人精浆中端粒酶活性测定及其临床意义

摘要

Objective To investigate the levels oftelomerase activity (TA) in seminal plasma of patients with different types of male infertility, and analyze the relationships between levels of seminal plasma TA and reproductive hormone levels, as well as sperm quantity and sperm quality.Methods Total of 110 cases with different types of male infertility and 30 normal fertile males were randomly recruited in the study.The level of TA in seminal plasma was measured by ELISA; The concentrations of T (testosterone), FSH(follicle stimulating hormone) and LH(luteinizing hormone) in seminal plasma were detected by RIA; Sperm density, percentage of sperm survival, percentage of a+b level sperm motility and the count of white blood cells in semen were analyzed by CASA.Results Levels of TA and T in seminal plasma in infertility group were significantly lower than that of fertility group (all P＜0.01), wherea levels of FSH and LH in seminal plasma in infertility group were significantly higher than that of fertility group (all P＜0.05).In infertility group, TA level gradually decreased in parallel with decreasing sperm amount in semen; TA level correlated positively with T level in seminal plasma (P＜0.01).However, there was no significant correlation between TA and FSH, LH (P＞0.05).Levels of TA in seminal plasma in groups with normal sperm vitality and activity were significantly higher than those in groups with abnormal sperm vitality and activity (P＜0.01).Levels of TA in WBC semen group were significantly higher than those in non-WBC semen group (P＜0.05).Conclusion There existed the relationships between TA level and sperm quantity and quality, moreover there was a synergistic effect between TA and T for sperm development.The levels of TA in seminal plasma might be used to understand the prevention and treatment of fertility impairment.%目的 观察精浆端粒酶活性(TA)在不同类型男性不育症患者中的变化,以及与精浆生殖激素浓度、精液中精子数量和质量之间的相互关系.方法 随机选取110例男性不育症患者与30例生育者,应用酶联免疫吸附(ELISA)方法,对其精浆TA进行检测;应用放射免疫分析(RIA)方法对其精浆T、FSH、LH浓度进行检测;按WHO规定的方法,定量分析精液中的精子密度、精子活率、(a+b)级精子活力百分率、精液中白细胞数量.结果 不育症组精浆TA和T浓度均明显低于生育组(P均<0.01);不育症组精浆FSH和LH浓度均明显高于生育组(P均<0.05).在不育症组中,随着精液中精子数量的递减,TA水平亦呈现明显的逐渐下降趋势;精浆中TA与T浓度之间存在明显的相关性(P<0.01),.与FSH和LH浓度之间无相关性(P>0.05);精子活力、活率正常组精浆TA均高于不良组(P<0.01);WBC精液组精浆TA高于非WBC精液组(P<0.05).结论 精浆TA水平与精子数量和质量存在一定的相关性,同时与精子发育密切相关的睾酮浓度有协同促进作用,端粒酶在人类生殖发育中发挥着重要作用.检测精浆TA水平对于进一步了解、预防和治疗某些病理状态下所致的生殖能力低下有重要意义.