目的：探讨通过Xbar图监控精液分析中各主要检测参数月均值的变化来实施实验室内部质控的有效性。方法应用Excel表格图表工具，以本实验室内2010年6月至2010年12月（共7个月）所有被检患者的精子浓度、前向运动精子百分率、不动精子百分率、精子正常形态率月均值的均值作为靶值，以靶值±2×标准误、靶值±3×标准误为警戒限和处置限绘制Xbar图。按照Xbar图的基本质控规则对各指标随后的月均值进行监测。控制限的设置随着观测值的不断增加，定期进行必要的修改。结果（1）精子浓度：2010年10月至2011年6月连续9个月均值均在控制限上侧，提示存在系统误差。（2）前向运动精子百分率：从2010年6月至2011年6月均值监控良好，而2011年6月至2012年12月活力连续偏低。（3）不动精子百分率：2011年8月份均值超过警戒限，其余均在控制限范围内。（4）精子正常形态率：2010年6月至2011年12月正常形态率均值均在10%左右；2012年连续7个月均值均在控制限以下，提示需警惕系统性误差。结论精液参数月均值Xbar图是一个简单实用、比较敏感直观的男科实验室内部质量保证方法。%Objective To explore the application of Xbar chart monitoring monthly mean values of semen parameter in the internal quality control of andrology laboratory. Methods Based on the monthly mean values of sperm concentration, percentage of progressive motility spermatozoa, percentage of immotility spermatozoa and normal morphology spermatozoa rate of all the patients who was detected from June 2010 to December 2010, a Xbar chart was plotted respectively, with warning limit(mean±2×standard error) and action limit(mean±3×standard error). According to the basic contol rules of Xbar chart, the monthly mean values of semen parameters were monitored. The control limits were determined and revised regularly. Results (1) From September 2010 to June 2011, eight consecutive mean results of sperm concentration were all above the mean of Xbar chart, indicatinga systematic error;(2) From July 2011 to July 2012, the mean of progressive motility spermatozoa all were below the mean of Xbar chart, indicating a systematic error. (3) All the mean results of percentage of immotility spermatozoa were in the control range excepting the data in October of 2011. (4) The mean of normal morphology spermatozoa rate was in the control range well from July 2010 to December 2011, but seven consecutive data in 2012 were below the mean line of Xbar chart. It hinted a systematic error. Conclusion The Xbar chart is a simple,practical and more sensitive method for internal quality control in monthly mean value of semen parameters.
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