本文選題：電子垃圾拆解區(qū) + 生殖能力　； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:近年來,國內(nèi)外許多研究表明男性精液質(zhì)量越來越差,并且下降的速度越來越快。至于導(dǎo)致男性精液質(zhì)量下降的原因,可能與以下幾方面因素有關(guān):(1)內(nèi)在因素,包括遺傳因素和解剖生理因素等;(2)外在因素,包括環(huán)境因素等。其中環(huán)境因素對精液質(zhì)量的影響得到越來越多的重視,包括氣溫、空氣、接觸性物質(zhì)等,有研究表明空氣污染可以影響男性生殖健康,接觸性環(huán)境化學(xué)藥物毒物對男性生殖健康的影響非常大。特別是在過去的30年中中國的工業(yè)迅速發(fā)展,環(huán)境污染也日益嚴(yán)重,其中電子與電器設(shè)備在日常生活中的廣泛應(yīng)用,以及產(chǎn)品更新?lián)Q代速度的加快,大量報(bào)廢的電子電器設(shè)備或稱為電子垃圾在世界范圍內(nèi)急劇增長。在處理這些電子垃圾過程中所產(chǎn)生的種類繁多的有毒有害物質(zhì)(如重金屬及其他化學(xué)物質(zhì)),可能對環(huán)境和人類生活造成巨大的威脅。廣東貴嶼鎮(zhèn)是“世界電子垃圾終點(diǎn)站”之一,有著二十多年的作坊式電子垃圾拆解歷史。長期不當(dāng)?shù)碾娮永幚矸绞?給當(dāng)?shù)氐沫h(huán)境造成了嚴(yán)重的污染,其中,以重金屬和持久性有毒物質(zhì)(如多環(huán)芳烴和多溴聯(lián)苯醚等)的污染最為突出。但迄今為止,關(guān)于電子垃圾回收拆解區(qū)男性居民生殖能力情況相關(guān)研究還鮮見報(bào)道。目的:通過比較電子垃圾拆解區(qū)和非電子垃圾拆解區(qū)男性居民生殖能力情況,闡明電子垃圾拆解區(qū)環(huán)境污染對男性生殖能力的影響。方法:選擇2013年-2016年于潮陽區(qū)各醫(yī)院生殖科(不孕不育中排除男方因素)、泌尿外科的患者為研究對象,以在貴嶼電子垃圾拆解區(qū)居住的男性患者為暴露組,匹配非電子垃圾拆解區(qū)男性患者為對照組。分析這兩組患者研究對象的精液常規(guī),睪酮水平,應(yīng)用偉力彩色精子質(zhì)量分析系統(tǒng)分析精子活力、直線運(yùn)動(dòng)速度(VSL)、曲線運(yùn)動(dòng)速度(VCL)、平均路徑速度(VAP)、平均移動(dòng)角度(MAD)、側(cè)擺幅度(ALH)、鞭打頻率(BCF)、前向性(STR)、直線性(LIN)和擺動(dòng)性(WOB)等參數(shù)。為進(jìn)一步闡明垃圾拆解區(qū)影響男性生殖健康的影響因素,我們將檢測精液中鉛、鎘、鉻及鎳的水平,探索他們與研究對象生殖狀況的關(guān)系。結(jié)果:比較兩組研究對象的的精液常規(guī)指標(biāo),結(jié)果顯示暴露組的精子密度下降,但差異不顯著,但是暴露組的精子活動(dòng)率明顯下降,差異具有統(tǒng)計(jì)學(xué)意(P0.05)。比較兩組患者精子運(yùn)動(dòng)參數(shù)的變化,結(jié)果顯示暴露組精子運(yùn)動(dòng)能力的精子曲線運(yùn)動(dòng)度、精子直線運(yùn)動(dòng)速度、精子平均路徑運(yùn)動(dòng)速度、以及精子運(yùn)動(dòng)直線性比例等指標(biāo)均顯著下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。比較兩組研究對象血清中的激素水平,結(jié)果顯示兩組研究對象的卵泡刺激素、黃體生成素及泌乳素均無顯著變化,而暴露組的睪酮水平明顯下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。分別檢測兩組患者精液中鉛(Pb)、鎘(Cd)、鉻(Cr)及鎳(N)的水平,結(jié)果顯示對照組和暴露組的水平分別為(108.6±20.4)與(48.9±12.7)、(2.5±0.9)與(3.2±1.1)、(25.1±8.0)與(26.8±8.1)、(8.9±2.0)與(9.2±3.1)。其中,暴露組中Pb、Cd水平明顯高于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。進(jìn)一步比探索精液中鉛、鎘水平與暴露組生殖健康的相關(guān)性,結(jié)果顯示Pb與暴露組的精子活動(dòng)率及暴露年限密切相關(guān),差異具有統(tǒng)計(jì)學(xué)意義(P0.05);Cd與暴露組的精子活動(dòng)率、直線速(μm/s)、路徑速(μμm/s)、暴露年限密切相關(guān),差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。探索鎘離子(CdCl)在(10、50、100、500、1000umol/L)不同濃度下對健康志愿者精子活動(dòng)率的影響,結(jié)果顯示鎘離子濃度與精子活動(dòng)率之間呈負(fù)相關(guān),隨著鎘離子濃度增加,精子活動(dòng)率明顯下降,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:暴露組的的精子活動(dòng)率、精子曲線運(yùn)動(dòng)度、精子直線運(yùn)動(dòng)速度、精子平均路徑運(yùn)動(dòng)速度、以及精子運(yùn)動(dòng)直線性比例等指標(biāo)均顯著下降,暴露組的睪酮水平明顯下降。暴露組中Pb、Cd水平明顯高于對照組,進(jìn)一步探索發(fā)現(xiàn)精液中鎘水平與暴露組生殖健康密切相關(guān),體外實(shí)驗(yàn)進(jìn)一步證明Cd會(huì)影響精子活動(dòng)率。
[Abstract]:Background: in recent years, many studies at home and abroad have shown that the quality of male semen is getting worse and worse, and the decline is getting faster and faster. As to the cause of the quality decline of male semen, the following factors may be related to the following factors: (1) internal factors, including genetic and anatomical factors, and (2) external factors, including environmental factors. More and more attention has been paid to the effect of boundary factors on the quality of semen, including air temperature, air, contact material and so on. Some studies have shown that air pollution can affect male reproductive health. The effects of contact environmental chemical drugs on male reproductive health are very great. Especially in the past 30 years, China's industry has developed rapidly and environmental pollution. Dyeing is becoming more and more serious, in which electronic and electrical equipment are widely used in daily life, and the speed of product renewal is accelerated. A large number of discarded electronic and electrical equipment, or electronic waste, are growing rapidly in the world. And other chemicals) may pose a huge threat to the environment and human life. Guangdong Guiyu town is one of the "world's electronic waste terminal stations", which has a history of more than 20 years of workshop type electronic garbage dismantling. Long term improper disposal of electronic waste has caused serious pollution to the local environment, in which heavy metals and persistence are used. The pollution of sexual toxic substances, such as polycyclic aromatic hydrocarbons and polybrominated diphenyl ethers, is the most prominent. But so far, there are few reports about the reproductive capacity of male residents in