【摘要】：目的：通過(guò)測(cè)定彈性蛋白酶(NE)在慢性前列腺炎患者（chronic prostatitis,CP)精漿中的濃度，同時(shí)行前列腺液常規(guī)、精液常規(guī)檢測(cè)、細(xì)菌培養(yǎng)、支原體、衣原體及前列腺炎癥狀評(píng)分(CPSI)，通過(guò)統(tǒng)計(jì)軟件分析彈性蛋白酶在慢性前列腺炎中的濃度變化及對(duì)精液質(zhì)量的影響，以探討該酶在慢性前列腺炎診療中的意義及對(duì)生育的影響。 方法：收集2013年1-6月在我院男科就診的CP患者的精液及前列腺液標(biāo)本，根據(jù)其生育情況將其分為不育患者（A組30例），生育患者（B組30例），30例不育癥患者為結(jié)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，經(jīng)我院婦產(chǎn)科檢查排除女方不孕因素，30例生育患者均為配偶懷孕中的男性，同時(shí)收集健康志愿者（C組30例）的前列腺液及精液標(biāo)本，，對(duì)90例試驗(yàn)對(duì)象均進(jìn)行彈性蛋白酶、前列腺液常規(guī)、細(xì)菌培養(yǎng)、支原體、衣原體及精液常規(guī)檢測(cè)，在病史采集的同時(shí)完成前列腺炎癥狀評(píng)分（CPSI）。最后通過(guò)統(tǒng)計(jì)得出NE濃度、精液常規(guī)參數(shù)、精液中白細(xì)胞數(shù)（WBC）在慢性前列腺炎患者與健康志愿者的差別，進(jìn)一步分析NE的濃度對(duì)精子活力、活動(dòng)率、精子密度、液化時(shí)間、酸堿度的影響，并分析NE與年齡、CPSI、WBC的關(guān)系，以確定NE在CP中的診斷價(jià)值及對(duì)精液質(zhì)量存在的潛在負(fù)面影響及與不育的關(guān)系。所有患者自愿參與本研究。3個(gè)月前無(wú)抗菌治療史。 結(jié)果：A、B組的NE濃度均明顯高于C組，（P0.05）；精子活力、精子活率、精子密度均顯著低于C組（P0.05），精液液化時(shí)間較C組長(zhǎng)；A、B兩組的精子活力及活動(dòng)率亦有差別（P0.05）；A、B均兩組的PH值明顯低于C組(P0.05)；A組NE高于B組，P=0.0150.05，有顯著差異；A組與B組間的精子密度、PH值的比較無(wú)顯著差異（P分別為0.354、0.6540.05）；A組CPSI明顯高于B組，P＜0.05，比較有統(tǒng)計(jì)學(xué)意義；A、B精液中WBC的數(shù)量與CPSI存在正相關(guān)關(guān)系，相關(guān)系數(shù)r=0.617，NE與精液中WBC數(shù)亦存在正相關(guān)關(guān)系，r=0.749，NE與CPSI的存在正相關(guān)關(guān)系，r=0.523； 結(jié)論：1、彈性蛋白酶是反應(yīng)慢性前列腺炎的一輔助診斷的新指標(biāo)，并可判斷炎癥的程度，可能作為泌尿男科常規(guī)檢測(cè)診斷的指標(biāo)； 2、彈性蛋白酶的濃度與精液質(zhì)量存在負(fù)相關(guān)關(guān)系，酶濃度越高，精液質(zhì)量越差，一定程度上可能導(dǎo)致男性不育； 3、通過(guò)檢測(cè)彈性蛋白酶濃度，可以指導(dǎo)臨床上治療方案的選擇及對(duì)疾病預(yù)后的判斷。
[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.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R697.33

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本文編號(hào)：2402529