1197例男性不育症患者精子DNA结构完整性的研究

A study on the integrity of sperm DNA construction in 1197 infertile men

目的探讨男性不育症患者精子DNA结构完整性。方法收集男科门诊1197例不育症患者的精液标本,采用计算机辅助精液分析(CASA)分析精子浓度和活力。精子形态分析采用Shorr染色法,分析标准采用WHO推荐的Tygerberg标准。采用吖啶橙实验(AOT)检测精子DNA碎片化程度。结果精子DNA碎片化指数(DFI)与精子浓度、精子总活动率、精子前向运动率和精子正常形态率均呈负相关(r=-0.145、-0.126、-0.127和-0.260,P<0.01),与精子头部畸形率呈正相关(r=0.318,P<0.01)。与正常精液组相比,畸形精子症组、少畸精子症组、弱畸精子症组和少弱畸形精子症组的DFI均升高(P<0.01),其正常形态精子率均小于4.0%。结论 DFI较高的患者精液质量明显低于DFI正常的患者。检测DFI有助于行卵胞浆内单精子注射时筛选DNA结构完整的精子。

Objective To investigate the integrality of sperm DNA of infertile men .Methods Semen samples were collected from 1197 infertile men in andrology clinic .Computer‐assisted semen analysis（CASA） was used to evaluate sperm concentration and vitality .Sperm morphology analysis was conducted by Shorr staining method and was conformed to Tygerberg standard recommended by WHO .After the analysis of sperm conventional parameters ,the patients were divided into eight groups according to the new reference values .The DNA fragmentation index（DFI） as a marker of sperm DNA damage was determined by acridine orange test（AOT） .Results Significant negative correlations were noted between DFI and sperm concentration （ r= -0 .145 ,P=0 .002 ） ,percentages of motility （ r= -0 .126 , P=0 .127 ） , progressive motility （ r= -0 .093 , P=0 .040 ） and normal forms （r= -0 .260 ,P=0 .002） in all study groups .DFI was possitively correlated to the malformation rate of sperm head （ r=0 .318 ,P〈0 .01 ） .Compared with normozoospermic patients ,significant high degrees of DFI were found in the patients with teratozoospermia ,asthenoteratozoospermia and oligoasthenoteratozoospermia（P〈0 .01） ,which all had a proportion of normal forms below 4% . Conclusion The semen quality is lower in infertile men with higher DFI than that in those with normal DFI .Detection of DFI is helpful in screening the sperm with intact sperm DNA .