目的 探讨精浆弹性蛋白酶水平对男性生殖道感染引起不育的诊断价值.方法 选取2016年1—12月在南京军区福州总医院生殖中心就诊的疑似感染男性不育患者303例,所有患者检测精浆弹性蛋白酶水平和精液质量,并根据感染情况进行分组分析精浆弹性蛋白酶水平与精液质量的关系,以及精浆弹性蛋白酶对男性生殖道感染引起不育的诊断价值.结果 感染组精子密度、活动率、A+B级动力、精液液化时间和精子畸形率与非感染组差异均具有统计学意义(P＜0.05),且随着精浆弹性蛋白酶水平的升高上述指标的差异越大.精浆弹性蛋白酶以290 ng/mL为诊断界值时,其灵敏度为0.83、特异度为0.41;以1 000 ng/mL为诊断界值时,其灵敏度为0.72、特异度为0.71;但随着精浆弹性蛋白酶水平的继续升高,其灵敏度和特异度均呈下降趋势.结论 精浆弹性蛋白酶水平与精子质量密切相关,在诊断男性生殖道感染引起的不育中具有重要价值,其水平在290~1 000 ng/mL时具有较高的诊断灵敏度和特异度.%Objective To investigate the diagnostic value of seminal plasma elastase level in male infertility caused by genital tract infection. Methods A total of 303 male infertility patients with suspected infection were selected from the reproductive center, Fuzhou General Hospital of Nanjing Military Region from January 2016 to December 2016. The levels of elastase in seminal plasma and semen quality were detected in all patients. The relationship between elastase levels in seminal plasma and semen quality was analyzed by grouping the patients according to infection status, and the diagnostic value of elastase levels in seminal plasma was evaluated in infertility patients caused by male genital tract infection. Results There were significant differences in sperm density, motility, A + B motility, semen liquefaction time and sperm deformity rate between the infected and non-infected groups(P<0.05), and the differences were gradually greater with seminal plasma elastase level increases. The sensitivity and specificity were 0.83 and 0.41 at cut-off value of 290 ng/mL, respectively. The cut-off value of 1 000 ng/mL had a sensitivity of 0.72 and a specificity of 0.71. But the sensitivity and specificity had a tendency of decrease with the seminal plasma elastase level increase. Conclusion The elastase level in seminal plasma is closely related to the sperm quality. It is of great value in the diagnosis of infertility caused by male genital tract infection.
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