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目的:探讨体重指数(BMI)对于男性精液、促性腺激素、性激素的影响。方法:随机抽取男性不育患者524例,根据BMI分成三组。即正常体重组179例,超重组219例,肥胖组126例。对不育患者进行精液常规分析,采用化学发光法测定促卵泡激素、促黄体生成素、睾酮、雌二醇水平。结果:肥胖组精液量(2.30±1.05)ml与正常体重组精液量(2.73±1.02)ml相比较,低于后者,差异有统计学意义(P<0.05)。超重组精子活动率(55.10±20.53)%与正常体重组(49.80±24.47)%相比较,高于后者,差异有统计学意义(P<0.05),但在前向运动精子率中超重组与正常体重组相比差异无统计学意义(P>0.05)。正常体重组睾酮水平(449.70±120.07)ng/dl,超重组(394.47±178.28)ng/dl,肥胖组(323.37±137.34)ng/dl,三组相比较,差异有统计学意义(P<0.05)。随着BMI增加,各组睾酮逐渐下降。雌二醇虽有增加,但各组间差异无统计学意义。BMI与促黄体生成素水平呈负相关性(r=-0.17,P<0.05)。BMI与总睾酮水平呈明显负相关性(r=-0.31,P<0.01),BMI与促卵泡生成素和雌激素水平无相关性。结论:肥胖男性不育患者在治疗中应补充雄激素,同时加强锻炼,健康饮食,减轻体重是治疗的重要部分。
Objective: To investigate the effect of body mass index (BMI) on sperm, gonadotropin and sex hormones in men. Methods: 524 male infertility patients were randomly selected and divided into three groups according to BMI. 179 cases of normal weight group, 219 cases of overweight group, 126 cases of obesity group. Sperm routine analysis of infertility patients, the use of chemiluminescence determination of follicle stimulating hormone, luteinizing hormone, testosterone, estradiol levels. Results: The semen volume in obese group (2.30 ± 1.05) ml was lower than that in normal body weight group (2.73 ± 1.02) ml, the difference was statistically significant (P <0.05). Compared with the normal weight group (49.80 ± 24.47)%, the activity of overweight group (55.10 ± 20.53)% was higher than the latter (P <0.05) There was no significant difference in normal weight group (P> 0.05). The levels of testosterone in normal weight group (449.70 ± 120.07 ng / dl, 394.47 ± 178.28 ng / dl in overweight group and 323.37 ± 137.34 ng / dl in obesity group were significantly different between the three groups (P <0.05 ). As BMI increased, testosterone in each group decreased gradually. Although estradiol increased, but no significant difference between the groups. BMI was negatively correlated with luteinizing hormone (r = -0.17, P <0.05). BMI was negatively correlated with total testosterone (r = -0.31, P <0.01). There was no correlation between BMI and follicle stimulating hormone and estrogen levels. Conclusion: Obese male infertility patients should be supplemented with androgens in the treatment, while strengthening exercise, healthy diet, weight loss is an important part of treatment.