特发性弱精子症精子前向运动率与DNA碎片指数、高活性氧率及高线粒体膜电位率的相关性分析

Correlation analysis between sperm progressive motility and sperm DNA fragments,reactive oxygen species and mitochondrial membrane potential levels in patients with idiopathic asthenozoospermia

目的探讨特发性弱精子症患者精子DNA碎片指数(DFI)、高活性氧(ROS)率、高线粒体膜电位(MMP)率与精子前向运动率之间的关系。方法选取2022年12月至2023年11月在空军军医大学唐都医院生殖医学中心男科门诊就诊的250例患者,根据精子前向运动率将其分为轻度(20%≤精子前向运动率<32%,86例)、中度(10%≤精子前向运动率<20%,67例)、重度(精子前向运动率<10%,47例)弱精子症组和正常组(女方因素不孕,男方精液常规结果均在参考区间内,精子前向运动率≥32%,50例)。采用流式细胞术检测精子DFI、高ROS率、高MMP率水平,并分析其与精子前向运动率的相关性。结果与正常组相比,弱精子症组精子浓度、活动率、正常形态百分率、高MMP率水平显著降低(P<0.05),DFI、高ROS率水平显著升高(P<0.01)。重度弱精子症组精子DFI、高ROS率显著高于轻、中度组,高MMP率水平显著低于轻、中度组(P<0.01);轻、中度组间精子DFI、高ROS率、高MMP率水平差异无统计学意义(P>0.05)。随着弱精子症严重程度增加,精子DFI、高ROS率水平升高,高MMP率水平降低。相关性分析显示,精子前向运动率与高MMP率呈显著正相关(r=0.439,P<0.01),与高ROS率(r=-0.435,P<0.01)、DFI(r=-0.478,P<0.01)呈显著负相关。结论特发性弱精子症患者精子DFI、高ROS率水平升高,高MMP率水平降低,且与弱精子症严重程度相关。较高ROS水平可能通过损伤精子DNA和线粒体功能,导致精子前向运动能力下降。

Objective To investigate the relationship between sperm DNA fragmentation index(DFI),high reactive oxygen species(ROS)rate,high mitochondrial membrane potential(MMP)rate,and progressive motility(PR)in patients with idiopathic astheno-zoospermia.Methods A total of 250 patients who visited the Male Department of Reproductive Medicine Center,Tangdu Hospital,from December 2022 to November 2023 were enrolled in this study.The patients were divided into mild(20%≤PR<32%,n=86),moderate(10%≤PR<20%,n=67),and severe(PR<10%,n=47)asthenozoospermia groups,and a normal group(female factor infertility,normal semen parameters,PR≥32%,n=50)was formed based on their PR values.The levels of sperm DFI,high ROS and MMP rates were measured using flow cytometry,and their correlations with PR were analyzed.Results Compared with the normal group,the asthenozoospermia groups showed significantly lower sperm concentration,motility,normal morphology percentage and high MMP rate(P<0.05),but significantly high DFI and ROS rate(P<0.01).The severe asthenozoospermia group had significantly high DFI and ROS rate and high MMP rate was lower than that in the mild and moderate groups(P<0.01).No significant differences in DFI,high ROS rate and MMP rates were found between the mild and moderate groups(P>0.05).As the severity of asthenozoospermia increased,DFI and high ROS rate showed an increasing trend,while high MMP rate decreased.Correlation analysis revealed a signifi-cant positive correlation between PR and high MMP rate(r=0.439,P<0.01)and significant negative correlations between PR and high ROS rate(r=-0.435,P<0.01),DFI(r=-0.478,P<0.01).Conclusion The patients with idiopathic asthenozoospermia ex-hibit altered levels of sperm DFI,high ROS and MMP rates,which are associated with the severity of asthenozoospermia.Elevated ROS levels may lead to sperm DNA damage and mitochondrial dysfunction,resulting in decreased sperm progressive motility.