98%无头精子一例并文献复习

98% Acephalic Sperm——A Case Report and Review of Literature

目的:报道98%无头精子1例并探讨其发生机制,旨为该类患者的诊治提供实验室依据。方法:对此例无头精子患者的睾丸曲细精管病理结构和精子超微结构进行分析;将20%、15%无头精子患者设为对照组,分别对3例无头精子患者的精子进行精子染色质扩散实验(sperm nucleus DNA integrity kit,SCD)合并精子荧光原位杂交技术(fluorescence in situ hybridization,FISH)检测。结果:无头精子患者睾丸曲细精管严重病变;在透射电子显微镜下可见到精子顶体、线粒体、轴丝等程度不同的结构异常:无头精子患者的精子染色体非整倍体率与精子核DNA损伤程度成正比,且随无头精子比例增多而升高。结论:无头精子有病理意义,其发生与精子DNA损伤、精子染色体异常以及编码头尾连接段的基因缺陷有关。

Objective： To report a case of 98% acephalic sperm and explore its mechanism, in order to provide a laboratory evidence to those who want to have a treatment with acephalic sperm. Methods： Transemission electronic microscopic study of the semen sample from testicular seminiferous tubules was done and ultrastructural study of acephalic sperm was done; with 20%, 15% acephalic sperm as controls, the sperm nucleus DNA integrity kit com- bined with sperm fluorescence in situ hybridization （FISH） were used to detect the 3 cases. Results： The testicular seminiferous tubules had severe lesions in patients with acephalic sperm; under transmission electron microscopy （TEM）, different levels of structural abnormalities in acephalic sperm, such as acephalic sperm, with abnormalities in mitochondria, axoneme could be observed. Sperm chromosome aneuploidy rate had proportional to the degree of sperm nucleus DNA damage in the patients with acephalic sperm, and increased with the proportion of acephalic sperm. Conclusion： Acephalic sperm have a pathological significance, its occurrence is associated with sperm nucleus DNA damage, sperm chromosomal abnormalities and gene defect which encodes the connection of the sperm head and tail segments.