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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (07) : 489 -492. doi: 10.3877/cma.j.issn.1674-0785.2019.07.002

所属专题： 文献；

临床研究

精子DNA完整性对男性生育力的补充预测价值
陈宇捷1, 宋兵1, 贺小进1, 曹云霞1,†()   
  1. 1. 230022　合肥，安徽医科大学第一附属医院妇产科　国家卫生健康委配子及生殖道异常研究重点实验室　出生人口健康教育部重点实验室　生殖健康与遗传安徽省重点实验室　安徽省生命资源保存与人工器官工程技术研究中心（安徽医科大学）
  • 收稿日期:2019-03-07 出版日期:2019-04-01
  • 通信作者: 曹云霞
  • 基金资助:
    国家自然基金培育基金(2015KJ04); 生殖与遗传安徽省重点实验室开放基金(9021407201)

Value of sperm DNA integrity as a supplementary predictor of male fertility

Yujie Chen1, Bing Song1, Xiaojin He1, Yunxia Cao1,†()   

  1. 1. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Anhui Medical University NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China Anhui Province Key Laboratory of Reproductive Health and Genetics Biopreservation and Artificial Organs, Anhui Provincial Engineering Research Center, Anhui Medical University, Hefei 230032, China
  • Received:2019-03-07 Published:2019-04-01
  • Corresponding author: Yunxia Cao
  • About author:
    Corresponding author: Cao Yunxia, Email:
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陈宇捷, 宋兵, 贺小进, 曹云霞. 精子DNA完整性对男性生育力的补充预测价值[J]. 中华临床医师杂志(电子版), 2019, 13(07): 489-492.

Yujie Chen, Bing Song, Xiaojin He, Yunxia Cao. Value of sperm DNA integrity as a supplementary predictor of male fertility[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(07): 489-492.

目的

探究精子DNA完整性检测相对传统的精液常规在男性生育力评价中的辅助预估价值。

方法

采集收集2017年4月至10月共1076例不育男性精液标本，男性患者来源于安徽医科大学第一附属医院妇产科，每份标本分成2份，分别行精液常规及精子DNA完整性检测，根据精子DNA碎片指数（DFI）分为精子DNA完整性良好组（DFI≥30%）、完整性一般组（15%<DFI<30%）及完整性差组（DFI≤15%）。根据患者年龄分为21~30岁、31~40岁及≥41岁；按照精子浓度分为浓度正常（≥15×106/ml）及少精症（<15×106/ml），按照精子前向活动率分为正常（≥32%）及弱精子症（<32%），采用χ2检验分析不同精子DNA完整性组之间的年龄、浓度和前向活动率的差异，采用Pearson相关分析分析患者年龄、精子浓度及前向活动率分别与精子DFI的相关性。

结果

不同精子DNA完整性组间，精子浓度正常与少精症水平差异具有统计学意义（χ2=96.82，P<0.001）、活力正常与弱精子症水平差异均具有统计学意义（χ2=2.06，P<0.001）。年龄与DFI成正相关（r=0.154，P<0.001），精子浓度及前向活动率与DFI成负相关（r=-0.231，P<0.001；r=-0.564，P<0.001）。

结论

精子DFI与精子浓度及活动率呈负相关，与年龄呈正相关，精子DNA完整性检测一定程度上可以弥补精液常规参数分析在评价男性生育能力上的不足，具有重要参考价值。

关键词: 精子, DNA, 男性, 生育力, 精液常规, 精子染色质结构分析
Objective

To evaluate the value of sperm DNA integrity test compared with traditional semen analysis in the supplementary assessment of male fertility.

Methods

A total of 1076 semen samples were collected at the Reproductive Medicine Center of the First Affiliated Hospital of Anhui Medical University from April to October 2017. Each specimen was divided into two parts for conventional semen analysis and sperm DNA integrity test. Sperm DNA integrity was assessed to be good (DFI≥30%), fair (15%<DFI<30%), or poor (DFI≤15%) according to sperm DNA fragmentation index (DFI). According to the age of the patients, the specimens were divided into three groups: 21-30 years old, 31-40 years old, and ≥40 years old. According to sperm concentration, the specimens were divided into normal (≥15×106/ml) and oligospermia groups (<15×106/ml). According to sperm forward motility rate, the specimens were divided into normal (≥32%) and asthenospermia groups (<32%). The Chi-square test was used to compare the differences in sperm DNA integrity between different groups. Pearson correlation analysis was used to analyze the correlation of patient age, sperm concentration, and forward motility rate with sperm DFI.

Results

There were significant differences in sperm DNA integrity between the normal and oligospermia groups and between the normal and asthenospermia groups (χ2=96.82, P<0.001; χ2=2.06, P<0.001). Age was positively correlated with DFI (r=0.154, P<0.001), and sperm concentration and forward motility rate were negatively correlated with DFI (r=-0.231, P<0.001). r=-0.564, P<0.001).

Conclusion

Sperm DFI is negatively correlated with sperm concentration and forward motility rate, and positively correlated with age. Sperm DNA integrity test can make up for the deficiency of semen analysis in evaluating male fertility.

Key words: Sperm, DNA, Male, Fertility, Semen analysis, Sperm chromatin structure analysis
表1 3组患者年龄及精液常规参数的比较［例（%）］
组别 例数 年龄（岁） 浓度（×106/ml） 精子前向活动率
21~30 31~40 ≥41 ≥15 <15 ≥32% <32%
精子DNA完整性差组 357 187（52.4） 151（42.3） 19（5.3） 341（95.5） 16（4.5） 270（75.6） 87（24.4）
精子DNA完整性一般组 400 162（40.5） 195（48.8） 43（10.7） 309（77.2） 91（22.8） 179（44.8） 221（55.2）
精子DNA完整性良好组 319 126（39.5） 143（44.8） 50（15.7） 209（65.5） 110（34.5） 44（13.8） 275（86.2）
χ2值 ? 7.76 23.36 13.02 96.82 2.60
P值 ? 0.021a <0.001b 0.001c <0.001 <0.001
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