精索静脉曲张对精子染色质结构及运动能力的影响

Influence of Varicocele on Sperm Chromatin Structure and Sperm Motility

目的:探讨精索静脉曲张对精子染色质结构及运动能力的影响。方法:对精索静脉曲张组(无慢性疾病及生殖系统病史者,n=74)和对照组(n=89)进行精子染色质结构分析(SCSA)和精液常规分析(精液量、粘稠度、pH值、精子顶体完整率、精子存活率、畸形率、精子密度、活动率及各运动参数)。结果:精索静脉曲张组精子密度、a+b级精子百分率和精子存活率[分别为(41.4±38.7)×106/ml,(31.7±16.9)%,(62.8±22.2)%]显著低于对照组[分别为(80.9±63.1)×106/ml,(46.8±20.5)%,(77.2±17.5)%],P均<0.05;精子运动参数VCL、VSL、VAP精索静脉曲张组分别为(37.4±12.5)、(23.4±7.8)、(26.5±8.2)μm/s,对照组分别为(42.4±10.7)、(27.3±7.3)、(30.7±7.8)μm/s,精索静脉曲张组与对照组相比显著降低(P均<0.05),而MAD显著增加(P<0.01),SCSACOMPαt值精索静脉曲张组(为23.2±16.2)明显高于对照组(为14.1±11.8)(P<0.05)。结论:精索静脉曲张引起精子DNA损伤和精子运动能力的改变,可能是导致男性不育的主要原因之一。

Objective ： To study the influence of varicocele on sperm chromatin structure and sperm motility. Methods ： Routine semen analysis and sperm chromatin structure assay （SCSA） were performed in a varicocele group （n = 74） and a control group （n = 89）. Results： Sperm concentration （ [41.4 ±38.7] × 10^6/ml） , grade a＋b sperm percentage （ [31.7 ± 16.9]% ） and sperm viability （ [ 62.8 ± 22.2 ] % ） in the varicocele group were evidently lower than those （ [ 80.9 ± 63.1 ] × 10^6/ml, [ 46.8 ± 20.5 ] % , [ 77.2 ± 17.5 ] % ） in the control group （ P 〈 0.05 ）, and so were VCL, VSL and VAP （ [ 37.4 ± 12.5 ] μm/s, [ 23.4 ± 7.8 ] μm/s, [ 26.5 ± 8.2] μm/s） in the varicocele group than those （[42.4 ± 10.7] μm/s, [ 27.3 ±7.3] μm/s, [ 30.7 ± 7.8] μm/s） in the control （ P 〈 0.05 ）. MAD was increased （ P 〈 0.01 ）, and the COMPctt of SCSA （23.2 ± 16.2） was obviously higher in the former than in the latter （ 14.1 ± 11.8） （ P 〈 0.05 ）. Conclusion ： Varicocele causes damage to sperm DNA and changes sperm motility, which may result in male infertility.