2343例男科就诊患者精子动态参数分析

Analysis of sperm mobility parameters in 2343 outpatient semen samples

目的探讨精子动态参数在评价男性生育能力方面的应用价值。方法严格按照WHO技术规范,用计算机辅助精液分析(CASA)系统对本院2 343例男科门诊就诊的患者精液进行常规指标和精子动态参数分析。结果①正常精液组和异常精液组各项精子动态参数比较,均存在统计学差异;②随着精子存活率的下降,曲线速度(VCL)、直线速度(VSL)、平均路径速度(VAP)、平均移动角度(MAD)、侧摆幅度(ALH)、前向性(STR)下降明显,鞭打频率(BCF)呈上升趋势,而直线性(LIN)、摆动性(WOB)差异无显著性;③与密度活力正常组比较:少精组除LIN、STR有所增加,MAD、BCF有所下降,差别有统计学意义外,其余五项参数差别无统计学意义;弱精组除MAD无统计学差异外,其余八项参数均有统计学差异;少弱精组除MAD和ALH无统计学差异外,其余七项参数均有统计学差异。结论精子动态参数是评估精液质量的重要指标,为男性不育的诊断、治疗和研究提供了充分的依据。

Objective To discuss the application of sperm mobility parameters in evaluating the ability of male fertility. Methods The semen samples from 2 343 male outpatients were examinated following the World Health Organization （WHO） guide by CASA, and sperm mobility parameters were also evaluated. Results There were significant difference of all sperm mobility parameters between normal and abnormal semen groups. As spermatozoa vialibity reduced, VCL, VSL, VAP, MAD, ALH and STR decreased while BCF increased significantly. Compared with the group whose spermatozoa density and activity were both normal, LIN and STR reduced while MAD and BCF increased in the small quantity sperm group. All parameters had significant difference except ALH in the lower sperm activity group. And for the group whose spermatozoa density and activity were both abnormal, only MAD and ALH had no significant difference. Conlusion Sperm mobility parameters may serve as key parameters of semen quality analysis and play an important role in evaluating the ability of male fertility, which can provide powerful evidence for the diagnosis and treatment of male infertility.