少弱精子症患者精液常规参数与精子形态特点的分析研究
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摘要
目的研究少、弱及少弱精子症患者精液常规参数与精子形态特点,评价精液质量。方法以2017年7月-2018年4月在新疆医科大学第一附属医院产前诊断中心就诊的411例男性为研究对象,采用WLJY-9000型彩色精子质量检测系统检测精液常规参数,包括前向运动精子率、精子密度、外观、精液体积、黏稠度、pH值、精子存活率以及精子形态,根据《WHO人类精液检查与处理实验室手册》(第5版)判断标准分为正常组(n=106例)、少精子症组(n=105例)、弱精子症组(n=150例)、少弱精子症组(n=50例)。结果 (1)与正常组比较,少精子症组、弱精子症组和少弱精子症组的前向运动精子率降低、精子密度减少,差异有统计学意义(P<0.05);与少精子症组比较,弱精子症和少弱精子症的前向运动精子率、前向+非前向运动精子率降低,弱精子症的精子总数、精子密度升高,差异有统计学意义(P<0.05);与弱精子症比较,少弱精子症的前向+非前向运动精子率、精子总数、精子密度降低,差异有统计学意义(P<0.05)。(2)与正常组比较,弱精子症组、少弱精子症组精液外观以乳白色为主,差异有统计学意义(P<0.05);与正常组比较,少精子症组、弱精子症组和少弱精子症组的精液体积、不液化出现率增加,精子存活率降低,差异有统计学意义(P<0.05);各组间比较,精液黏稠度、pH值,差异无统计学意义(P>0.05);与少精子症组比较,弱精子症组和少弱精子症组的精子存活率降低,差异有统计学意义(P<0.05);与弱精子症组比较,少弱精子症组的精子存活率降低,差异有统计学意义(P<0.05)。(3)与正常组比较,少精子症组、弱精子症组和少弱精子症组的精子平均大小、平均周长、正常个数、尾部畸形个数减小,精子畸形个数、精子头部畸形个数、体部畸形个数和混合畸形个数增加,差异有统计学意义(P<0.05);与少精子症组比较,少弱精子症组的正常个数、尾部畸形个数减少,头部畸形、体部畸形个数增加,差异有统计学意义(P<0.05)。结论精液外观、不液化、精液体积、精子存活率、精子形态畸形与少精子症、弱精子症及少弱精子症的形成与发展密切相关,精液常规参数检测可以衡量精液质量,指导临床诊断及治疗。
Objective To explore the changes of semen parameters and sperm morphology in oligozoospermia, asthenozoospermia and oligoasthenozoospermia, and to evaluate semen quality. Methods A total of 411 male patients who visited the Center of Prenatal Diagnosis of the First Affiliated Hospital of Xinjiang Medical University from July 2017 to April 2018 were studied. The sperm routine parameters, including forward motile sperm rate, sperm density, appearance, semen volume, viscosity, pH value, sperm survival rate and sperm morphology were measured by WLJY-9000 color sperm quality detection system. Based on Laboratory Manual for Examination and Treatment(5 th edition), they were divided into normal group(n=106 cases), oligozoospermia group(n=105 cases), asthenozoospermia group(n=150 cases), oligoasthenozoospermia group(n=50 cases). Results(1) Compared with the normal group, the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group had lower forward motility sperm rate and lower sperm density(P<0.05). Compared with the oligozoospermia group, the forward motile sperm rate, forward and non-forward motile sperm rate of the asthenozoospermia group and oligoasthenozoospermia group decreased, while the total sperm number and sperm density of the asthenozoospermia group increased with statistical significance(P<0.05). Compared with the asthenozoospermia group, the forward and non-forward motile sperm rate, total sperm number and sperm density of the oligoasthenozoospermia group decreased with statistical significance(P<0.05).(2) Compared with the normal group, the sperm appearance of the asthenozoospermia group and oligoasthenozoospermia group were mainly milky white, with statistical significance(P<0.05); compared with the normal group, the semen volume of the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group increased, the rate of non-liquefaction increased, and the sperm survival rate decreased, with statistical significance(P<0.05); There were no statistical differences between the groups(P>0.05). Compared with the oligozoospermia group, the sperm survival rate of the asthenozoospermia group and oligoasthenozoospermia group decreased with statistical significance(P<0.05); compared with the asthenozoospermia group, the sperm survival rate of the oligoasthenozoospermia group decreased with statistical significance(P<0.05).(3) Compared with the normal group, the average sperm size, average perimeter, normal number and number of tail abnormalities in the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group decreased, while the number of sperm abnormalities, head abnormalities, body abnormalities and mixed abnormalities increased, and the differences were statistically significant(P<0.05). Compared with the oligozoospermia group, the number of normal and tail abnormalities of the oligoasthenozoospermia group decreased, while the number of head and body abnormalities increased(P<0.05). Conclusion Semen appearance, non-liquefaction, semen volume, sperm survival rate and morphological abnormalities are closely related to the formation and development of oligozoospermia, asthenozoospermia and oligoasthenozoospermia. Detection of semen routine parameters can evaluate semen quality and guide clinical diagnosis and treatment.
