Sidhu R S, Hallak J, Sharma R K, Thomas A J, Agarwal A
Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
J Assist Reprod Genet. 1998 Apr;15(4):188-92. doi: 10.1023/a:1023096201880.
The creatine kinase level indicates sperm maturity and correlates with the spermatozoal fertilizing potential. The relationship between creatine kinase levels in subfertile men and their clinical diagnosis was examined.
Patients with unexplained infertility (n = 34), varicocele (n = 20), postvasectomy reversal (n = 7), or cancer (n = 22) were included in this prospective clinical study. The control group consisted of healthy normal donors (n = 15).
The median and interquartile range values of creatine kinase for each group were as follows: normal donors, 0.061 U/10(8) sperm (0.056 to 0.076 U/10(8) sperm); idiopathic male factor, 0.119 U/10(8) sperm (0.061 to 0.190 U/10(8) sperm); varicocele, 0.392 U/10(8) sperm (0.209 to 1.494 U/10(8) sperm); postvasectomy reversal, 0.589 U/10(8) sperm (0.425 to 4.043 U/10(8) sperm); and cancer, 0.068 U/10(8) sperm (0.047 to 0.168 U/10(8) sperm). Sperm creatine kinase levels were significantly higher in patients with varicocele compared to normal donors (P = 0.0001), cancer patients (P = 0.0002), and men with idiopathic infertility (P = 0.0009). Sperm concentration and creatine kinase level were inversely correlated in patients (r = -0.7, P < 0.001) but not in normal donors.
Semen quality is poorer in subfertile patients with clinical varicocele and postvasectomy reversal than in cancer patients and patients with idiopathic male infertility. That the creatine kinase levels in cancer patients were similar to those of normal donors suggests that the final phase of spermatogenesis may not be altered in men with cancer; thus semen from these patients should be banked to ensure fertility after cancer treatment.
肌酸激酶水平可反映精子成熟度，并与精子的受精潜力相关。本研究旨在探讨不育男性肌酸激酶水平与其临床诊断之间的关系。
本前瞻性临床研究纳入了不明原因不孕症患者（n = 34）、精索静脉曲张患者（n = 20）、输精管复通术后患者（n = 7）或癌症患者（n = 22）。对照组由健康正常供者（n = 15）组成。
各组肌酸激酶的中位数和四分位数间距值如下：正常供者，0.061 U/10⁸精子（0.056至0.076 U/10⁸精子）；特发性男性因素，0.119 U/10⁸精子（0.061至0.190 U/10⁸精子）；精索静脉曲张，0.392 U/10⁸精子（0.209至1.494 U/10⁸精子）；输精管复通术后，0.589 U/10⁸精子（0.425至4.043 U/10⁸精子）；癌症患者，0.068 U/10⁸精子（0.047至0.168 U/10⁸精子）。与正常供者（P = 0.0001）、癌症患者（P = 0.0002）和特发性不育男性（P = 0.0009）相比，精索静脉曲张患者的精子肌酸激酶水平显著更高。患者的精子浓度与肌酸激酶水平呈负相关（r = -0.7，P < 0.001），但正常供者中无此相关性。
临床精索静脉曲张和输精管复通术后的不育患者精液质量比癌症患者和特发性男性不育患者差。癌症患者的肌酸激酶水平与正常供者相似，这表明癌症男性的精子发生终末阶段可能未改变；因此，这些患者的精液应予以保存，以确保癌症治疗后的生育能力。
