摘要目的:探讨精浆弹性蛋白酶（PMNE）与精液质量在男性不育中的临床意义。方法:选取2017年6月至2018年12月在大连市妇女儿童医疗中心就诊的941例患者精液标本。根据世界卫生组织（WHO）第五版标准：白细胞≥ 1 × 10 9/L为阳性组，白细胞< 1 × 10 9/L为阴性组，分析PMNE含量与白细胞的关系；将PMNE含量以600 μg/L为分界点分为炎性反应组及非炎性反应组，分析PMNE含量与精液常规及支原体阳性率的关系；根据WHO标准将标本分为不育组及正常组，分析两组间精液常规参数、PMNE含量及支原体的关系。 结果:阳性组PMNE显著高于阴性组[（1 823.29 ± 557.64） × 10 9/L比（480.60 ± 195.36） × 10 9/L]，PMNE与白细胞呈正相关（ P < 0.05），炎性反应组的精液质量降低，支原体阳性率比非炎性反应组高[（23.7%（71/299）比11.5%（74/642）]（ P < 0.05），不育组的精液质量降低，PMNE和支原体阳性率均比正常组高[（1 230.89 ± 489.09） × 10 9/L比（596.78 ± 159.25） × 10 9/L、34.7%（90/259）比8.1%（55/682）]（ P < 0.05）。 结论:精浆PMNE含量与白细胞有很好的相关性，可作为评价男性生殖系统感染的指标；精浆PMNE含量与精液质量关系密切，在诊断男性不育中有临床价值。

abstractsObjective:To investigate the clinical significance of seminal plasma polymorphonuclear neutrophil elastase(PMNE) concentration and semen quality in male infertility.Methods:Semen samples of 941 patients admitted to the andrology department from June 2017 to December 2018 in Dalian Municipal Women and Children′s Medical Center were selected. According to the World Health Organization (WHO) fifth edition standards, the positive group had a leukocyte content ≥ 1 × 10 9/L, and the negative group had a leukocyte content < 1 × 10 9/L; the samples were divided into the inflammatory group and the non-inflammatory group with the PMNE concentration of 600 μg/L as the cut-off point, and the relationship between the PMNE, semen parameters and mycoplasma positive rate was analyzed; the samples were divided into sterile group and normal group according to WHO standard, and the relationships among semen routine parameters, PMNE concentration and mycoplasma positive rate were analyzed. Results:PMNE in the positive group was significantly higher than that in the negative group [(1823.29 ± 557.64) × 10 9/L vs. (480.60 ± 195.36) × 10 9/L], and PMNE concentration was positively correlated with leukocyte content ( P<0.05); the semen quality of the inflammatory group decreased, and the positive rate of mycoplasma was higher than that of the non-inflammatory group [(23.7%(71/299) vs. 11.5%(74/642)] ( P<0.05). The semen quality of the sterile group decreased, and the PMNE and mycoplasma positive rate were both higher than that in the normal group [(1 230.89 ± 489.09) × 10 9/L) vs. (596.78 ± 159.25) × 10 9/L, 34.7%(90/259) vs. 8.1%(55/682)]( P<0.05). Conclusions:There is a good correlation between the concentration of PMNE and the leukocyte content, which can be used as an index to evaluate the male reproductive system infection. The concentration of PMNE is closely related to semen quality, which has clinical value in the diagnosis of male infertility.