【摘要】：[目的]檢測梗阻性無精子癥患者精液中人附睪蛋白4在行吻合術(shù)后不同時間的表達,探討其表達意義。[方法]隨訪2015年12月至2017年1月期間在昆明醫(yī)科大學第二附屬醫(yī)院男性科診斷為“梗阻性無精子癥”的患者。排除附睪輸精管缺如、發(fā)育不良等情況的患者。收集已行輸精管-輸精管/附睪管吻合術(shù)3個月(10例)、6個月(7例)、12個月(8例)的患者精液標本共25例,正常對照組精液標本8例。對比術(shù)后不同時間患者以及吻合術(shù)后妊娠患者和未妊娠患者精液中人附睪蛋白4的表達。[結(jié)果]1.吻合術(shù)后3個月、6個月患者精液中人附睪蛋白4的表達量與正常志愿者相比較p分別為0. 001和0. 003,有統(tǒng)計學意義;術(shù)后12個月的患者與正常對比p0. 05,無統(tǒng)計學意義。2.術(shù)后精液參數(shù)正常但未懷孕的患者與精液參數(shù)正常已懷孕及正常志愿者相比較,p0. 05,無統(tǒng)計學意義。[結(jié)論]1.隨著術(shù)后時間的延長,患者精液中HE4的表達量有下降趨勢。根據(jù)本實驗前期成果,隨著吻合手術(shù)后時間的延長精子密度、精子總數(shù)、精子總活力、前向運動精子數(shù)(PR)逐步改善。因此說明解除精道梗阻后,精液質(zhì)量的改善可能與HE4的分泌下調(diào)有關(guān)。2.在精液參數(shù)正常情況下,HE4不影響患者配偶懷孕;
[Abstract]:[objective] to detect the expression of human epididymal protein-4 in semen of patients with obstructive azoospermia at different time after anastomosis. [methods] the patients diagnosed as obstructive azoospermia from December 2015 to January 2017 were diagnosed as obstructive azoospermia in male department of the second affiliated Hospital of Kunming Medical University. To exclude the absence of the epididymal vas deferens and dysplasia. Semen samples were collected from 25 patients who had undergone vasovasal-vasovasal / epididymal duct anastomosis for 3 months (10 cases), 6 months (7 cases), 12 months (8 cases) and 8 cases of normal control group. The expression of human epididymal protein 4 in semen at different time after operation, pregnancy after anastomosis and without pregnancy was compared. [result] 1. The expression of human epididymal protein-4 in semen of patients at 3 months and 6 months after anastomosis was 0. 001 and 0. 003, with statistical significance, 12 months after operation compared with the normal p0. 05, no statistical significance. 2. The normal semen parameters but not pregnant patients were compared with normal pregnant and normal volunteers (P 0. 0). 05, no statistical significance. [conclusion] 1. With the extension of postoperative time, the expression of HE4 in semen decreased. According to the results of this experiment, the sperm density, the total sperm count, the total sperm motility and the forward motile sperm number (PR) were improved gradually with the extension of the operation time after anastomosis. Therefore, the improvement of semen quality may be related to the down-regulation of HE4 secretion after relieving the obstruction of spermatozoa. Under normal semen parameters, HE4 did not affect the pregnancy of the spouse.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R699.8

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