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目的分析精浆中人附睾蛋白4(HE4)含量与男性不育症的相关性,探讨精浆HE4检测在男性不育症诊断中的应用价值。方法采集231例生殖男科就诊的不育症患者精液,依据WHO诊断标准分为5组:无精子症组45例、少精子症组43例、弱精子症组41例、畸形精子症组45例和精液参数正常组57例,选取40例已生育者为正常生育组,采用计算机辅助精子分析仪(CASA)分析各组精液精子浓度、精子总数、精子活力、前向运动精子(PR)和精子形态,电化学发光法检测各组精浆中HE4含量,并与精液常规指标进行相关性分析。结果 271例男性精浆HE4平均含量为(793.4±362)pmol/L。无精子症、少精子症、弱精子症和畸形精子症组精浆中HE4含量分别为(987.43±386.75)、(857.12±355.64)、(807.72±375.21)和(837.04±371.36)pmol/L,均高于正常生育组(604.45±272.02)pmol/L,P值分别为0.000、0.001、0.009、0.002。少精子症、弱精子症和畸形精子症组中精子浓度、精子总活力和PR均低于正常生育组(P值均为0.000),且精浆HE4含量与精子浓度、精子总数、精子总活力、PR及正常形态精子百分率均呈负相关(r值分别为-0.371、-0.348、-0.284、-0.240、-0.158)。结论精浆HE4含量与男性不育症患者精液常规五项指标呈负相关,可作为判断男性生育能力的参考指标。
Objective To analyze the correlation between the content of human epididymal protein 4 (HE4) and male infertility in seminal plasma and to explore the value of using HE4 in seminal plasma in the diagnosis of male infertility. Methods A total of 231 infertile patients receiving reproductive medicine were collected and divided into 5 groups according to WHO diagnostic criteria: 45 cases of azoospermia, 43 cases of oligozoospermia, 41 cases of asthenospermia, 45 cases of malformation sperm disease Sperm motility, motility spermatozoa (PR) and spermatozoa were measured by using computer-assisted sperm analyzer (CASA) Morphology and electrochemiluminescence were used to detect the content of HE4 in seminal plasma of each group, and the correlation was analyzed with the routine indexes of semen. Results The average content of HE4 in 271 male seminal plasma was (793.4 ± 362) pmol / L. The levels of HE4 in seminal plasma of azoospermia, oligospermia, asthenospermia and teratospermia were (987.43 ± 386.75), (857.12 ± 355.64), (807.72 ± 375.21) and (837.04 ± 371.36) pmol / Were higher than the normal fertility group (604.45 ± 272.02) pmol / L, P values were 0.000,0.001,0.009,0.002. Spermatozoa concentration, sperm motility and PR were lower in oligozoospermia, asthenospermia and malformation sperm group than those in normal fertility group (P <0.0001), and the content of sperm motility and sperm concentration, sperm count, sperm motility , PR and normal form of sperm were negatively correlated (r values were -0.371, -0.348, -0.284, -0.240, -0.158). Conclusion There is a negative correlation between the content of seminal plasma HE4 and the routine five indexes of semen in male infertility, which can be used as a reference index to judge male fertility.