Objective To explore the changes of semen parameters and sperm morphology in oligozoospermia, asthenozoospermia and oligoasthenozoospermia, and to evaluate semen quality. Methods A total of 411 male patients who visited the Center of Prenatal Diagnosis of the First Affiliated Hospital of Xinjiang Medical University from July 2017 to April 2018 were studied. The sperm routine parameters, including forward motile sperm rate, sperm density, appearance, semen volume, viscosity, pH value, sperm survival rate and sperm morphology were measured by WLJY-9000 color sperm quality detection system. Based on Laboratory Manual for Examination and Treatment(5 th edition), they were divided into normal group(n=106 cases), oligozoospermia group(n=105 cases), asthenozoospermia group(n=150 cases), oligoasthenozoospermia group(n=50 cases). Results(1) Compared with the normal group, the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group had lower forward motility sperm rate and lower sperm density(P<0.05). Compared with the oligozoospermia group, the forward motile sperm rate, forward and non-forward motile sperm rate of the asthenozoospermia group and oligoasthenozoospermia group decreased, while the total sperm number and sperm density of the asthenozoospermia group increased with statistical significance(P<0.05). Compared with the asthenozoospermia group, the forward and non-forward motile sperm rate, total sperm number and sperm density of the oligoasthenozoospermia group decreased with statistical significance(P<0.05).(2) Compared with the normal group, the sperm appearance of the asthenozoospermia group and oligoasthenozoospermia group were mainly milky white, with statistical significance(P<0.05); compared with the normal group, the semen volume of the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group increased, the rate of non-liquefaction increased, and the sperm survival rate decreased, with statistical significance(P<0.05); There were no statistical differences between the groups(P>0.05). Compared with the oligozoospermia group, the sperm survival rate of the asthenozoospermia group and oligoasthenozoospermia group decreased with statistical significance(P<0.05); compared with the asthenozoospermia group, the sperm survival rate of the oligoasthenozoospermia group decreased with statistical significance(P<0.05).(3) Compared with the normal group, the average sperm size, average perimeter, normal number and number of tail abnormalities in the oligozoospermia group, asthenozoospermia group and oligoasthenozoospermia group decreased, while the number of sperm abnormalities, head abnormalities, body abnormalities and mixed abnormalities increased, and the differences were statistically significant(P<0.05). Compared with the oligozoospermia group, the number of normal and tail abnormalities of the oligoasthenozoospermia group decreased, while the number of head and body abnormalities increased(P<0.05). Conclusion Semen appearance, non-liquefaction, semen volume, sperm survival rate and morphological abnormalities are closely related to the formation and development of oligozoospermia, asthenozoospermia and oligoasthenozoospermia. Detection of semen routine parameters can evaluate semen quality and guide clinical diagnosis and treatment.
引文
[1] 世界卫生组织.人类精液检查与处理实验室手册[M].5版.北京:人民卫生出版社,2011:17-20.
[2] CAMARGO M,INTASQUI P,CAMILA B D L,et al.MALDI‐TOF Fingerprinting of seminal plasma lipids in the study of human male infertility[J].Lipids,2014,49(9):943-956.
[3] 赵俊红.男性不育患者精液分析[J].医学信息,2015,28(31):185-188.
[4] 杜金明.126例男性无精症、少精症相关诱发因素分析[J].黑龙江医学,2015,39(3):283-286.
[5] WEI L I,ZHU W,TANG Z,et al.Semen quality of 16835 infertile men in China[J].Cent South Univ,2014,39(2):157-160.
