Gerasun Borys, Kopets Roman, Hrytsko Roman, Gerasun Oleksandr
Danylo Halytskyi Lviv National Medical University, Lviv, Ukraine.
Lviv Regional Reproductive Health Center Lviv, Ukraine.
Cent European J Urol. 2013;66(3):316-9. doi: 10.5173/ceju.2013.03.art16. Epub 2013 Nov 18.
Cryoglobulinemia can be among the causes of sperm bad quality. But conventional examination algorithm for patients with idiopathic oligozoospermia makes no provision for cryoglobulin determination in blood serum.
We examined 55 patients with idiopathic spermatogenesis disorder. Each patient had cryoglobulin determined in blood serum. For this purpose, optical density of the patient's blood serum before and after its 7-day cooling at a temperature of 4°C was compared. Type of cryoglobulins was established by the method evaluation of serum optic density in different periods of cooling incubation (before and after cooling) using the curves of temperature resistance for comparison. Patients with cryoglobulinemia underwent intracutaneous immunization with autoleukocytes separated from heparinized venous blood.
Cryoglobulins were revealed in 16 patients of all 55 examined (29.09%): in six patients' cryoglobulins of second type; in nine - third type and in one patient - cryoglobulins of first type were detected. In a control group, which consisted of 50 men is blood - donors' frequency of cryoglobulinemia was 2%. Pathogenetic connection between cryoglobulinemia and disturbances in sperm quality is also supported by the fact that after autoleukocyte immunization in patients who positively responded to cryoglobulinemia treatment (14 persons of 16 or 87.5%) spermogram was found to be improved. Thus, in 12 patient number of spermatozoa. In all patients progressive motility and precentage of normal forms increased with spermatoza concentration.
It is reasonable to include determination of cryoglobulins in blood serum for patients with idiopathic oligo- and zoospermia.
冷球蛋白血症可能是精子质量差的原因之一。但特发性少精子症患者的传统检查算法未规定检测血清中的冷球蛋白。
我们检查了55例特发性生精障碍患者。每位患者均检测血清冷球蛋白。为此,比较了患者血清在4℃冷却7天前后的光密度。通过评估血清在不同冷却孵育期(冷却前后)的光密度,并使用耐温曲线进行比较,确定冷球蛋白类型。冷球蛋白血症患者用从肝素化静脉血中分离的自身白细胞进行皮内免疫。
在所有55例受检患者中,有16例(29.09%)检测到冷球蛋白:6例为Ⅱ型冷球蛋白;9例为Ⅲ型,1例检测到Ⅰ型冷球蛋白。在由50名男性献血者组成的对照组中,冷球蛋白血症的发生率为2%。冷球蛋白血症与精子质量障碍之间的发病机制联系还得到以下事实的支持:对冷球蛋白血症治疗有阳性反应的患者(16例中的14例,即87.5%)在自身白细胞免疫后,精子图谱得到改善。因此,在12例患者中精子数量增加。在所有患者中,随着精子浓度的增加,进行性运动和正常形态的百分比也增加。
对于特发性少精子症和无精子症患者,检测血清冷球蛋白是合理的。