男性不育患者精液质量及其影响因素分析

Analysis on semen quality and its influencing factors in male infertility patients

目的:分析男性不育患者的精液质量,探讨近年来男性不育患者精液质量的总体情况和变化趋势。方法:选取就诊于中国人民解放军陆军第七十三集团军医院生殖医学中心和厦门大学附属第一医院生殖医学中心的4190例男性不育患者,分析总体精液参数。按患者年龄、检测年份、禁欲天数和检测季节分组,分析其精液常规参数和正常形态精子百分率,进行组间比较。采用多元线性回归分析,分析患者年龄、检测年份、禁欲天数和检测季节等因素对精液参数的影响。结果:患者平均年龄(31.81±5.55)岁,患者精液量、精液pH值、精子浓度、精子总数、精子总活动率、前向运动精子(PR)和正常形态精子百分率的中位数分别为3.0 mL、7.3、47.0×10^(6)mL^(-1)、139.3×10^(6)/每次射精、75.0%、53.0%和3.4%。年份组间精液参数差异有统计学意义(P<0.05),患者精子总活动率、PR和正常精子形态百分率在2017—2019年呈逐年下降趋势;年龄分组中,患者精子总活动率和正常形态精子百分率组间比较差异有统计学意义(P<0.05);禁欲天数分组中,患者精子浓度、精子总数、精子总活动率和PR在各组间比较差异有统计学意义(P<0.05);季节分组中,患者精子浓度、精子总活动率、PR和正常形态精子百分率在各组间比较差异有统计学意义(P<0.05)。多元线性回归分析,不同年龄组间精液参数比较差异无统计学意义(P>0.05);禁欲天数与患者精子浓度、精子总数、精子总活动率和PR有关联;季节变化与患者精子总数、精子总活动率和PR有关联。结论:4190例男性不育患者精子总活动率、PR和正常形态精子百分率在2017—2019年呈逐年下降趋势,禁欲天数和检测季节可影响患者部分精液参数。

Objective:To analyze the semen quality of male infertility patients,and to discuss the general situation and trend of semen quality of the male infertility patients in recent years.Methods:A total of4190 male infertility patients who were treated in Reproduction Medicine Center of 73rd Army Hospital of the People’s Liberation Army and Reproductive Medicine Center of the First Affiliated Hospital of Xiamen University were selected and their total semen parameters were analyzed.The patients were grouped according to age,testing year,abstinence days and testing season,and the routine parameters of semen and the percentage of normal sperm were analyzed and compared between groups.Multiple linear regression analysis was conducted to analyze the effects of age,testing year,abstinence days and testing season on the semen parameters.Results:The mean age of the patients was(31.81±5.55)years old;the medians of semen volume serum,pH value semen,sperm concentration,total number of sperm,total motility rate,forward motility sperm(PR)and percentage of normal sperm of patients were 3.0 mL,7.3,47×10^(6)mL^(-1),139.3×10^(6)/each ejaculation,75%,53%and 3.4%,respectively.There were statistically significant differences in the semen parameters between testing year groups(P<0.05),and the total motility rate,PR and the percentage of normal sperm of patients showed a decreasing trend from 2017—2019.Among age groups,there were significant differences in the total activity rates and percentages of normal sperm of patients among various groups(P<0.05).In abstinence groups day,there were statistically significant differences in the sperm concentrations,total number of sperm,total motility rates of sperm and PR of patients among various groups(P<0.05).In the seasonal groups,there were statistically significant differences in the sperm concentrations,total motility rate of sperm,PR and percentages of normal sperm of patients among various groups(P<0.05).The results of multiple linear regression analysis showed that there was no significant differences in the semen parameters between different age groups;the abstinence days was related to sperm concentration,total number of sperm,total motility rate of sperm and PR of patients,and the seasonal variation was related to the total sperm,total motility rate of sperm and PR of patients.Conclusion:The total motility rate,PR and percentage of normal sperm in 4190 male infertility patients show a decreasing trend from 2017—2019,and abstinence days and testing season can affect some semen parameters of the patients.