高原低氧环境对成年男性生精功能的影响

摘要

目的 了解不同海拔高度与不同驻留时间对男性生精功能的影响.方法 采用自身前后对照方法,对同一批进驻高原某部官兵,于上山前一个月、上山后半年、上山后一年和下山后半年四个时间段,分别观察不同海拔高度血清抑制素B(INHB)水平、精液质量及精子运动参数变化.血清INHB测定使用ELISA方法,正常值<150 pg/ml;精液分析应用CASA系统完成.结果 对同一批官兵,于上山前、中及下山后分别测定血清INHB浓度,结果显示,上山半年血清INHB水平显著升高,至一年血清INHB仍然维持较高水平,到离开低氧暴露环境半年时间后,血清INHB浓度虽有下降,但仍未完全恢复到上山前水平.精液质量检测发现,上山半年组与上山前相比,精子总数、精子密度、精子活力和精子活率显著降低,精液液化时间显著延长;上山一年组与上山前相比,精子活力和精子活率进一步明显减低,但精子密度大幅回升;下山半年后,除液化时间仍然明显延长之外,其它指标均已回复.精子运动参数观察表明,上山半年后,精子的鞭打频率显著增加,直线性、摆动性和前向性显著降低;到上山一年时,精子的直线速度、曲线速度、路径速度和侧摆幅度显著降低,但精子的前向性、摆动性、直线性及鞭打频率基本正常;下山半年后,精子的各项运动参数均已恢复到上山前状态.结论 急进高原时,低氧暴露因素对男性生精功能有较严重的影响.随着时间延长,受机体应急和调节机制作用,机体的生精功能有所恢复.在脱离低氧暴露环境后,其生精功能逐步趋于正常,但这种复原将是一个缓慢的过程.%Objective To investigate the influence of different altitudes and different dwell time on male spermato genesis. Methods Using pre and post self control test,same group of officers and soldiers stayed at high altitude were observed with their serum inhibin B (INHB) levels,semen quality and sperm motion parameters in different elevations on four period times such as one month before, six months after, one year after staying on the high altitude and six months after down the high altitude. Serum INHB were analysed by ELISA method,its normal range is below 150 pg/ ml. Semen specimens was detected by using computer assisted sperm analysis system(CASA). Results Compared with that of before staying on the high altitude,serum INHB level were increased significantly six months after staying and were still at a high level after one year staying then decreased a little after leaving hypoxia exposure environment for half a year but not yet restored to the level before staying. Semen quality testing found that the group staying on high altitude for half a year compared with before staying,the total number of sperm,sperm density,sperm motility and ratio of living sperm were significantly decreased. Semen liquefaction time were significantly prolonged. The group staying on high altitude for one year compared with that before staying,sperm motility and sperm motility rate were further re duced,but the sperm density restored sharply. All indicators were restored except semen liquefaction time were still prolonged obviously after the group down the high altitude six months. Sperm kinesis parameters showed that beat cross frequency (BCF) were significantly increased, linearity (LIN) ,wobble(WOB) and straightness(STR) were signifi cantly decreased after half a year staying on high altitude. When staying on plateau for one year,velocity of straigh line (VSL) ,velocity of curvilinear(VCL) ,velocity of average path(VAP) ,and amplitude of oscillation(ALH) were signifi cantly reduced,but STR,WOB,LIN and BCF were all normal. All the sperm kinesis parameters were restored to normal after half a year down the high altitude. Conclusion There were serious negative effects on male spermatogenesis with hypoxia exposure factors when rapidly entering high altitude pateau. The function of spermatogenesis has been restored by stress and regulatory mechanisms of the body along with prolonged staying time. It would gradually become normal after leaving hypoxia exposure environment. But this recovery process was very slow.