精子DNA碎片率与复发性流产及精液参数的相关研究

Relationship between sperm DNA fragmentation and recurrent spontaneous abortion and sperm parameters

目的探讨精子DNA碎片率对复发性流产的影响及其与精液参数的关系。方法选择配偶有复发性流产史的男性患者200例作为实验组,1年内正常生育的男性200例作为对照组,对两组男性的精子DNA碎片率和年龄、精子浓度、向前活动精子、精子畸形率进行分析。并按照试剂盒推荐的参考范围10%,将400例患者分为精子DNA碎片率<10%组(215例)和DNA碎片率≥10%组(185例),比较其复发性流产率,并对实验组男性的精子DNA碎片率与各项精液参数进行相关性分析。结果实验组的精子DNA碎片率明显高于对照组,前向运动精子率低于对照组(t分别=7.84、-15.73,P均<0.05),两组在精子浓度及精子畸形率方面比较,差异均无统计学意义(t分别=0.92、0.03,P均>0.05)。精子DNA碎片率<10%组的流产率明显低于精子DNA碎片率≥10%组的流产率(χ2=79.66,P<0.05)。在实验组中,患者的精子DNA碎片率与其精子浓度、前向运动精子率呈负相关(r分别=-0.46、-0.60,P均<0.05),与精子畸形率呈弱相关(r=0.19,P<0.05)。结论精子DNA碎片率增高与复发性流产有关,可作为评估精液的一项重要指标。

Objective To explore the relationship between sperm DNA fragmentation and recurrent spontaneous abortion and sperm parameter.Methods Totally 200 males whose spouses with recurrent spontaneous abortion were enrolled as the experimental group.A total of 200 adult healthy fertile males in one year were enrolled as the control group.Sperm DNA fragmentation,age,sperm concentration,percentage of progressive motility and sperm abnormality rate were compared between two groups.According to the reference range 10%recommended by the kit,the 400 cases were divided into groups of sperm DNA fragmentation higher than 10%and lower than 10%,and the rates of recurrent abortion in those two groups were compared.In the experimental group,the correlation between sperm DNA fragmentation and sperm parameters was analyzed.Results The sperm DNA fragmentation of the experimental group was significantly higher than that of the control group,while the percentage of progressive motility was lower than that of the control group(t=7.84,-15.73,P<0.05).There were no differences in sperm concentration and sperm abnormality rate between the two groups(t=0.92,0.03,P>0.05).The abortion rate of group that sperm DNA fragmentation lower than 10%was significantly lower than that in group that sperm DNA fragmentation higher than 10%(χ2=79.66,P<0.05).In the experimental group,the sperm DNA fragmentation was negatively correlated with sperm concentration and percentage of progressive motility(r=-0.46,-0.60,P<0.05),and it was slightly related to sperm abnormality rate(r=0.19,P<0.05).Conclusion Increased sperm DNA fragmentation is associated with recurrent spontaneous abortion,which can be used as an important indicator for the evaluation of semen.