精浆氧化应激及生殖激素水平与畸形精子症及ICSI结局的相关性研究  

Relationship between seminal plasma oxidative stress and reproductive hormone levels with teratospermia and ICSI outcomes

作　　者：李晓蕊 苏华[1] 刘浩 Li Xiaorui;Su Hua;Liu Hao(Reproductive Medicine Department,First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院生殖医学科,河北张家口075000

出　　处：《中国男科学杂志》2024年第2期86-91,129,共7页Chinese Journal of Andrology

基　　金：河北省卫生健康委员会医学科学研究课题计划(20220509)。

摘　　要：目的探讨精浆氧化应激及生殖激素水平与畸形精子症及卵胞质内单精子注射技术(ICSI)结局的相关性。方法选取2021年8月—2022年12月我院生殖医学中心的男性不育症患者206例为研究对象,根据世界卫生组织第五版《世界卫生组织人类精液检查与处理实验室手册》,其中正常形态精子百分率<4%的120例,纳入畸形精子症组;正常形态精子百分率≥4%的86例,纳入正常组。两组均检测精浆氧化应激[活性氧(Reactive oxygen species,ROS),超氧化物歧化酶(SOD)]及生殖激素[卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)]水平,分析畸形精子症影响因素。比较畸形精子症组不同精浆氧化应激及生殖激素水平患者ICSI受精率,分析畸形精子症程度与精浆氧化应激、生殖激素水平的相关性。结果畸形精子症组高龄、高体重指数以及吸烟、饮酒、精索静脉曲张、糖尿病发生率比例大于对照组,精子活动率、前向运动精子率小于对照组(P<0.05);畸形精子症组精浆ROS、FSH、LH高于对照组,SOD、T低于对照组(P<0.05);吸烟、饮酒、精索静脉曲张、ROS是畸形精子症的独立危险因素,SOD、T是畸形精子症的独立保护因素(P<0.05);畸形精子症组随着ROS水平升高,患者受精率呈降低趋势,随着精浆SOD、T水平升高,患者受精率呈升高趋势(P<0.05);Spearman相关系数分析,畸形精子症程度与精浆ROS水平呈正相关(r=0.832,P<0.001),与SOD水平呈负相关(r=-0.825,P<0.001),与T水平基本无相关性(r=0.206,P=0.024)。结论氧化应激反应、生殖激素异常表达与畸形精子症的发生密切相关,同时会影响其ICSI结局。Objective To explore the correlation between seminal plasma oxidative stress and reproductive hormone levels with teratospermia and ICSI outcome.Methods A total of 206 male infertility patients from the reproductive medicine center of our hospital from August 2021 to December 2022 were selected as the research objects.They were grouped according to the fifth edition of the World Health Organization’s Handbook on Human Semen Testing and Processing Laboratories,of which 120 patients with percentage of normal sperm morphology<4%were included in the teratospermia group.86 cases with percentage of normal sperm morphology≥4%were included in the normal group.The levels of seminal plasma oxidative stress(reactive oxygen species(ROS),superoxide dismutase(SOD))and reproductive hormones(follicle⁃stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T))were detected in both groups.The influencing factors of teratospermia were analyzed.The ICSI rates of patients with different spermatozoa oxidative stress and reproductive hormone levels were compared in the teratospermia group.The correlation between the severity of teratozoospermia and seminal oxidative stress and reproductive hormone levels was analyzed.Results The proportions of advanced age,higher body mass index,smoking,drinking,varicocele and diabetes in the teratospermia group were higher than those in the control group,while sperm activity rate and forward movement sperm rate were lower than those in the control group(P<0.05).Levels of ROS,FSH and LH in spermatozoa group were higher than those in the control group,while the levels of SOD and T in the spermatozoa group were lower than those in the control group(P<0.05).Smoking,varicocele and ROS were independent risk factors for teratospermia,while SOD and T were independent protective factors for teratospermia(P<0.05).In the teratospermia group,the fertilization rate was decreased with the increase of ROS level,and it was increased with the increase of seminal plasma SOD and T level(P<0.05);Spearman’s

关 键 词：精液 氧化性应激 生殖激素 畸形精子症 精子注射 卵胞质内 

分 类 号：R698.2[医药卫生—泌尿科学] R321.1[医药卫生—外科学]