[6] 张志杰,陈小均,贾玉森,等.中医对少弱精子症的临床治疗研究进展[J].中国性科学,2015,24(9):71-74.
[7] 朱彤,吴媛媛,陈素华,等.无精子症及少弱精子症2436例患者的细胞遗传学病因分析[J].现代妇产科进展,2017,26(6):422-425.
[8] 孙宝刚,管福来,曹井贺,等.特发性少、弱精子症患者精液质量指标及辅助生殖妊娠结局相关性研究[J].中国男科学杂志,2018,32(2):36-40.
[9] 王起来,谭岩,马寅芙,等.人工常规精液分析与计算机辅助精液质量分析的相关研究[J].中国实验诊断学,2016,20(12):2083-2084.
[10] CUI D,HAN G,SHANG Y,et al.Antisperm antibodies in infertile men and their effect on semen parameters:A systematic review and meta-analysis[J].Clin Chim Acta,2015,444(2):29-36.
[11] COMAR V A,PETERSEN C G,MAURI A L,et al.Influence of the abstinence period on human sperm quality:analysisof 2,458 semen samples[J].Jbra Assist Reprod,2017,21 (4):306-312.
[12] 刘哲琪.167例男性不育患者精液分析[J].浙江临床医学,2018,20(2):343-346.
[13] GUZICK D S,OVERSTREET J W,FACTORLITVAK P,et al.Sperm morphology,motility,and concentration in fertile and infertile men[J].N Engl Med,2001,345(19):1388-1393.
[14] 刘晓光.精子形态和睾丸容积在生育与不育男性中的变化[J].杭州师范大学学报(自然科学版),2010,9(6):445-447.
[15] 蒋敏,岳焕勋,李福平,等.精液中白细胞异常增高对精液质量的影响及其与男性生育力的相关性[J].成都医学院学报,2018,13(3):291-294.
[2] CAMARGO M,INTASQUI P,CAMILA B D L,et al.MALDI‐TOF Fingerprinting of seminal plasma lipids in the study of human male infertility[J].Lipids,2014,49(9):943-956.
[3] 赵俊红.男性不育患者精液分析[J].医学信息,2015,28(31):185-188.
[4] 杜金明.126例男性无精症、少精症相关诱发因素分析[J].黑龙江医学,2015,39(3):283-286.
[5] WEI L I,ZHU W,TANG Z,et al.Semen quality of 16835 infertile men in China[J].Cent South Univ,2014,39(2):157-160.
[6] 张志杰,陈小均,贾玉森,等.中医对少弱精子症的临床治疗研究进展[J].中国性科学,2015,24(9):71-74.
[7] 朱彤,吴媛媛,陈素华,等.无精子症及少弱精子症2436例患者的细胞遗传学病因分析[J].现代妇产科进展,2017,26(6):422-425.
[8] 孙宝刚,管福来,曹井贺,等.特发性少、弱精子症患者精液质量指标及辅助生殖妊娠结局相关性研究[J].中国男科学杂志,2018,32(2):36-40.
[9] 王起来,谭岩,马寅芙,等.人工常规精液分析与计算机辅助精液质量分析的相关研究[J].中国实验诊断学,2016,20(12):2083-2084.
[10] CUI D,HAN G,SHANG Y,et al.Antisperm antibodies in infertile men and their effect on semen parameters:A systematic review and meta-analysis[J].Clin Chim Acta,2015,444(2):29-36.
[11] COMAR V A,PETERSEN C G,MAURI A L,et al.Influence of the abstinence period on human sperm quality:analysisof 2,458 semen samples[J].Jbra Assist Reprod,2017,21 (4):306-312.
[12] 刘哲琪.167例男性不育患者精液分析[J].浙江临床医学,2018,20(2):343-346.
[13] GUZICK D S,OVERSTREET J W,FACTORLITVAK P,et al.Sperm morphology,motility,and concentration in fertile and infertile men[J].N Engl Med,2001,345(19):1388-1393.
[14] 刘晓光.精子形态和睾丸容积在生育与不育男性中的变化[J].杭州师范大学学报(自然科学版),2010,9(6):445-447.
[15] 蒋敏,岳焕勋,李福平,等.精液中白细胞异常增高对精液质量的影响及其与男性生育力的相关性[J].成都医学院学报,2018,13(3):291-294.
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