The Clinical Significance Of Seminal Plasma Elastase In Male Infertility

Objective: In recent years,with the change of social environment,ratio of male infertility,the life factors showed a clear upward trend,according to WHO(World Health Organization,WHO)survey,about 15% of couples of childbearing age are fertility problems,which causes more than 20% infertility is caused by male factors alone,the rest are 30%-40% and male factors,therefore become imminent.Elastase is a kind of enzyme which can hydrolyze elastin,which is distributed in many kinds of tissues and cells,such as neutrophils and macrophages.The semen distribution,using enzyme-linked immunosorbent assay for batch detection,the difference is small,accuracy and repeatability are high,so it is suitable for clinical detection of semen,elastase can be used to evaluate the reproductive system inflammation,has important clinical significance for the diagnosis of male infertility.Other studies have shown through the detection of seminal plasma elastase,different values can reflect the patients with genital tract infection or dominant recessive infection,can provide more accurate basis for the correct treatment of patients.Through the analysis of Dalian MunicipalWomen and Children's Medical Center from September 2015 to March 2016 in semen samples from 508 cases of male patients,compared the relationship between seminal plasma elastase concentration and semen parameters,the content of semen white blood cells and semen mycoplasma culture,to explore the clinical significance of seminal plasma elastase in male infertility.Method:(1)Collected from September 2015 to March 2016 in Dalian MunicipalWomen and Children's Medical Center,male patients with 508 cases of semen samples,finishing the relevant clinical data.(2)Analysis of semen routine parameters by using MX7 and the dynamic and static state image detection system.(3)The content of leukocytes in semen was determined by peroxidase staining.(4)The method of liquid culture was used to detect mycoplasma.(4)Using enzyme-linked immunosorbent assay for detection of seminal plasma elastase concentration.(5)To 508 samples according to the standard of WHO is divided into male group and normal group,analysis of the parameters of the relationship between the two groups;in the seminal plasma elastase concentration of 600 ng/ml as the cut-off point,analysis of whether there is a correlation between the parameters and the elastase concentration in seminal plasma.Results:(1)The parameters of infertile semen routine in the forward motion ratio,pH,sperm density,sperm motility,the average velocity(VCL),average path velocity(VAP),(BCF),averagewhip frequency moving average angle(MAD)and linear movement sperm densitycompared with the normal group was statistically significant(P < 0.05),and decreasedsignificantly;activity ratio,average perimeter,mean sway amplitude(ALH)and linearmotion(LIN%),(WOB%)and the movement of moving forward(STR%)compared withthe normal group was statistically significant(P < 0.05),and significantly increased;age,semen volume,non prorsad percentage,average linear velocity(VSL),average size,average perimeter,linear movement sperm motility was not statistically significant(P >0.05).(2)Infertility group seminal plasma neutrophil content is 1.4±2.35 * 106/ml,normal groupneutrophil content is 0.61±0.66 * 106/ml,the comparison was statistically significant(P< 0.05),the former was significantly higher than that of the latter.(3)The positive rate of mycoplasma culture in sterile group was 35%,and that of normalgroup was 8.15%,which was statistically significant(P < 0.05),The former is obviouslyhigher than the latter.(4)The concentration of seminal plasma elastase infertility group was 1152.7 + 1159.28ng/ml,the normal group is550.91 + 854.5 ng/ml,compared with the two,there wasstatistical significance(P < 0.05),the former was significantly higher than that of thelatter.(5)Seminal plasma elastase concentration in abnormal group compared with the normalgroup,age,activity ratio,average sway amplitude(ALH)was statistically significant(P <0.05),the former is higher than the latter;prorsad percentage,sperm motility,the averagevelocity(VCL),average path velocity(VAP),the average switching frequency(BCF),moving average angle(MAD)and linear motion(LIN%),the movement of swing(WOB%)was statistically significant(P < 0.05),the former is lower than the latter;PH,sperm density,non prorsad percentage,average linear velocity(VSL),semen volume,average diameter and average perimeter linear movement,linear movement sperm density,sperm movement forward(STR%)had no statistical significance(P > 0.05).(6)Neutrophil elastase concentration in seminal plasma in abnormal group is 1.58±2.29 *106/ml,the normal group is 0.49±0.36 * 106/ml,compared with the two,there wasstatistical significance(P < 0.05),the former was significantly higher than that of thelatter.(7)The positive rate of seminal plasma elastase concentration anomaly group Mycoplasmawas 24.1%,11.7% in normal group,the comparison has statistical significance(P < 0.05),the former was significantly higher than that of the latter.Conclusion:(1)The routine parameters of semen in infertile group were significantly different fromthose in normal group.(2)The seminal plasma leukocyte content,mycoplasma culture positive rate and seminalelastase concentration in infertile group were significantly higher than those in normalgroup.(3)There were significant differences in semen routine parameters between the abnormalgroup and the normal group.(4)The leukocyte content and Mycoplasma positive rate in the abnormal group of abnormalelastase concentration were significantly higher than those in normal group(5)The concentration of seminal plasma elastase can be used as the evaluation index of themale reproductive system infection,has important clinical significance in the diagnosisand treatment of the male infertility and fertility evaluation and semen function.