沭阳地区不育症患者精子形态学特点与动力学参数相关性分析

Relationship between sperm motility parameters and sperm morphology in male infertility in Shuyang area

目的通过分析江苏沭阳地区不育男性的精子形态学缺陷情况及特点,讨论精子形态学与动力学之间的关系。方法采用瑞姬染色技术将572例精子数目及活力异常的男性不育症患者的精子进行染色,使用伟力彩色精子动态分析系统(WLJY-9000型)进行鉴别分析。结果在畸形精子形态类型中,头颈多部位异常的比例最多,共129例(45%,129/286);其次为头部异常的比例高,共81例(28%,81/286);再者为颈部异常,共49例(17%,49/286);而尾部异常比例最低,共27例(10%,27/286)。精子形态正常组的曲线速率(VCL)、直线速率(VSL)、平均路径速率(VAP)、鞭打频率(BCF)均显著高于精子形态异常组(P<0.01),而两组之间直线性(LIN)、摆动性(WOB)、前向性(STR)、精子头侧摆幅度(ALH)差异无统计学意义(P>0.05)。形态正常精子百分率与VCL、VSL、VAP、BCF存在显著正相关性(P<0.01);单纯头部精子异常和单纯颈部异常百分率与VSL、VCL、VAP、ALH、BCF存在明显的正相关关系(P<0.01);混合畸形精子百分率与VSL、VCL、VAP、ALH、BCF、LIN、STR存在显著负相关性(P<0.01)。单纯尾部异常则与所有运动参数均为负相关关系(P<0.01)。结论精子形态学异常是部分男性不育症的重要致病因素,精子形态学与精子运动速率学参数之间存在相关性,精子形态异常影响精子的运动速率、空间位移程度和运动方式。单纯精子畸形不是影响精子运动速率和空间位移程度的唯一因素。多部位畸形是影响精子运动能力的主要原因。

Objective To investigate the relationship between sperm morphology and sperm motility parameters in male infertility in Shuyang area. Methods Total of 572 semen samples were collected from male infertility in the study.Sperm motility parameters were analyzed by Computer-aided sperm analysis,and the sperm morphology was observed by Wright＇s staining. Sperm morphology and motility were classified based on the ＂WHO laboratory manual for the examination and processing of human semen＂（Fifth Edition）. Some of the samples were morphologically normal（normal group,n=286） and the others were morphologically abnormal（abnormal group,n=286）. Results 129 cases（45%, 129/286） had multiple abnormalities, 81 cases（28%, 81/286） had abnormal heads,49 cases（17%, 49/286） abnormal necks, 27 cases（10%, 27/286） abnormal tail. VCL, VSL, VAP and BCF were significantly higher in the morphologically normal group than those of the abnormal group（P 〈0.01）,but there were no significant differences in LIN, WOB, ALH and STR between the two groups（P 〉0.05）.There were significantly positive correlations between the morphologically normal sperm rates and VCL, VSL, VAP, BCF. The percentage of the sperms that only had the abnormal heads and necks was positively correlated with VSL, VCL, VAP, ALH, BCF. The percentage of multiple abnormalities sperms was negatively correlated with VSL, VCL, VAP, ALH, BCF, LIN, STR. Conclusion There are correlations between sperm morphology and sperm motility parameters. Abnormal sperm morphology influences the movement velocity,the space displacement and the movement way of sperms.The sperm deformity is not the decisive factors affecting the sperm motility rate and the degree of space displacement.Multiple abnormalities may be one of the main reasons affecting sperm motility.