性激素及精浆生化检测指标与精液液化时间的相关性

摘要

Objective To analyze the gonadal hormone and seminal plasma of patients with abnormal semen liquefaction and investigate the influence mechanism in order to provide guidance for the diagnosis and treatment. Methods 152 men of childbearing age were divided into two groups according to the liquefaction time (cut⁃off point: 60 minutes). Routine semen parameters,gonadal hormone and seminal plasma were tested and compared between the above groups. T⁃test was applied to compare individual gland function (pH value,neutralα⁃glycosidase,fructopyranose,seminal plasma zinc and citric acid) and gonadal hormone (FSH,LH,PRL,T and E2). Logistic regression analysis was adopted to probe the influencing factors for abnormal semen liquefaction. Results Seminal pH value (7.47 ± 0.13 vs. 7.32 ± 0.18),citric acid(51.12 ± 12.95 vs. 83.11 ± 33.46)and FSH (4.40 ± 1.03 vs. 4.85 ± 1.50)levels were significant different between the two groups (P < 0.05),but the other indexes showed no significant difference. Correlation regression analysis showed that semen liquefaction capacity has correlative relationship with seminal plasma fructose (OR=2.644),citric acid (OR=0.922),serum T (OR=1.029) and E2,while no correlative relationship with other indexes. Conclusions Correlation between two glands (seminal vesicle and prostate) and balance in the two hormones (T and E2) influence the liquefaction time. Specific causes should be distinguished before diagnosis.%目的：通过探讨精液液化异常患者性激素水平及生殖管道各附属腺体（附睾、精囊、前列腺等）功能状态，系统分析影响精液液化时间的相关因素，为精液液化异常的个体化诊治提供临床依据。方法：纳入符合入组标准的育龄男性患者152例，根据精液液化时间将患者分为两组：液化异常组（精液液化时间＞60 min组）和液化正常组（液化时间为≤60 min组）。测定精液常规参数、性激素5项及附属腺体功能指标精浆生化等。一是运用T检验比较两组间生殖管道各附属腺体功能状态（pH值、中性α⁃糖苷酶、果糖、精浆锌和柠檬酸）及性激素水平（FSH、LH、PRL、T和E2）是否存有显著差异；二是运用Logistic回归分析检测上述指标与精液液化能力的相关性。结果：精液液化异常组（52例）与正常组（100例）相比，两组间精液pH值（7.47±0.13 vs 7.32±0.18）、柠檬酸（51.12±12.95 vs 83.11±33.46）和FSH（4.40±1.03 vs 4.85±1.50）差异有统计学意义（P<0.05），余差异无统计学意义。相关性回归分析显示，精液液化能力与精囊腺功能指标果糖（OR=2.644）、前列腺功能指标柠檬酸（OR=0.922）、血清T（OR=0.611）及E2（OR=1.029）水平存在相关性（P<0.05），而与分析指标中的其他因素无明显关系。结论：精液的液化能力与两腺体（前列腺/精囊腺）功能状态及两激素水平（T/E2）存在相关性，临床诊疗精液液化异常患者时，可根据具体致病因素给予区别化针对性治疗。