男性不育患者精液质量异常特征分析

Analysis of the characteristics of abnormal semen quality in male infertility patients

目的 分析男性不育患者精液质量异常的特征。方法 回顾性分析2020年10月至2022年9月厦门大学附属中山医院收治的613例男性不育患者的临床资料,其中精液质量异常男性不育患者512例,按照年龄将精液质量异常男性患者分为≤25岁组(58例)、>25~30岁组(179例)、>30~35岁组(185例)、>35~41岁组(65例)与≥41岁组(25例),比较五个亚组患者的精液参数,分析精子顶体酶活性与精子总活力、前向运动精子(PR)百分率的相关性。结果 患者精液质量的异常率为83.5%。≥41岁组患者的PR百分率、精子总活力、精子存活率均低于≤25岁组、>25~30岁组、>30~35岁组和>35~41岁组,差异有统计学意义(P<0.05)。精子存活率、PR百分率和液化时间为最常出现异常的参数,异常率分别为55.9%、54.9%和51.4%。液化时间、精液pH、“精子存活率+PR百分率+精子总活力”为最常见的异常模式,分别占异常精液的16.4%、11.1%、9.8%。精子顶体酶活性与精子总活力(r=0.390,P<0.01)、PR百分率(r=0.301,P<0.01)呈正相关。结论 男性不育患者的精液异常主要表现为精子存活率、PR百分率和液化时间的异常,PR百分率、精子总活力、精子存活率从41岁后就出现明显下降。

Objective To analyze the characteristics of abnormal semen quality in male infertility patients.Methods Clinical data of 613 male infertility patients admitted to Zhongshan Hospital Xiamen University from October 2020 to September 2022 were retrospectively analyzed,including 512 male infertility patients with abnormal semen quality.According to age,the male patients with abnormal semen quality were divided into ≤25 years old group(58 cases),>25-30 years old group(179 cases),>30-35 years old group(185 cases),>35-41 years old group(65 cases) and ≥41 years old group(25 cases).The semen parameters of the five subgroups were compared,and the correlation of sperm acrosin activity with total sperm motility and the percentage of forward motile sperm(PR) was analyzed.Results The percentage of abnormal semen quality was 83.5%.The PR percentage,total sperm motility and sperm survival rate in ≥41 years old group were lower than those in ≤25 years old group,>25-30 years old group,>30-35 years old group and >35-41 years old group,and the differences were statistically significant(P<0.05).Sperm survival rate,PR percentage and liquefaction time were the most common abnormal parameters,with abnormal rates of 55.9%,54.9% and 51.4%,respectively.The most common abnormal patterns were liquefaction time,semen pH,sperm survival rate+PR percentage+total sperm motility,which accounted for16.4%,11.1% and 9.8% of abnormal semen,respectively.Sperm acrosin activity was positively correlated with total motility(r=0.390,P<0.01) and percentage of PR(r=0.301,P<0.01).Conclusion Semen abnormalities in male infertility patients mainly showed abnormal sperm survival rate,PR percentage and liquefaction time.PR percentage,total sperm motility and sperm survival rate decreased significantly after 41 years of age.