东莞市不育男性精子功能检查参数的分析

The value of sperm function parameters analysis for male infertility in Dongguan city

目的：分析东莞地区不育男性患者精子功能相关检查结果。方法随机选取本院25～44岁300例诊断为男性不育患者（不育组）与200名正常生育男性（对照组）精液标本，比较两组精子形态学分析、顶体酶定量、精子DNA碎片检测及进行去透明带仓鼠卵人精子穿透实验的受精指数的差异，并将各项指标与不育进行相关性分析。结果不育组精子正常形态百分率（3.00±2.30）%，对照组精子正常形态百分率（8.00±4.30）%，差异有统计学意义（P＜0.05）。不育组精子顶体酶活性为（69.40±31.50）μIU/106精子，对照组精子顶体酶活性（93.50±32.70）μIU/106精子，差异有统计学意义（P＜0.05），不育组DNA碎片率（20.94±1.00）%，对照组DNA碎片率（11.27±0.79）%，差异有统计学意义（P＜0.05）。不育组与对照组中去透明带仓鼠卵人精子穿透实验受精指数差异无统计学意义（P＞0.05）。各种检查结果与不育的相关回归分析结果是，精子正常形态率与不以呈负相关（r=-0.823，P＜0.05）、顶体酶活性与不育呈负相关（r=-0.723，P＜0.05），与不育呈正相关的有头部畸形率（r=0.894，P＜0.05）、DNA碎片率（r=0.778，P＜0.05）。结论精子形态分析、顶体酶活性、精子DNA碎片检测是检测精子功能的有效指标。精子正常形态率、顶体酶活性与不育呈负相关关系，与不育正相关的有头部畸形率、DNA碎片率。

Objective To study the sperm function parameters of male infertility in Dongguan city. Methods According to the difference of the reproductive function,semen samples randomly selected and divide to two groups（25-44 years old）：300 cases of male infertility（infertility group） and 200 normal fertile men（control group）. Compare of two groups the sperm morphology index,acrosomal enzyme index,sperm DNA fragmentation index and fertility index in Zona free hamster oocyte human sperm penetration assay（SPA）.And study the parameters correlation to infertility. Results The difference of the normal sperm morphology rate was significant（P 〈 0.05） with the infertility group（3.00±2.30）% vs the control group（8.00±4.30）%.The acrosomal enzyme index in infertility group was（69.40±31.50）μIU/106 sperm,vs the control group（93.50±32.70）μIU/106sperm,the difference was statistically significant（P 〈 0.05）.DNA fragmentation Index in infertility group was（20.94±1.00）% vs the control group（11.27±0.79）%,with statistical significance（P 〈 0.05）.The fertilization index between two groups in SPA had no statistical difference（P 〉 0.05）.The normal morphology rate（r=-0.823,P 〈 0.05）and acrosomal enzyme（r=-0.723, P 〈 0.05）are in negative correlation to infertility,and head deformity rate（r=0.894,P 〈 0.05）and DNA fragmentation rate（r=0.778,P 〈 0.05）are in positive correlation with infertility. Conclusion The index of sperm morphology,acrosomal enzyme,DNA fragmentation have high clinical application value for evaluating male semen quality.The normal sperm morphology rate and acrosomal enzyme are in negative correlation to infertility,while head deformity rate and DNA fragmentation rate are in positive correlation with infertility.