精浆和血清生殖激素与精液质量的关系

摘要

Objective: To estimate the relationship between concentration and motility of sperm and reproductive hormone in serum or seminal plasma from men with different semen quality, as well as investigate the correlation between reproductive hormone in serum and in seminal plasma. Methods: A total of 301 men were divided to four groups after semen examination according to the semen quality:normal group ( n=176 ) , asthenozoospermia group ( n=66 ) , oligozoospermia group ( n=40 ) and non-obstructive azoospermia group (n=19). Levels of FSH, LH, prolactin (PRL), progesterone (P), testosterone (T) and estradiol ( E2 ) in serum or seminal plasma were detected by electrochemiluminescence immunoassay. The inter-group variances were compared meanwhile the correlations were analyzed. Results: The levels of FSH and E2 in serum from normal and asthenozoospermic group were significantly lower than those from oligozoospermia and non-obstructive azoospermia group (P<0. 05), while levels of LH and P in serum of normal group were significantly lower than those in the other three groups (P<0. 05). The levels of PRL in seminal plasma of normal, asthenozoospermic and oligozoospermic group were significantly higher than those of non-obstructive azoospermic group ( P<0. 05 ) . FSH levels in serum were negatively correlated with sperm concentration ( r =-0. 350,-0. 273 and-0. 448 respectively, P<0. 05) in all groups except in non-obstructive azoospermic group. The levels of PRL in seminal plasma were positively correlated with sperm concentration both in normal ( r=0. 269, P<0. 05) and asthenozoospermic group (r=0. 432,P<0. 05). Conclusions: The PRL level in seminal plasma and FSH in serum could reflect sperm concentration and motility, which might offer reference and potential value in diagnosis of male infertility.%目的：为了评估精液质量不同的男性精浆和血清生殖激素的浓度与精子浓度及活动力的关系,探索精浆与血清生殖激素的关系。方法对301名男性进行精液检查,按照精液的质量参数将受试对象分成4组：精液正常组( n=176),弱精子症组(n=66),少精子症组(n=40)和非梗阻性无精子症组(n=19)。采用电化学发光免疫法测定各组受试对象血清卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、孕酮(P)、睾酮(T)和雌二醇(E2)六项生殖激素和精浆PRL、T、P和E2四项生殖激素的浓度,比较组间差异并进行相关性分析。结果精液正常组和弱精子症组血清FSH和E2的浓度显著低于少精子症组和非梗阻性无精子症组(P<0．05),精液正常组血清LH和P 的浓度显著低于弱精子症、少精子症和非梗阻性无精子症的人群(P<0．05)；而精液正常、弱精子症和少精子症三组精浆PRL的浓度则高于非梗阻性无精子症组(P<0．05)。除了非梗阻性无精子症组,受试者血清FSH的浓度与其精子浓度呈负相关(r分别为-0．350、-0．273和-0．448,P<0．05)。精液正常组精浆PRL的浓度和精子的浓度之间呈正相关(r=0．269,P<0．05)；在少精子症组中,亦有相同趋势的相关性(r=0．432,P<0．05)。结论精浆PRL及血清FSH的浓度能够反映精子浓度或活动力,在男性不育的病因分析中具有一定的指导价值。