男性不育患者精子形态学分析与生殖激素关系的研究  

Relationship of sperm morphology with reproductive hormone levels in infertile men

作　　者：唐文豪[1] 姜辉[1] 马潞林[1] 洪锴[1] 钟群[2] 杨池荪[2] 赵连明[1] 刘德风[1] 毛加明[1] 杨译[1] 陈茜[1] 袁人培[1] 张新[1] 李斌[1] 魏楠[1] 

机构地区：[1]北京大学第三医院泌尿外科,北京100191 [2]北京大学第三医院生殖中心内分泌实验室,北京100191

出　　处：《中华男科学杂志》2012年第3期243-247,共5页National Journal of Andrology

摘　　要：目的:研究男性不育患者精子形态与生殖激素的关系,探讨畸形精子症的发病机制。方法:研究对象为90例男性不育患者,年龄25～40岁,利用Prader睾丸计评估患者睾丸容积,根据世界卫生标准进行精液常规分析,利用化学发光法测定血清生殖激素和性激素结合球蛋白(SHBG)浓度,计算得出游离睾酮和生物活性睾酮的浓度。结果:90例男性不育患者精子浓度均在正常范围,根据精子形态分析结果分为3个研究组,即组1(正常形态精子<4%)、组2(正常形态精子≥4%且<10%)和组3(正常形态精子≥10%),每组30例。3组之间年龄没有统计学差异(P>0.05);左侧睾丸容积分别为(14.27±3.65)ml,(16.90±3.57)ml和(14.57±3.57)ml,P组1,2=0.006,P组1,3=0.741和P组2,3=0.014;右侧睾丸容积分别为(14.60±3.70)ml,(16.60±3.35)ml和(14.67±3.54)ml,P=0.05;血清泌乳素(PRL)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、总睾酮(TT)和SH-BG在3组之间均没有统计学差异(P>0.05);血清游离睾酮(FT)水平分别为(0.25±0.07)nmol/L,(0.29±0.07)nmol/L和(0.31±0.13)nmol/L,P组1,2=0.086,P组1,3=0.010和P组2,3=0.364;生物活性睾酮(Bio-T)水平分别为(5.81±1.58)nmol/L,(6.78±1.55)nmol/L和(7.29±3.02)nmol/L,P组1,2=0.086,P组1,3=0.010和P组2,3=0.364。另外,正常形态精子百分率与血清FT、Bio-T水平之间均存在正相关(P<0.05)。结论:男性不育患者血清FT和Bio-T水平越高,则正常形态精子百分率越高,提示FT和Bio-T可能参与畸形精子症发病过程。Objective： To investigate the relationship of sperm morphology with reproductive hormones in infertile men and the pathogenesis of teratozoospermia. Methods： This study included 90 infertile men aged 25 - 40 years. We measured their testis volumes using the Prader orchidometer, conducted routine semen analyses according to the WHO laboratory standard, and determined the concentrations of reproductive hormones and sex hormone-binding globulin （SHBG） by chemiluminescence and the levels of free testosterone （FF） and bioavailable testosterone （BioT）. Results ： All the subjects showed normal sperm concentration. Based on the results of semen morphology analysis, the 90 infertile men were equally divided into groups 1 （morphologically normal sperm 〈 4% ） , 2 （morphologically normal sperm 1〉4% and 〈 10% ）, and 3 （morphologically normal sperm ≥ 10% ）, with no significant differences in age among the three groups （P 〉0.05）. The volumes of the left testis were （14.27 ±3.65） ml, （ 16.90 ±3.57） ml and （14.57 ±3.57） ml, respectively （P = 0.006 group 1 vs group 2, P= 0.741 group 1 vs group 3, P= 0.014 group 2 vs group 3）, and those of the right testis were （ 14.60 ± 3.70） ml, （ 16.60 ± 3.35 ） ml and （ 14.67 ± 3.54） ml, respectively （ P = 0. 050）. There were no significant differences among the three groups in prolaetin, follicle-stimulating hormone, luteinising hormone, estradiol, total testosterone and SHBG, （P 〉 0.05）. The levels of serum FT were （0.25 ±0.07） nmol/L, （0.29 ±0.07） nmol/L and （0.31 ±0. 13） nmol/L （P = 0. 086 group 1 vs group 2, P = 0.010 group 1 vs group 3, P = 0. 364 group 2 vs group 3 ）, and those of BioT were （5.81 ± 1.58） nmol/L, （ 6.78 ± 1.55 ） nmol/L and （ 7.29 ± 3.02 ） nmol/L, respectively （ P = 0. 086 group 1 vs group 2, P = 0. 010 group t vs group 3, P = 0,364 group 2 vs group 3 ）. The percentage of morphologically normal sperm was positively correlated with the levels of serum

关 键 词：男性不育 精液常规 精子形态学分析 生殖激素 游离睾酮 

分 类 号：R698.2[医药卫生—泌尿科学]