中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
15期
2806-2810
,共5页
仕治达%张美华%王磊光%陈峰%刘华强%邱毅
仕治達%張美華%王磊光%陳峰%劉華彊%邱毅
사치체%장미화%왕뢰광%진봉%류화강%구의
精子发生%一氧化氮%DNA碎片裂%避孕%睾丸热压
精子髮生%一氧化氮%DNA碎片裂%避孕%睪汍熱壓
정자발생%일양화담%DNA쇄편렬%피잉%고환열압
Spermatogenesis%Nitric oxide%DNA fragmentation%Contraception%Scrotal heat stress
目的：观察成年生育男性阴囊在局部热压后血清生殖激素水平、精液参数、一氧化氮（NO）及精子DNA完整性的改变。方法23例已育成年健康男性志愿者阴囊外部放置恒温加热带（阴囊热压，SHS），热压温度43℃，每周2次，每次50 min，连续3个月。化学发光免疫分析法测定血清生殖内分泌激素T、FSH、LH，硝酸还原法测定精液NO含量，精液常规分析、精子低渗肿胀试验（HOS）及精子染色质扩散试验（SCD）分别在试验开始前和试验后进行。SHS 试验前后进行自身对照。结果 SHS试验1、2及3个月血清T水平、精子密度及存活率比试验前明显下降（P＜0.01），FSH及LH水平、畸形精子、精液NO含量及精子DNA碎片明显增高（P＜0.001）。停止SHS试验3个月后上述各项指标又恢复到试验前水平。精子存活率与精子畸形率呈正相关（r＝0.496，P＝0.016），精液 NO 含量与精子密度呈负相关（r＝-0.497，P＝0.016），与畸形精子比率及精子 DNA 碎片比率呈正相关（r＝0.510，P＝0.013；r＝0.508，P＝0.014）。结论短期恒温睾丸热压能够影响精液质量，抗生育效果明显，SHS停止后可较快恢复。
目的：觀察成年生育男性陰囊在跼部熱壓後血清生殖激素水平、精液參數、一氧化氮（NO）及精子DNA完整性的改變。方法23例已育成年健康男性誌願者陰囊外部放置恆溫加熱帶（陰囊熱壓，SHS），熱壓溫度43℃，每週2次，每次50 min，連續3箇月。化學髮光免疫分析法測定血清生殖內分泌激素T、FSH、LH，硝痠還原法測定精液NO含量，精液常規分析、精子低滲腫脹試驗（HOS）及精子染色質擴散試驗（SCD）分彆在試驗開始前和試驗後進行。SHS 試驗前後進行自身對照。結果 SHS試驗1、2及3箇月血清T水平、精子密度及存活率比試驗前明顯下降（P＜0.01），FSH及LH水平、畸形精子、精液NO含量及精子DNA碎片明顯增高（P＜0.001）。停止SHS試驗3箇月後上述各項指標又恢複到試驗前水平。精子存活率與精子畸形率呈正相關（r＝0.496，P＝0.016），精液 NO 含量與精子密度呈負相關（r＝-0.497，P＝0.016），與畸形精子比率及精子 DNA 碎片比率呈正相關（r＝0.510，P＝0.013；r＝0.508，P＝0.014）。結論短期恆溫睪汍熱壓能夠影響精液質量，抗生育效果明顯，SHS停止後可較快恢複。
목적：관찰성년생육남성음낭재국부열압후혈청생식격소수평、정액삼수、일양화담（NO）급정자DNA완정성적개변。방법23례이육성년건강남성지원자음낭외부방치항온가열대（음낭열압，SHS），열압온도43℃，매주2차，매차50 min，련속3개월。화학발광면역분석법측정혈청생식내분비격소T、FSH、LH，초산환원법측정정액NO함량，정액상규분석、정자저삼종창시험（HOS）급정자염색질확산시험（SCD）분별재시험개시전화시험후진행。SHS 시험전후진행자신대조。결과 SHS시험1、2급3개월혈청T수평、정자밀도급존활솔비시험전명현하강（P＜0.01），FSH급LH수평、기형정자、정액NO함량급정자DNA쇄편명현증고（P＜0.001）。정지SHS시험3개월후상술각항지표우회복도시험전수평。정자존활솔여정자기형솔정정상관（r＝0.496，P＝0.016），정액 NO 함량여정자밀도정부상관（r＝-0.497，P＝0.016），여기형정자비솔급정자 DNA 쇄편비솔정정상관（r＝0.510，P＝0.013；r＝0.508，P＝0.014）。결론단기항온고환열압능구영향정액질량，항생육효과명현，SHS정지후가교쾌회복。
Objective To observe changes in reproductive hormone, semen parameters, seminal nitric oxide (NO) and sperm DNA of adult healthy men after scrotal heat stress (SHS). Methods Exposure of the scrotum of 23 healthy male volunteers (have children) locally at 43℃belt warming 50 min each day for successive 2 d per week. The course of SHS was continuously 3 months. The reproductive hormone level of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (T) in serum was measured by chemiluminescent immunoassay. Routine semen analysis, hypo-osmotic swelling (HOS) test and determination of sperm DNA fragmentation by sperm chromatin dispersion (SCD) test were carried on before, during and after SHS. Seminal NO content was determined by nitrate reduction method. Self-control study was used. Results The mean parameter of sperm density, vitality, and serum T level was significantly decreased, in contrast, the mean abnormal sperm, sperm DNA fragmentation, seminal NO level, and serum FSH and LH was significantly increased for sperm collected during SHS 1, 2 and 3 months vs. pre-SHS (P<0.01-0.001). The SHS was stopped for 3 months, the various parameters restored to the level of before SHS. The significant positive correlation was found between sperm vitality and abnormal sperm (r=0.496, P=0.016), and between seminal NO level and the mean abnormal sperm, sperm DNA fragmentation (r=0.510, P=0.013 and r=0.508, P=0.014). The significant negative correlation was found between sperm density and seminal NO level (r=-0.497, P=0.016). Conclusion The continuously constant SHS can impact the semen quality and serum reproductive hormone of adult men, and the anti-fertility of SHS is excellent.
