及≥40岁组均显著高于25岁组(P0.05)。结论男科门诊患者中生殖道感染具有普遍性;伴随难以自愈的生殖道感染的少弱精子症、少精子症和弱精子症可能与男性患者年龄增加有关,亦可能与附性腺病变严重程度、病程进展所处不同阶段有关。

Relationship between ages and sperm quality and seminal plasma biochemical indexes

Objective:To investigate the relationship between age and sperm quality and biochemical indexes of seminal plasma.Methods:The clinical data of 3 262 patients with sperm quality and seminal plasma biochemistry indicators (seminal plasma elastase & α-glycosidase) in Jiaxing Maternal & Child Health Hospital were analyzed retrospectively.The patients were divided into 5 groups according to the age:<25 year group,25-29 year group,30-34 years group,35-39 years group and≥40 years group.In addition,the patients were divided into oligoasthenospermia (n=301),oligozoospermia (n=193) and asthenospermia (n=1335) and normal sperm group (n=1433) according to sperm quality.The correlation between the age or sperm quality and seminal plasma elastase & α-glycosidase was analyzed.Results:The abnormal rate of seminal plasma α-glycosidase was 7.14%,and the infection rate confirmed by seminal plasma elastase level was 29.25% in 3 262 patients.The abnormal rate of α-glycosidase was similar among the different age groups (P>0.05).The infection rate was significantly increased with age (P<0.05).The abnormal rate of α-glycosidase was significantly different among the different sperm quality groups (P<0.05).The abnormal rate of α-glycosidase in oligoasthenospermia or oligozoospermia was significantly higher than that of asthenospermia or normal sperm group (P<0.05),while the infection rate was similar (P>0.05).The abnormal rate of α-glycosidase was similar in different sperm quality group with the increase of age (P>0.05),while the abnormal rate of seminal plasma elastase was significantly increased with age (P<0.05),which also was significant different in the patients with oligoasthenospermia or oligozoospermia among the different age group (all P<0.05).The tendency of the seminal plasma elastase levels was increased with age in different sperm quality groups.Compared with<25 years old group,the seminal plasma elastase levels of normal sperm group with 35-39 years old and≥40 years old was significantly increased (P<0.05).Conclusions:Reproductive tract infection in male clinic patients is universality.Oligoasthenospermia,oligozoospermia,and asthenospermia in patients with difficult to self-healing of reproductive tract infections may be related the patients' age and the severity and advancement of infertile patients' accessory sex gland lesions.