精子形态学分析结合精液常规参数在男性不育症诊断中的应用

Application of sperm morphological analysis combined with routine semen parameters in the diagnosis of male infertility

目的探讨精子形态学分析结合精液常规参数在男性不育症诊断中的应用价值。方法选取80例男性不育症患者作为观察组,根据精子状态分为少精症组(精子浓度<15×10^(6)/ml,15例)、弱精症组(精子存活率<40%或前向运动精子的百分比<32%,但是精子浓度正常,35例)、白细胞精子症组(精液白细胞计数≥1×10^(6)/ml,30例);同时选取100例健康体检男性作为对照组。所有研究对象均进行手工精子形态学分析、精液常规检测、精子形态分析、精子DNA完整百分比检测。比较观察组和对照组的精液检测结果,观察组各小组的精液检测结果。结果观察组精子浓度、精子存活率、前向运动精子百分比、正常形态精子百分比、精子DNA完整百分比分别为(61.16±22.65)×10^(6)/ml、(66.36±7.52)%、(27.92±6.46)%、(14.72±3.84)%、(80.15±5.16)%,均低于对照组的(104.58±35.78)×10^(6)/ml、(84.19±8.20)%、(50.18±9.42)%、(26.57±6.41)%、(88.92±6.07)%,差异均有统计学意义(P<0.05)。少精症组精子浓度、精子存活率、前向运动精子百分比、正常形态精子百分比、精子DNA完整百分比分别为(9.96±2.85)×10^(6)/ml、(68.57±13.75)%、(26.74±9.46)%、(22.78±6.12)%、(79.79±3.36)%,弱精症组分别为(67.12±14.62)×10^(6)/ml、(61.09±9.90)%、(24.90±5.83)%、(15.92±4.37)%、(81.98±5.09)%,白细胞精子症组分别为(85.78±15.27)×10^(6)/ml、(75.28±12.42)%、(34.09±10.12)%、(9.67±3.12)%、(78.99±5.40)%。少精症组精子浓度均低于弱精症组、白细胞精子症组,弱精症组精子浓度低于白细胞精子症组,弱精症组精子存活率低于少精症组、白细胞精子症组,白细胞精子症组前向运动精子百分比高于少精症组、弱精症组,白细胞精子症组正常形态精子百分比低于少精症组、弱精症组,弱精症组正常形态精子百分比低于少精症组,差异均有统计学意义(P<0.05);三组精子浓度、精子存活率、前向运动精子百分比、正常形态精子百分比比较,差异均有统计学意义(P<0.05);三组精子DNA完整百分比比较差异无统计学意义(P>0.05)。结论男性不育症患者精子浓度、精子存活率、前向运动精子百分比、正常形态精子百分比均明显降低,为临床诊疗提供了可靠的理论依据。

Objective To discuss the application value of sperm morphological analysis combined with routine semen parameters in the diagnosis of male infertility.Methods A total of 80 male infertility patients were selected as the observation group and divided into oligospermia group(sperm concentration<15×10^(6)/ml,15 cases),asthenospermia group(sperm survival rate<40%or percentage of forward movement sperm<32%,but normal sperm concentration,35 cases),and leukocytospermia group(semen leukocyte count≥1×10^(6)/ml,30 cases)according to their sperm morphology;100 healthy males were also selected as the control group.All subjects underwent manual sperm morphological analysis,routine semen testing,sperm morphological analysis,and sperm DNA integrity percentage testing.Comparison was made on semen test results between the observation group and the control group,and the semen test results of each group in the observation group.Results The sperm concentration,sperm survival rate,percentage of forward movement sperm,percentage of sperm in normal morphology,and percentage of sperm DNA integrity in the observation group were(61.16±22.65)×10^(6)/ml,(66.36±7.52)%,(27.92±6.46)%,(14.72±3.84)%,and(80.15±5.16)%,which were lower than(104.58±35.78)×10^(6)/ml,(84.19±8.20)%,(50.18±9.42)%,(26.57±6.41)%,and(88.92±6.07)%in the control group,and the differences were statistically significant(P<0.05).The sperm concentration,sperm survival rate,percentage of forward movement sperm,percentage of sperm in normal morphology and percentage of sperm DNA integrity in oligospermia group were(9.96±2.85)×10^(6)/ml,(68.57±13.75)%,(26.74±9.46)%,(22.78±6.12)%,and(79.79±3.36)%,those of the asthenospermia group were(67.12±14.62)×10^(6)/ml,(61.09±9.90)%,(24.90±5.83)%,(15.92±4.37)% and(81.98±5.09)%,and those of the leukocytospermia group were(85.78±15.27)×10^(6)/ml,(75.28±12.42)%,(34.09±10.12)%,(9.67±3.12)% and(78.99±5.40)%.The sperm concentration in the oligospermia group was lower than that in the asthenospermia group and the leukocytospermia group.The sperm concentration in the asthenospermia group was lower than that in the leukocytospermia group;the sperm survival rate of the asthenospermia group was lower than that of the oligospermia group and the leukocytospermia group;the percentage of forward movement sperm in the leukocytospermia group was higher than that in the oligospermia group and the asthenospermia group;the percentage of sperm in normal morphology in the leukocytospermia group was lower than that in the oligospermia group and the asthenospermia group;the percentage of sperm in normal morphology in the asthenospermia group was lower than that in the oligospermia group;all the differences were statistically significant(P<0.05).The differences in sperm concentration,sperm survival rate,percentage of forward movement sperm,and percentage of sperm in normal morphology among the three groups were statistically significant(P<0.05).There was no statistically significant difference in percentage of sperm DNA integrity among the three groups(P>0.05).Conclusion The sperm concentration,sperm survival rate,percentage of forward movement sperm,and percentage of sperm in normal morphology in male infertility patients are significantly decreased,which provide a reliable theoretical basis for clinical diagnosis and treatment.