本文選題：特發(fā)性弱精子癥 + 精液分析　； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]通過對110例精液檢驗(yàn)結(jié)果的分析了解昆明市男性不育的主要影響因素,并對特發(fā)性弱精子癥患者與精液分析結(jié)果正常人群的精漿蛋白組化檢測出兩組人群中精漿蛋白質(zhì)水平,以初步探討蛋白質(zhì)在兩組人群中的差異。[方法]通過計(jì)算機(jī)輔助精液分析系統(tǒng)(CASA)得出分析結(jié)果并做數(shù)據(jù)分析,其中選取較典型的10名符合弱精子癥診斷標(biāo)準(zhǔn)的育齡期男性作為特發(fā)性弱精子癥組,8名年齡相匹配的健康者作為對照組。采集特發(fā)性弱精子癥組和對照組所有受試對象的精漿凍干粉作為標(biāo)本。應(yīng)用LC-MS質(zhì)譜鑒定(Shotgun)法檢測所有標(biāo)本中蛋白質(zhì)的表達(dá)水平。所有結(jié)果均利用統(tǒng)計(jì)軟件SPSS進(jìn)行分析,以P0.05說明有統(tǒng)計(jì)學(xué)意義。[結(jié)果]1、110例患者精液標(biāo)本中,精液量1.5ml的有16例,占14. 55%;酸堿度7. 2的有1例,占0.91%;精子濃度小于15×106的有36例,占32. 73%;精子總數(shù)小于39X 106的有43例,占39. 09%;精子總活力(PR+NP) 40%的有82例,占74. 55%;向前運(yùn)動力(PR)小于32%的有84例,占76. 36%;液化時(shí)間60min的有3例,占2.73% ;畸形精子96%的有3例,占2. 73%。2、特發(fā)性弱精癥患者的蛋白質(zhì)組化結(jié)果共有274個(gè)蛋白質(zhì)點(diǎn)與健康組不同(參考水平在三倍以上為有意義),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。3、在不同的274個(gè)不同蛋白質(zhì)中,共有109個(gè)蛋白質(zhì)點(diǎn)在特發(fā)性弱精癥患者精漿中的含量大于健康組含量,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),其中,99個(gè)蛋白質(zhì)點(diǎn)在健康組中未表達(dá)。4、在不同的274個(gè)不同蛋白質(zhì)中,共有165個(gè)蛋白質(zhì)點(diǎn)在特發(fā)性弱精癥患者精漿中的含量小于健康組含量,均有統(tǒng)計(jì)學(xué)意義,(P0.05),其中,144個(gè)蛋白質(zhì)點(diǎn)在特發(fā)性弱精癥患者精漿中未表達(dá)。5、以上我們排除了較小蛋白質(zhì)片段與未經(jīng)鑒定的蛋白質(zhì),其中熱休克蛋白、角蛋白、附睪分泌蛋白、Ras蛋白、組蛋白、前列腺干細(xì)胞抗原較有意義,并討論論證了它們可能均通過不同的機(jī)制影響到弱精子癥的發(fā)生、發(fā)展的病理過程。[結(jié)論]在精液常規(guī)各項(xiàng)目異常指標(biāo)中,昆明地區(qū)弱精子癥患者的精液以精子活力異常多見,而且精子活力異常往往同時(shí)伴有精子總數(shù)或者精子濃度的異常。精漿中的多種蛋白質(zhì)參與了弱精子癥發(fā)生、發(fā)展的病理過程,對判斷患者疾病的嚴(yán)重程度、預(yù)后及療效有一定意義,且可以作出初步假設(shè),各種蛋白質(zhì)在弱精子癥的發(fā)生發(fā)展中起到不同的作用,為下一步研究奠定了基礎(chǔ)。
[Abstract]:[objective] to understand the main influencing factors of male infertility in Kunming by analyzing the results of 110 semen tests. The seminal plasma protein levels of the two groups were detected by the seminal plasma protein histochemistry in order to explore the difference of the proteins in the two groups. [methods] the results were obtained by computer aided semen analysis system (CASAA) and the data were analyzed. Among them, 10 typical infertile men who met the diagnostic criteria of asthenospermia were selected as the control group with 8 age-matched healthy persons as the idiopathic asthenospermia group. The seminal plasma freeze-dried powder of all subjects in idiopathic asthenospermia group and control group were collected as specimens. LC-MS mass spectrometry was used to detect the protein expression in all specimens. All the results were analyzed by statistical software SPSS. [results] of the 1110 semen samples, 16 (14.4%) had 1.5ml. The alkalinity is 7. 2 in 1 case (0. 91%) and sperm concentration less than 15 脳 10 6 in 36 cases (32. 2%). The total number of spermatozoa was less than 39X106 in 43 cases (39. 5%). The percentage of total sperm motility PR NPs was 40% in 82 cases (74. 5%). There were 84 cases (76. 5%) with forward motion force (PRA) less than 32%. There were 3 cases (2.73%) of 60min with liquefaction time and 3 cases (2. 7%) with abnormal sperm 96%. There were 274 protein spots in patients with idiopathic azoospermia, which were different from those in the healthy group (the reference level was more than three times as significant as that in the control group), and the difference was statistically significant (P 0.05. 3) among 274 different proteins. A total of 109 protein spots were found in the seminal plasma of idiopathic asthenospermia patients, and the difference was statistically significant (P 0.05). Among them, 99 protein spots were not expressed in the healthy group, and there were 274 different proteins in the seminal plasma of the patients with idiopathic asthenospermia. A total of 165 protein spots were found in the seminal plasma of patients with idiopathic asthenospermia. Among them, 144 protein spots were not expressed in the seminal plasma of idiopathic asthenospermia patients. Above, we excluded smaller protein fragments and unidentified proteins, including heat shock protein, keratin, heat shock protein and keratin. The epididymal secretory protein Ras, histone and prostate stem cell antigen are of significance. It is discussed that they may affect the pathogenesis and development of asthenospermia through different mechanisms. [conclusion] among the abnormal indexes of semen routine, sperm motility is more common in patients with asthenospermia in Kunming area, and the abnormal sperm motility is often accompanied by abnormal sperm count or sperm concentration. A variety of proteins in seminal plasma are involved in the pathogenesis and development of asthenospermia, which have certain significance in judging the severity, prognosis and curative effect of the disease, and can make a preliminary hypothesis. Various proteins play different roles in the occurrence and development of asthenospermia, which lays a foundation for further research.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R698.2

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