少、弱、畸形精子症患者体外精子的PR、PR+NP以及顶体酶活性在不同时间段的下降速率比较

Decreases of progressive motility,total motility,and acrosin activity of sperm from oligoasthenoteratospermia males at different time points after sperm activation

目的：探讨不同组别（据精液参数分组）精子在不同时间段的前向运动精子百分率（PR）、总活动率（PR＋NP）和顶体酶活性的变化率。方法：根据WHO《人类精液检查与处理实验室手册》第5版的判定标准和改良巴氏染色将精液分为3组。精子活化后,采用CASA检测在3个时间点（1、24、48 h）的PR和PR＋NP,改良Kennedy法检测顶体酶活性。结果：1～24 h段与24～48 h段比较,3组精子的PR和PR＋NP的变化均有显著性差异（P〈0.05）,前段的变化小于后段;而顶体酶在正常组有显著性差异（P=0.013）,前段的变化大于后段,在弱畸精子症组与少弱畸精子症组中的变化均无差异（P=0.519和0.979）。结论：活化后精子的PR、PR＋NP和顶体酶活性均随时间的延长而降低,3个指标的变化率有不同的规律。应将顶体酶活性推广列入男性生育能力评估的常规检测项目。

Objective： To investigate the progressive motility, （PR）, total motility （progressive ＋ non-progressive motility, PR ＋ NP）, and acrosin activity of sperm from normal and infertile men at different time points after sperm activation. Methods ： Based on the 5th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen and the results of modified Papan- icolaou staining, we divided the semen samples into groups A （normal, n = 28）, B （oligoasthenoteratospermia, n = 30）, and C （as- thenoteratospermia, n = 32）. At I, 24, and 48 hours after sperm activation, we detected sperm PR and PR ＋ NP by CASA and chemi- cal colorimetry, and determined sperm acrosin activity using the modified Kennedy method. Results ： Sperm PR and PR ＋ NP were significantly decreased in all the three groups at 1 - 24 hours and even more significantly at 24 - 48 hours after sperm activation as compared with the baseline （P 〈0.05）. Sperm acrosin activity showed remarkable reduction in group A （P = O. 013 ）, even more significant at 1 - 24 hours than at 24 - 48 hours after sperm activation, but not in groups B and C （P = 0.519 and 0.979）. Conclusion ： Sperm PR, PR ＋ NP, and acrosin activity are all decreased with the extension of time after sperm activation, each in a specific manner. Examination of sperm acrosin activity should be applied as a routine tool in the assessment of male fertility.