不育患者精液的氧化应激对精子DNA完整性等参数的影响

摘要

目的 探讨男性不育患者精液的氧化应激对精子动态、形态以及功能等参数的影响.方法 通过检测81例男性不育患者的精液参数,将其分为少精症组(精子浓度＜ 15×106/mL)共5例；弱精子症组[即精子前向运动率(PR)＜32％]共31例,设为活力Ⅰ组；前向运动精子32％＜ PR＜ 50％组共25例,设为活力Ⅱ组；活力前向运动PR＞ 50％组共11例,设为活力Ⅲ组；白细胞精子症组(简称为白精症组,即精液白细胞计数＞1×106/mL)共9例；另设健康对照组21名.分别测定其精液量,精子浓度、活率、PR、精子膜功能、精子正常形态率以及丙二醛(MDA)、总抗氧化能力(TAC)、精子DNA完整性等参数.结果 与健康对照组比较,各组修正后MDA浓度均明显高于对照组(P＜0.05或P＜0.01),且随着精子活力的下降,精子MDA呈现增加的趋势；活力Ⅰ组,活力Ⅱ组,活力Ⅲ组的MDA浓度分别与少精症组、白精症组比较,差异均有统计学意义(P＜0.01).精液氧化应激指数与精子浓度、精子总数、MDA含量、精子DNA碎片化指数(DFI)成正相关；与精子活率、PR、低渗肿胀率(HOS)、快速直线运动浓度、快速直线运动总数、路径速度(VAP)、直线速度(VSL)、TAC、正常形态率成负相关.结论 精液的氧化应激可以造成精子膜功能、动态、形态参数的改变以及精子核DNA的损伤,可能是精液氧化应激引起男性不育的重要机制之一.%Objective To investigate the sperm dynamic parameter,shape parameter and function parameter of seminal oxidative stress in males with infertility.Methods Sperm parameters in 81 males with infertility were detected,and they were classified into oligospermia group (sperm concentration ＜ 15 × 106/mL,5 cases),weak sperm group [progressive rate (PR) ＜32％,31 cases,Group Ⅰ],sperm prior to the movement group (32％ ＜PR ＜50％,25 cases,Group Ⅱ,dynamic forward PR group (PR ＞ 50％,11 cases,Group Ⅲ) and leucocyte sperm disease group (referred as white essence disease group,sperm white blood cell count ＞ 1 × 106/mL,9 cases).A total of 21 healthy subjects were as healthy controls.The semen,sperm concentration and motility rate,PR,sperm membrane function,sperm shape normality,malonaldehyde(MDA),total antioxidant capacity(TAC) and sperm DNA integrity parameters were determined.Results In comparison with healthy control group,modified MDA concentration of each group was significantly higher than that in healthy control group (P ＜ 0.05 or P ＜ 0.01),and with the decline of sperm motility,sperm MDA increased.The MDA concentrations in Group Ⅰ,Ⅱ and Ⅲ had statistical significance with those in oligospermia group and leucoyte sperm disease group (P ＜ 0.01).Semen indices of oxidative stress with sperm concentration,total number of sperm,MDA content and sperm DNA fragmentation index(DFI) had positive correlation,and those with sperm motility rate,PR,hypoosmotic swelling rate (HOS),fast linear motion concentration,fast linear motion number,path velocity (VAP),linear velocity (VSL),TAC and sperm shape normality had negative correlation.Conclusions Seminal oxidative stress can cause the changes of sperm membrane function,dynamic parameter,shape parameter and sperm nuclear DNA damage,and may be one of the mechanisms causing male infertility.