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目的 探讨精子膜表面AsAb导致男性不育的机制。方法 对102例不孕夫妇的丈夫精液进行混合球蛋白反应试验(MAR),其中48例同时进行了血清AsAb的检测。结果 48例同时进行MAR和ELISA的不育男性,精液MAR阳性率为14.6%(7/48);血清ELISA阳性率为50%(24/48)。两种方法的阳性率有非常显著性差异(P<0.001)。102例进行MAR检测的不育男性中,随着精液量、密度、存活率、活动力、畸形率的变化,精子膜表面AsAb的阳性率均无显著性差异(P>0.05)。根据精子膜表面AsAb阳性与否分成两组组间的病人年龄、精液量、密度、存活率、活动力、畸形率均无显著性差异(P>0.05)。结论 血清ELISA阳性率过高,不宜用于不育男性免疫因素的检测;精液精子膜表面AsAb并不影响精液分析的各项参数。因此,精液各项参数的分析对于男性免疫因素不育的筛查没有太大的意义。
Objective To investigate the mechanism of male infertility caused by AsAb on the surface of sperm membrane. Methods A total of 102 infertile couples were tested for mixed globulin response (MAR), of which 48 were tested for serum AsAb at the same time. Results In 48 infertile men with MAR and ELISA, the positive rate of semen MAR was 14.6% (7/48). The positive rate of serum ELISA was 50% (24/48). There was a very significant difference between the two methods (P <0.001). There was no significant difference in the positive rate of AsAb on the sperm membrane between 102 males with MAR (P> 0.05), with the changes of sperm volume, density, survival rate, motility and deformity. There was no significant difference in age, semen volume, density, survival rate, activity, and deformity between the two groups according to AsAb positive or not on the surface of sperm membrane (P> 0.05). Conclusion Serum ELISA positive rate is too high, not suitable for the detection of infertile male immune factors; sperm membrane surface AsAb does not affect the semen analysis of the parameters. Therefore, the analysis of various parameters of semen for infertility screening of male immune factors is not much significance.