不育男性精浆左旋肉碱浓度与精子活力和浓度的关系  

Correlation between L-carnitine Level of Semen Plasma and Sperm Motility As Well As Sperm Concentration in Infertile Male Patients

作　　者：梁佩燕 蔡靖 尹彪 刘红杰 卢燕玲 梁锦明 李观贵 曾勇 

机构地区：[1]深圳中山泌尿外科医院生殖医学中心,深圳518045 [2]深圳市围着床期生殖免疫重点实验室,深圳518045 [3]深圳中山生殖与遗传研究所,深圳518045

出　　处：《生殖与避孕》2014年第8期690-694,共5页Reproduction and Contraception

基　　金：广东省医学科学技术研究基金(项目编号:B2012331);深圳市基础研究项目(项目编号:JCYJ20120829150019349)资助

摘　　要：目的:探讨精浆左旋肉碱测定在男性不育症诊疗中的临床意义。方法:按照第5版《世界卫生组织人类精液检查与处理实验室手册》的参考值,将不育男性按照精液常规分析结果分为精子活力正常组(前向运动精子百分率≥32%)(n=283)和弱精子症组(前向运动精子百分率<32%)(n=892)。通过比色法检测精浆中的游离左旋肉碱含量,分析左旋肉碱浓度与精子活力、精液浓度的相关性。通过受试者操作特征分析曲线(receiver operating characteristic curve,ROC curve)确定左旋肉碱浓度的阈值,以阈值为分界点,将弱精子症组患者分为高于左旋肉碱阈值组和低于左旋肉碱阈值组,分析左旋肉碱与精子活力和精子浓度的相关性。结果:弱精子症组的精浆左旋肉碱浓度(384.14±188.81μmol/L)显著低于精子活力正常组(434.04±171.77μmol/L,P<0.05)。精子活力正常组和弱精子症组精浆中的左旋肉碱含量与前向运动精子百分率和精子浓度的相关性极低或不相关(r<0.2)。肉毒碱检测的ROC曲线下面积(AUC)为0.592,阈值为380.9,低于左旋肉碱阈值弱精子症组与前向运动精子百分率有较弱的正相关关系(r=0.329,P=0.000)。结论:对于拟行辅助生育的不育男性患者,精浆中左旋肉碱浓度作为精浆生化的指标之一,可能对弱精子症患者有一定的临床参考意义。Objective： To investigate the clinical meaning of the L-carnitine level in semen plasma. Methods： The infertile male patients were divided into two groups according to ＂WHO laboratory manual for the examination and process of human semen （the fifth edition）＂, 283 cases in the normal sperm motility group （progressive motility ≥ 32%） and 892 cases in asthenozoospermia group （progressive motility〈32%）. The camitine level in semen plasma, the correlation between the camitine level and sperm motility as well as sperm concentration of the two groups were compared. The receiver operating characteristic （ROC） curve were analyzed to determine the cut-off value of L-carnitine, dividing the asthenozoospermia group into two subgroups by the cut-offvalue, the correlation between the carnitine level and sperm motility as well as sperm concentration of the two subgroups were further analyzed. Results： Camitine level of asthenozoospermia group （384.14 ± 188.81 μmol/L） was significantly lower than that in the normal sperm motility group （434.04 ± 171.77 μmol/L, P〈0.05）. There was no correlation between the camitine level and the percentage of sperm with progressive motility as well as sperm concentration in the two groups. The area under the ROC curve was 0.592, cut-offvalue was 380.9, there was a weak positive correlation between the camitine level and the percentage of sperm with progressive motility in the lower cut-off subgroup of asthenozoospermia （r=0.329,/9=-0.000）. Conclusion： For the infertile male population who resort to assisted reproduction technique, the camitine level may be one of the influencing factors for the asthenozoospermia.

关 键 词：左旋肉碱 弱精子症 辅助生育 

分 类 号：R698.2[医药卫生—泌尿科学]