發(fā)布時(shí)間：2018-04-21 19:08

  本文選題：生物標(biāo)志物 + 消毒副產(chǎn)物��； 參考：《華中科技大學(xué)》2014年博士論文

【摘要】：第一部分管網(wǎng)水THMs暴露與男性精液質(zhì)量之間的關(guān)系研究 目的：采用管網(wǎng)水中監(jiān)測的四種三鹵甲烷(trihalomethanes, THMs)濃度結(jié)合個(gè)體日常用水情況作為外暴露標(biāo)志物,初步探討管網(wǎng)水THMs暴露與男性精液質(zhì)量之間的關(guān)系。 方法：采用前瞻性隊(duì)列研究設(shè)計(jì),以來武漢市某綜合醫(yī)院生殖醫(yī)學(xué)中心尋求精液分析并且居住于某大型水廠區(qū)域內(nèi)的324名育齡期男性為研究對象,通過監(jiān)測研究對象精液樣本收集前三個(gè)月管網(wǎng)水中四種THMs[三氯甲烷(chloroform, TCM)、二氯一溴甲烷(bromodichloromethane, BDCM)、一氯二溴甲烷(dibromochloromethane, DBCM)和三溴甲烷(bromoform,TBM)]濃度的時(shí)間和空間分布,并結(jié)合日常生活用水活動(dòng)信息和THMs不同暴露途徑吸收系數(shù)評估個(gè)體的THMs外暴露水平,采用多變量線性回歸分析經(jīng)口和經(jīng)洗澡途徑暴露管網(wǎng)水中THMs與精液質(zhì)量之間的關(guān)系。 結(jié)果：多變量線性回歸分析結(jié)果顯示經(jīng)口攝入的TTHMs、TCM和Br-THMs與降低的精子密度(P for trend分別為0.01、0.03和0.05)和精子總數(shù)(P for trend分別為0.02、0.05和0.09)之間存在顯著或建議性的劑量-反應(yīng)關(guān)系。此外,研究發(fā)現(xiàn)與第一分位數(shù)經(jīng)洗澡攝入的TCM相比較,第三分位數(shù)經(jīng)洗澡攝入的TCM與精子直線性存在顯著的負(fù)相關(guān)(β＝2.28%,95%CI：-4.44,-0.11)。 結(jié)論：本部分研究結(jié)果表明人群經(jīng)口途徑暴露飲用水THMs可能與降低的精子密度和精子總數(shù)有關(guān)。 第二部分基礎(chǔ)水平的血液THMs與男性精液質(zhì)量和睪酮之間的關(guān)系研究 目的：采用基礎(chǔ)水平的血液THMs作為內(nèi)暴露生物標(biāo)志物,進(jìn)一步探討飲用水THMs暴露與男性精液質(zhì)量和睪酮之間的關(guān)系。 方法：采用橫斷面研究設(shè)計(jì),以來武漢市某綜合醫(yī)院生殖醫(yī)學(xué)中心尋求精液分析的401名育齡期男性為研究對象,采用固相微萃取-氣相色譜法檢測早晨采集的血樣中四種THMs濃度評估個(gè)體基礎(chǔ)水平的THMs內(nèi)暴露水平,采用多變量線性回歸分析基礎(chǔ)水平的血液THMs與精液質(zhì)量和睪酮之間的關(guān)系。 結(jié)果：多變量線性回歸分析結(jié)果顯示與第一分位數(shù)血液BDCM相比較,第二分位數(shù)血液BDCM與精子總數(shù)之間存在顯著的負(fù)相關(guān)(β=-0.13million,95%CI:-0.22,-0.03)；與第一分位數(shù)血液DBCM相比較,第二分位數(shù)血液DBCM與精子直線性之間也存在顯著的負(fù)相關(guān)(β=-4.74%,95%CI:-807,-1.42);同時(shí)發(fā)現(xiàn)血液TCM和TTHMs與降低的精子密度之間存在建議性的劑量-反應(yīng)關(guān)系(both P for trend=0.07)。此外,研究結(jié)果還顯示血液DBCM與降低的血清總睪酮之間存在建議性的劑量-反應(yīng)關(guān)系(P for trend=0.07)。 結(jié)論：本部分研究結(jié)果進(jìn)一步表明人群暴露飲用水THMs可能與降低的精子總數(shù)和精子密度有關(guān),同時(shí)也可能與降低的睪酮有關(guān)。 第三部分尿液中TCAA水平與男性精液質(zhì)量之間的關(guān)系研究 目的：采用尿液中三氯乙酸(trichloroacetic acid, TCAA)水平作為內(nèi)暴露生物標(biāo)志物,探討飲用水消毒副產(chǎn)物(disinfection by-products, DBPs)暴露與男性精液質(zhì)量之間的關(guān)系。 方法：本部分我們開展了一項(xiàng)大規(guī)模橫斷面研究,以來武漢市某綜合醫(yī)院生殖醫(yī)學(xué)中心尋求精液分析的2009名育齡期男性為研究對象,采用氣相色譜法檢測尿液中TCAA濃度評估個(gè)體經(jīng)飲用水暴露DBPs的水平,采用多變量logistic回歸和多變量線性回歸分析尿TCAA水平與精液質(zhì)量之間的關(guān)系。 結(jié)果：多變量logistic回歸分析結(jié)果顯示與第一份位數(shù)尿TCAA水平相比,第二和第四分位數(shù)尿TCAA水平使低于精子密度正常參考值風(fēng)險(xiǎn)增加(OR=1.79,95%CI:1.19,2.69和OR=1.51,95%CI:0.98,2.31);第二和第三分位數(shù)尿TCAA水平使低于精子活力正常參考值風(fēng)險(xiǎn)增加(OR=1.46,95%CI:1.12,1.90和OR=1.30,95%CI:1.00,1.70)；第二分位數(shù)尿TCAA水平使低于精子總數(shù)正常參考值風(fēng)險(xiǎn)增加(OR=1.62,95%CI：1.04,2.55)。多變量線性回歸分析顯示了相似的結(jié)果。 結(jié)論：本部分研究結(jié)果表明人群經(jīng)飲水途徑暴露DBPs可能與降低的精子密度、精子總數(shù)和精子活力有關(guān)。
[Abstract]:Study on the relationship between the exposure of water THMs in the first part and the quality of semen