the electronic garbage collection and disassembly area. Objective: to clarify the electronic waste by comparing the reproductive capacity of male residents in the dismantling area and non Electronic Refuse dismantling area. The effect of environmental pollution in dismantling area on male reproductive ability. Methods: in the Chaoyang District of Chaoyang in 2013, the reproductive Department of each hospital was excluded from the male factors in infertility. The patients in the Department of urology were selected as the research object. The male patients who lived in the dismantling area of Guiyu electronic garbage dismantling were the exposed group, and the male patients were matched with the non electronic garbage dismantling area. Group. Analysis of the semen routine, testosterone level of the two groups of patients and the analysis of sperm motility, linear velocity (VSL), curvilinear velocity (VCL), average path velocity (VAP), average movement angle (MAD), lateral pendulum amplitude (ALH), whiplash frequency (BCF), STR, straightness (LIN) and pendulum. WOB and other parameters. In order to further clarify the factors affecting male reproductive health in the dismantling area, we will examine the levels of lead, cadmium, chromium and nickel in the semen and explore their relationship with the reproductive status of the subjects. Results: the sperm density of the two groups of subjects was compared, and the results showed that the sperm density decreased in the exposed group, but the result was poor. The sperm motility of the exposed group was significantly decreased, but the difference was statistically significant (P0.05). The changes of sperm motility parameters in the two groups were compared. The results showed that the motility of sperm motility in the exposed group, the speed of sperm line movement, the average path velocity of sperm, and the linear ratio of sperm motility were the indicators of the sperm motility in the exposed group. The difference was statistically significant (P0.05). The serum levels of hormone in the two groups were compared. The results showed that there were no significant changes in the follicle stimulating hormone, luteinizing hormone and prolactin in the two groups, but the level of testosterone in the exposed group was significantly decreased, and the difference was statistically significant (P0.05). Two groups of patients were detected respectively. The level of lead (Pb), cadmium (Cd), chromium (Cr) and nickel (N) in the liquid showed that the level of the control group and the exposed group were (108.6 + 20.4) and (48.9 + 12.7), (2.5 + 0.9) and (3.2 + 1.1), (25.1 + 8) and (26.8 + 8.1), and (8.9 + 48.9) and (8.9 +). The level of Pb and Cd in the exposed group was significantly higher than that in the control group, and the difference was statistically significant (P0.05). The correlation between the levels of lead and cadmium in the semen and the reproductive health of the exposed group showed that Pb was closely related to the sperm activity rate and exposure years in the exposed group, and the difference was statistically significant (P0.05); the sperm activity rate of Cd and the exposed group, the linear speed (Mu m/s), the path speed (mu m/s), and the exposure years were closely related, and the difference was statistically significant (P0 .05). Explore the effect of cadmium ion (CdCl) on the sperm activity rate of healthy volunteers at different concentrations (10,501005001000umol/L). The results showed that the concentration of cadmium ions was negatively correlated with the sperm motility, and the sperm activity rate decreased with the increase of cadmium ion concentration, and the difference was statistically significant (P0.05). Conclusion: the sperm activity of the exposed group The rate of motility, the motility of sperm curve, the speed of sperm line movement, the average speed of sperm path movement, and the linear proportion of sperm motility decreased significantly, and the level of testosterone in the exposed group decreased obviously. The level of Pb and Cd in the exposed group was significantly higher than that of the control group. Guan, in vitro experiments further proved that Cd could affect sperm motility.

【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R114

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