血清尿酸水平与精液参数及人工授精妊娠结局的相关性分析  

Correlation analysis of serum uric acid level with semen parameters and pregnancy outcome after artificial insemination

作　　者：李鑫 李瑾然 黄敏 吴瑛 杨元晨 顾小铃 陈艳男 宋建[4] 郁敏燕[4] 孙晓莉[4] LI Xin;LI Jinran;HUANG Min;WU Ying;YANG Yuanchen;GU Xiaoling;CHEN Yannan;SONG Jian;YU Minyan;SUN Xiaoli(Medical School of Nantong University,Nantong 226001;Department of Obstetrics and Gynecology,Dongtai People′s Hospital,Jiangsu Province;Department of Obstetrics and Gynecology,Nanjing Jiangbei Hospital,Jiangsu Province;Department of Center for Reproductive Medicine,the Affiliated Hospital of Nantong University)

机构地区：[1]南通大学医学院,南通226001 [2]江苏省东台市人民医院妇产科 [3]江苏省南京市江北医院妇产科 [4]南通大学附属医院生殖医学中心

出　　处：《南通大学学报（医学版）》2023年第5期421-425,共5页Journal of Nantong University(Medical sciences)

基　　金：江苏省卫生健康委员会资助项目(F202051);南通市社会民生面上项目(MS22022119);南通市卫生健康委员会资助项目(MS2023019)。

摘　　要：目的:探讨血清尿酸水平与精液参数及人工授精妊娠结局的相关性。方法:回顾性分析2015年1月—2020年9月于南通大学附属医院生殖医学中心行人工授精治疗的1040对夫妻的临床资料,根据男性血清尿酸水平分为高尿酸组(>416μmol/L)和正常尿酸组(≤416μmol/L),比较两组的一般资料、精液参数及妊娠结局的差异。结果:共行宫腔内人工授精治疗2018个周期,妊娠266例,累计周期妊娠率为13.18%。高尿酸组与正常尿酸组相比,女方年龄、男方BMI、男方尿酸的差异均有统计学意义(均P<0.05)。高尿酸组精液参数中精子体积显著低于正常尿酸组(P<0.05),进一步将1040例男性分为肥胖组(BMI≥28 kg/m^(2))与非肥胖组(BMI<28 kg/m^(2)),无论在肥胖组还是非肥胖组,高尿酸亚组男性优化前及优化后的前向运动精子总数在数值上低于正常尿酸亚组,但差异无统计学意义(P>0.05)。对妊娠结局的分析表明,男方肥胖组与非肥胖组不同尿酸亚组配偶的人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)阳性率、临床妊娠率、持续妊娠率、流产率差异均无统计学意义(均P>0.05)。肥胖组的正常尿酸亚组男性配偶的HCG阳性率、临床妊娠率、持续妊娠率在数值上高于高尿酸亚组,但差异无统计学意义(P>0.05)。结论:肥胖及高尿酸血症的不育男性应改变不良生活习惯、降低BMI及尿酸水平后备孕,以提高辅助生殖的成功率。Objective:To explore the correlation between serum uric acid levels,semen parameters and artificial insemination pregnancy outcomes.Methods:The clinical data of 1040 couples who underwent artificial insemination treatment in the Reproductive Medicine Center of Affiliated Hospital of Nantong University from January 2015 to September 2020 were retrospectively analyzed.According to the male serum uric acid level,they were divided into high uric acid group(>416μmol/L)and normal uric acid group(≤416μmol/L),compare the general information,semen parameters and pregnancy outcomes between the two groups.Results:A total of 2018 cycles of intrauterine insemination treatment were performed,with 266 cases of pregnancy,and the cumulative cycle pregnancy rate was 13.18%.Compared with the normal uric acid group,the differences in the woman′s age,the man′s BMI,and the man′s uric acid were statistically significant(P<0.05).The semen volume of the high uric acid group was significantly lower than that of the normal uric acid group(P<0.05).1040 men were further divided into obese group(BMI≥28 kg/m^(2))and non-obese group(BMI<28 kg/m^(2)).Whether in the obese or non-obese group,the number of forward-moving sperm in the high uric acid subgroup before and after optimization was numerically lower than that in the normal uric acid subgroup,but the difference was not statistically significant(P>0.05).Analysis of pregnancy outcomes showed that there was no statistically significant difference in the human chorionic gonadotropin(HCG)positive rate,clinical pregnancy rate,continued pregnancy rate,and miscarriage rate among spouses of different uric acid subgroups between the male obese group and the non-obese group(P>0.05).Numerically,the HCG positive rate,clinical pregnancy rate,ongoing pregnancy rate,and miscarriage rate of male spouses in the normal uric acid subgroup of the obese group were higher than those in the high uric acid subgroup.Conclusions:Obese and hyperuricemia infertile men should change their bad habits,lower th

关 键 词：男性不育 高尿酸血症 精液参数 妊娠结局 氧化应激 

分 类 号：R698.2[医药卫生—泌尿科学]