超声视觉下附睾特征值与不育男性精子质量的相关性分析

Correlation Analysis of Epididymal Characteristic Values and Sperm Quality in Infertile Men by Ultrasound Visualization

目的探索超声视觉下附睾特征值与不育男性精子质量的相关性,为超声预测精子质量提供参考。方法回顾性分析2021年3—9月间广东省生殖医院101例不育男性附睾各部厚度的超声测量特征值及其精子相关参数,根据世界卫生组织标准,按精子浓度(C)分成少精子症组、无精子症和正常精子组;按照前向运动精子百分率(PR)分成弱精子症组和正常精子组;按照正常精子百分率(N)分成畸形精子症组和正常精子组;按照精子DNA碎片率(DFI)分成异常组和正常精子组。单因素ANOVA和t检验比较不同精子质量类型男性的附睾特征值差异。Pearson相关分析评估附睾特征值与各精子参数的相关性,探索利用超声评估精子质量的价值。结果101例中无精子症48例,少精子症9例,精子浓度正常44例;弱精子症26例,精子活力正常27例;畸形精子症16例,正常精子37例;DFI正常20例,异常33例。无精子症组的双侧附睾体、左侧附睾尾厚度显著高于精子浓度正常组,畸形精子症的左侧附睾体厚度显著低于正常精子组,差异有统计学意义(P<0.05)。相关分析表明精子PR与双侧附睾体厚度呈负相关(r=-0.278、-0.236,P<0.05),而N与左侧附睾尾厚度呈负相关(r=-0.214,P<0.05),DFI与右侧附睾尾呈负相关(r=-0.201,P<0.05)。结论附睾厚度不同,精子质量存在显著差异,精子质量与附睾厚度关系密切,利用超声测量附睾的厚度对预测精子参数异常有帮助。

Objective To explore the correlation between epididymal characteristic values under ultrasound visualization and sperm quality in infertile men,and to provide a reference for ultrasound prediction of sperm quality.Methods The characteristic values of ultrasound measurements of the thickness of each epididymis and its sperm-related parameters in one hundred and one infertile men in Guangdong Province Reproductive Hospital between March and September 2021 were retrospectively analyzed.According to Word Health Organization criteria,they were divided into oligospermia group,azoospermia and normal sperm group according to sperm concentration(C).According to the percentage of forward-moving sperm(PR),they were divided into:the weak spermatozoa group and the normal sperm group.According to the percentage of normal spermatozoa(N),they were divided into:aberrant spermatozoa group and normal sperm group.The sperm DNA fragmentation rate(DFI)was divided into:abnormal and normal sperm groups.One-way ANOVA and t-test were used to compare the differences in epididymal characteristic values in men with different sperm quality types.Pearson correlation analysis was performed to assess the correlation between epididymal characteristic values and each sperm parameter and to explore the value of using ultrasound to assess sperm quality.Results There were 48 azoospermia,9 oligospermia,44 normal sperm concentration,26 weak spermatozoa,27 normal sperm motility,16 aberrant spermatozoa,37 normal spermatozoa,20 normal DFI,and 33 abnormal spermatozoa in one hundred and one individuals.The thickness of the bilateral epididymal body and left epididymal tail of the azoospermia group were significantly higher than those of the normal sperm concentration group,and the thickness of the left epididymal body of the aberrant spermatozoa was significantly lower than that of the normal sperm group,and the difference was statistically significant(P<0.05).Correlation analysis showed that sperm PR was negatively correlated with thickness bilateral epididymal bodies(r=-0.278,-0.236,P<0.05),while N was negatively correlated withthickness left epididymal tail(r=-0.214,P<0.05)and DFI was negatively correlated with thickness right epididymal tail(r=-0.201,P<0.05).Conclusion There are significant differences in sperm quality with different epididymal thickness,sperm quality is closely related to epididymal thickness,and measuring the thickness of epididymis using ultrasound is helpful in predicting abnormal sperm parameters.