男性年龄与精子顶体酶活性及精子DNA碎片指数的相关性分析

摘要

目的 探讨男性年龄与精子顶体酶活性、精子DNA碎片指数(DFI)的相关性. 方法 选取2016年1～8月在我院生殖医学中心就诊的436例不育症男性患者为研究对象,所有患者均行精液常规检查、精子顶体酶活性检查和(或)精子DFI分析.将患者按年龄分为＜30岁、30～39岁、≥40岁3组,分析各组的精液常规、顶体酶活性及精子核DFI的差异及其相关性. 结果 不同年龄段患者的体重指数(BMI)、禁欲天数、精液量无显著性差异(P＞0.05);年龄≥40岁组患者的前向运动精子百分率、活动精子百分率及精子顶体酶活性显著低于＜30岁和30～39岁组(P＜0.05);≥40岁组患者的精子DFI显著高于＜30岁和30～39岁组(P＜0.05).年龄与前向运动精子百分率及活动精子百分率之间呈负相关(P＜0.05),但是相关性较弱.精子顶体酶活性与精子正常形态率、前向运动精子百分率、非前向运动精子百分率、活动精子百分率呈正相关(P＜0.05);精子DFI与年龄、禁欲天数、前向运动精子百分率呈正相关(P＜0.01),与精液量、精子浓度、活动精子百分率呈负相关(P＜0.05);精子顶体酶活性和DFI之间无相关性(P＞0.05). 结论 年龄增长会导致精液前向运动精子百分率、活动精子百分率、精子顶体酶活性、DFI等参数改变,直接或间接影响男性生育力.说明年龄对男性不育的影响是多方面的,建议有生育需求的大龄(≥40岁)男性尽早进行生育咨询与评估.%Objective:To analyze the relationship between male age and sperm acrosin activity,sperm DNA fragmentation index (DFI).Methods:A total of 436 infertile men in our reproductive medical center from January to August 2016 were investigated.All the patients were conducted the examination of semen parameters,sperm acrosin activity and (or) sperm DFI.The patients were divided into 3 groups according to male age:＜30 years group,31-39 years group,and≥40 years group.Comparison and correlation analysis among their semen parameters,sperm acrosin activity and sperm DFI were conducted.Results:There were no significant differences in BMI,days of abstinence,semen volume among the three groups (P＞0.05).The percentage of morphologically normal sperm,progressive sperm rate and sperm motility,sperm acrosin activity in ≥40 years group were significantly lower (P＜0.05),but DFI was significantly higher than ＜30 years group and 31-39 years group (P＜0.05).There was a negative correlation between age and progressive sperm rate and sperm motility (P＜0.05).There were positive correlations between sperm acrosin activity and the percentage of morphologically normal sperm,progressive sperm rate and motility (P＜0.05).Sperm DFI was positively correlated with age,abstinence days,progressive sperm rate (P＜0.01),while it was negatively correlated with semen volume,semen concentration &.motility (P＜0.05).No correlation was found between sperm acrosin activity and DFI.Conclusions:Increase of male age can lead to the deterioration of progressive sperm rate,sperm motility,sperm acrosin activity and sperm DFI,and directly or indirectly affects male infertility.Preconception counseling and evaluation of fertility are recommended for elder men (≥40 years) with reproduction requirement.