肾移植前后精液质量变化和精子扫描电镜观察  

The changes of the semen quality and the sperm in patients before and after renal transplantation under scanning electron microscopy

作　　者：许龙根[1] 史时芳[2] 戚晓平[1] 黄晓峰[3] 徐惠明 宋启哲[1] 王鑫洪[1] 阎利[1] 邵宗福[1] 张军荣 

机构地区：[1]解放军第117医院肾移植中心,杭州310014 [2]浙江大学医学院附属第一医院泌尿外科 [3]第四军医大学电镜中心 [4]浙江省计划生育科学技术研究所男性研究室

出　　处：《中华器官移植杂志》2005年第1期22-24,共3页Chinese Journal of Organ Transplantation

摘　　要：目的探讨尿毒症患者肾移植前后精液质量以及精子超微结构的变化。方法于血液透析后1～4d采集8例尿毒症患者的精液,进行精液常规检查,同时对精子进行扫描电镜观察,并于肾移植后6～18个月肾功能正常时再次采集精液,进行上述检查,以5名正常生育男子的精液进行对照。结果患尿毒症时,患者的精液主要参数(精子的活动力、存活率)均明显下降,扫描电镜下,精子顶体缺失,核内空泡明显,顶体后环和核后环缺失,中段线粒体鞘缺失;肾功能恢复正常后,精液的主要参数得到明显改善(P<0.01),扫描电镜下,多数精子的顶体、顶体后环和核后环、中段线粒体鞘趋向正常。结论肾移植可明显改善尿毒症患者的精液质量,使多数精子的形态与结构趋于正常。Objective To study the changes of the semen quality and the spermatogoa ultrastructure in uremic patients before and after renal transplantation. Methods The semen was analyzed and spermatogoa were investigated under scanning electron microscopy (SEM) in 8 patients before and after renal transplantation and 5 normal volunteers. Results In uremic patients, there was significant decreases in sperm motility, survival rate and sperm density. Under SEM, the deletion of the acrosome, distinct vacuoligation in the nucleus, deficiency of the postacromal and postnuclear ring and ~absence of the middle segment of mitochondrial sheath were found. After renal transplantation, the semen main parameters were significantly improved (P<~0.01 ), and in the great majority of sperm the acrosome, postacromal and postnuclear ring, and the middle segment of mitochondrial sheath turned toward to the normal under SEM. Conclusion The significant improvement of the semen quality and recovery of the sperm normal morphology and ultrastructure in uremic patients could be achieved by successful renal transplantation.

关 键 词：肾移植 精液质量 扫描电镜 肾功能 顶体后环 核后环 

分 类 号：R699.2[医药卫生—泌尿科学]