弱精子症患者精子运动参数及DNA 碎片化指数的检测与分析

摘要

Objective To study the changes of sperm motion parameters and DNA fragmentation index (DFI) in patients with asthenozoospermia.Methods The routine analysis, semen analyzer activity detection and fluorescence microzooscopy of 41 cases of asthenozoospermia patients ( asthenozoospermia group) and 48 cases of normal vitality patients(normal vitality group) were performed.Semen routine parameters(sperm concentration, total number of sperm and sperm activity rate), sperm motion parameters [ progressive motility ( PR), average path velocity ( VAP), curvilinear velocity ( VCL), straight line velocity ( VSL), linearity ( LIN), wobble ( WOB), straightness ( STR), amplitude of lateral head displacement(ALH), beat-cross frequency(BCF) and mean angular displacement(MAD)] and DFI in patients with asthenozoospermia and normal vitality group were compared. Results The sperm concentration, total number of sperm, sperm activity rate, PR, VAP, VCL, VSL, LIN, WOB, STR, ALH, BCF and MAD of asthenozoospermia group were (69.0 ±49.1) ×10 6 /mL, (203 ±159) ×10 6 , 60.8% ±15.7%, 21.1% ± 8.0%,(10.7 ±2.8)μm/s, (20.6 ±4.9)μm/s, (6.3 ±2.2)μm/s, 29.9% ±8.1%,51.4% ±5.8%, 57.2% ± 10.4%, (0.53 ±0.12)μm, (3.20 ±0.85)Hz and (14.2 ±3.2)°, respectively.These parameters were significantly lower than those of normal vitality group[(98.8 ±38.2) ×10 6 /mL(P <0.05),(281 ±171) ×10 6 (P <0.05), 82.0%±7.9%(P <0.01), 45.1% ±8.5%(P <0.01), (18.5 ±3.0)μm/s(P <0.01), (30.7 ±5.3)μm/s(P <0.01), (12.0 ±2.3)μm/s (P <0.01), 39.6% ±7.0%(P <0.01), 60.5% ±5.0%(P <0.01), 65.1% ±7.2%(P <0.01), (0.72 ±0.13)μm (P <0.01), (5.07 ±0.81)Hz(P <0.01) and (17.8 ±2.5)°(P <0.01)].The DFI in asthenozoospermia group(17.9% ±12.5%) was significantly higher than that in normal vitality group(8.5 ±6.4%, P <0.01).Conclusions Besides the performance of low sperm motility, asthenozoospermia is still accompanied by decreasing sperm concentration, total number of sperm and sperm motion parameters and increasing sperm DFI.The change of these parameters may be one of the mechanisms of male infertility caused by asthenozoospermia.%目的：了解弱精子症患者精子运动参数和 DNA 碎片化指数（DFI）的变化情况。方法通过对41例弱精子症患者（弱精子症组）和48例活力正常不育患者（活力正常组）精液的常规检测、精液分析仪检测和荧光显微镜检查，比较弱精子症组和活力正常组精液常规参数（包括精子浓度、精子总数、活动率）、精子运动参数[包括前向运动率（ PR）、平均路径速率（ VAP）、曲线速度（ VCL）、直线速度（VSL）、直线性（ LIN）、摆动性（WOB）、前向性（STR）、头侧摆幅度（ALH）、鞭打频率（BCF）和平均角位移（MAD）]及 DFI。结果弱精子症组精子浓度、精子总数、活动率、PR、VAP、VCL、VSL、LIN、WOB、STR、ALH、BCF 及 MAD 分别为（69．0±49．1）×106／mL、（203±159）×106、60．8％±15．7％、21．1％±8．0％、（10．7±2．8）μm／s、（20．6±4．9）μm／s、（6．3±2．2）μm／s、29．9％±8．1％、51．4％±5．8％、57．2％±10．4％、（0．53±0．12）μm、（3．20±0．85） Hz 和（14．2±3．2）°，均明显低于活力正常组[（98．8±38．2）×106／mL（P ＜0．05）、（281±171）×106（P ＜0．05）、82．0％±7．9％（P ＜0．01）、45．1％±8．5％（P ＜0．01）、（18．5±3．0）μm／s（P ＜0．01）、（30．7±5．3）μm／s（P ＜0．01）、（12．0±2．3）μm／s（P ＜0．01）、39．6％±7．0％（P ＜0．01）、60．5％±5．0％（P ＜0．01）、65．1％±7．2％（P ＜0．01）、（0．72±0．13）μm（P ＜0．01）、（5．07±0．81）Hz（P ＜0．01）和（17．8±2．5）°（P ＜0．01）]；而 DFI（17．9％±12．5％）明显高于活力正常组（8．5％±6．4％，P ＜0．01）。结论弱精子症患者除了表现为常规检查中的精子活力低下外，还伴有精子浓度和总数下降、精子运动参数下降以及精子 DFI 的增高，这些参数的改变可能是弱精子症引起男性不育的机制之一。