Objective : To investigate the relationship between water THMs exposure and semen quality of men by using trihalomethanes ( THMs ) concentrations monitored in pipe network water as external exposure markers .

Methods : A prospective cohort study was conducted to investigate the temporal and spatial distribution of four THMs in water in a large water plant , including the time and spatial distribution of four THMs , bromomethane ( BDCM ) , bromomethane ( DBCM ) , bromoform ( BDCM ) , monochlorodibromide ( DBCM ) and bromoform ( TBM ) in the area of a large water plant .

Results : The results of multivariate linear regression showed that TTHMs , TCM and Br - THMs ingested by oral intake and decreased sperm density ( P for trend were 0 . 01 , 0 . 03 and 0 . 05 ) and sperm count ( P for trend were 0 . 02 , 0 . 05 and 0 . 09 respectively ) and sperm count ( P for trend , 0 . 02 , 0 . 05 and 0 . 09 ) .

Conclusion : The results of this study indicate that THMs exposed to drinking water by oral route may be related to decreased sperm density and total sperm count .

Study on the relationship between the blood THMs of the second part and the semen quality and testosterone in men

Objective : To study the relationship between THMs exposure and semen quality and testosterone in drinking water .

Methods : A cross - sectional study was conducted to investigate the relationship between THMs and semen quality and testosterone in the blood samples collected in the morning by using solid - phase micro - extraction - gas chromatography to assess the exposure level of four THMs in blood samples collected in the morning .

Results : The results of multivariate linear regression analysis showed that there was a significant negative correlation between BDCM ( 尾 = - 0.13million , 95 % CI : - 0.22 , - 0.03 ) .
There was also a significant negative correlation between the second quartile blood DBCM and sperm linearity ( 尾 = - 4.74 % , 95 % CI : -807 , - 1.42 ) compared to the first quartile of blood DBCM , while there was a suggested dose - response relationship between TCM and TTHMs and decreased sperm density ( both P for trend = 0.07 ) . In addition , the study showed a suggested dose - response relationship between blood DBCM and decreased serum total testosterone ( P for trend = 0.07 ) .

Conclusion : The results of this study further suggest that the population exposed to drinking water THMs may be related to decreased sperm count and sperm density , and may also be associated with reduced testosterone .

Study on the relationship between TCAA level and semen quality in the third part of urine

Objective : To investigate the relationship between disinfection by - products ( DBPs ) exposure and semen quality in drinking water by using the level of trichloroacetic acid ( TCAA ) in urine as internal exposure biomarker .

Methods : A large - scale cross - sectional study was conducted in this part . In 2009 , we studied the relationship between urinary TCAA and semen quality by using multi - variable logistic regression and multivariate linear regression .

Results : The results of multivariate logistic regression analysis showed that compared with the first digit urine TCAA level , the second and fourth quartile urinary TCAA levels increased significantly below the normal reference value of sperm density ( OR = 1.79 , 95 % CI : 1.19 , 2.69 and OR = 1.51 , 95 % CI : 0.98 , 2.31 ) ; the second and third quartile urinary TCAA levels increased significantly below the normal reference value of sperm motility ( OR = 1.46 , 95 % CI : 1.12 , 1.90 and OR = 1.30 , 95 % CI : 1.00 , 1.70 ) ;
The second - digit urine TCAA level increased the risk of normal reference values below the total number of sperm ( OR = 1 . 62 , 95 % CI : 1.04 , 2.55 ) . Multivariate linear regression analysis showed similar results .

Conclusion : The results of this study suggest that exposure of DBPs to the population via drinking water pathway may be related to decreased sperm density , total sperm count and sperm motility .

【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R339.21;R123.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

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2 黃莉萍;李亞斐;熊鴻燕;曹佳;;近25年中國正常男性精液質(zhì)量的變化趨勢分析[J];生殖與避孕;2011年02期

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本文編號(hào)：1783734