弹性蛋白酶浓度在ⅢA型前列腺炎患者精浆中的变化及对精液影响研究

发布时间：2019-01-06 07:38

【摘要】：目的：通过测定弹性蛋白酶(NE)在慢性前列腺炎患者（chronic prostatitis,CP)精浆中的浓度，同时行前列腺液常规、精液常规检测、细菌培养、支原体、衣原体及前列腺炎症状评分(CPSI)，通过统计软件分析弹性蛋白酶在慢性前列腺炎中的浓度变化及对精液质量的影响，以探讨该酶在慢性前列腺炎诊疗中的意义及对生育的影响。方法：收集2013年1-6月在我院男科就诊的CP患者的精液及前列腺液标本，根据其生育情况将其分为不育患者（A组30例），生育患者（B组30例），30例不育症患者为结婚后性生活正常，未采取避孕措施，同居1年以上女方未妊娠患者，经我院妇产科检查排除女方不孕因素，30例生育患者均为配偶怀孕中的男性，同时收集健康志愿者（C组30例）的前列腺液及精液标本，，对90例试验对象均进行弹性蛋白酶、前列腺液常规、细菌培养、支原体、衣原体及精液常规检测，在病史采集的同时完成前列腺炎症状评分（CPSI）。最后通过统计得出NE浓度、精液常规参数、精液中白细胞数（WBC）在慢性前列腺炎患者与健康志愿者的差别，进一步分析NE的浓度对精子活力、活动率、精子密度、液化时间、酸碱度的影响，并分析NE与年龄、CPSI、WBC的关系，以确定NE在CP中的诊断价值及对精液质量存在的潜在负面影响及与不育的关系。所有患者自愿参与本研究。3个月前无抗菌治疗史。结果：A、B组的NE浓度均明显高于C组，（P0.05）；精子活力、精子活率、精子密度均显著低于C组（P0.05），精液液化时间较C组长；A、B两组的精子活力及活动率亦有差别（P0.05）；A、B均两组的PH值明显低于C组(P0.05)；A组NE高于B组，P=0.0150.05，有显著差异；A组与B组间的精子密度、PH值的比较无显著差异（P分别为0.354、0.6540.05）；A组CPSI明显高于B组，P＜0.05，比较有统计学意义；A、B精液中WBC的数量与CPSI存在正相关关系，相关系数r=0.617，NE与精液中WBC数亦存在正相关关系，r=0.749，NE与CPSI的存在正相关关系，r=0.523；结论：1、弹性蛋白酶是反应慢性前列腺炎的一辅助诊断的新指标，并可判断炎症的程度，可能作为泌尿男科常规检测诊断的指标； 2、弹性蛋白酶的浓度与精液质量存在负相关关系，酶浓度越高，精液质量越差，一定程度上可能导致男性不育； 3、通过检测弹性蛋白酶浓度，可以指导临床上治疗方案的选择及对疾病预后的判断。
[Abstract]:Objective: to determine the concentration of elastase (NE) in seminal plasma of patients with chronic prostatitis (chronic prostatitis,CP). Chlamydia and prostatitis symptom score (CPSI),) was used to analyze the change of elastase concentration in chronic prostatitis and its effect on semen quality by statistical software. To explore the significance of the enzyme in the diagnosis and treatment of chronic prostatitis and its effect on fertility. Methods: the semen and prostatic fluid samples of CP patients in our hospital from January to June 2013 were collected. According to their fertility, they were divided into infertile patients (group A, n = 30) and fertility patients (group B, n = 30). 30 cases of infertile patients who had normal sexual life after marriage, did not take contraceptive measures, lived together for more than one year without pregnant women, the gynecology and obstetrics examination in our hospital ruled out the factors of female infertility, 30 cases of fertile patients were male in the pregnancy of their spouses. The specimens of prostatic fluid and semen were collected from 30 healthy volunteers (group C) and 90 subjects were examined with elastase, prostatic fluid routine, bacterial culture, mycoplasma, chlamydia and semen. Complete prostatitis symptom score (CPSI). While collecting history Finally, the differences of NE concentration, semen routine parameters, semen white blood cell count (WBC) in patients with chronic prostatitis and healthy volunteers were obtained. The effects of NE concentration on sperm motility, sperm density and liquefaction time were further analyzed. In order to determine the diagnostic value of NE in CP, the potential negative effect on semen quality and the relationship between NE and infertility. All patients volunteered to participate in this study. No history of antimicrobial therapy 3 months ago. Results: the concentration of NE in group A was significantly higher than that in group C (P0.05), sperm motility, sperm density were significantly lower than those in group C (P0.05), semen liquefaction time was longer than that of group C (P0.05). There were significant differences in sperm motility and motility between the two groups (P0.05), and the PH values of both groups were significantly lower than those of group C (P0.05). The NE of); A group was higher than that of B group (P 0.05), and there was a significant difference between group A and group B (P 0.05). There was no significant difference in sperm density and PH between group A and group B (P > 0.05). The CPSI of group A was significantly higher than that of group B (P < 0.05). There was a positive correlation between the number of WBC in semen and CPSI, the correlation coefficient (r = 0.617) and the number of WBC in semen. There was a positive correlation between the quantity of WBC in semen and the number of WBC in semen, and there was a positive correlation between the quantity of WBC in semen and the number of CPSI (r = 0.523). Conclusion: 1. Elastase is a new index for the diagnosis of chronic prostatitis, and it can judge the degree of inflammation. It may be used as a diagnostic index for routine detection of urology. (2) there is a negative correlation between the concentration of elastase and the quality of semen. The higher the concentration of elastase, the worse the quality of semen, which may lead to male infertility to some extent. 3. By detecting the concentration of elastase, we can guide the choice of clinical treatment scheme and the judgement of disease prognosis.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R697.33

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