人精子顶体反应检测临床应用价值探讨  

The Importance of Clinic Application on the Detection of Human Spermatozoa Acrosome Reaction

作　　者：林典梁[1] 孙艳[1] 陈永艳[1] 张小燕[1] 康跃凡[1] 陈文祯[1] 

机构地区：[1]福建省妇幼保健院辅助生殖技术研究室,福州350001

出　　处：《海峡预防医学杂志》2006年第3期5-8,共4页Strait Journal of Preventive Medicine

摘　　要：[目的]检测Ca2+载体A23187诱导精子顶体反应(AR)率,探讨其临床应用价值。[方法]对51例患者检测A23187诱导精子AR率,分析其与精液常规分析、宫腔内人工授精(IUI)、体外受精(IVF)、单精子卵泡浆内注射(ICSI)结果的关系。[结果]①精液常规分析对诱导AR率的相关性不显著;②诱导AR率低于18.1%理论值时,IVF受精率理论值为0;③3次IUI失败者AR率较受精正常者降低(P<0.05)。④不明原因不育者精子AR率与IVF受精率、卵裂率关系呈正相关(r=0.89,P<0.05),与ICSI受精率、卵裂率无显著关系;用ICSI治疗,其受精率、妊娠率高于IVF治疗组。⑤IVF受精不良病例AR率低,用ICSI治疗后受精率、优质胚胎率升高(P<0.05)。[结论]Ca2+载体A23187诱导顶体反应能预测精子的受精能力,有助于男性不育的临床诊断与治疗。[Objective] To investigate the clinical application on the detection of human spermatozoa acrosome reaction （AR） induced by calcium ionophore （Ca2＋ ） A23187. [Methods] Ca^2＋ A23187-induced spermatozoa acrosome reactions of 51 male patients were detected to investigate the relationships within AR rate, semen analysis parameters and outcomes of IUI, IVF and ICSI. [Results] ① There was no significant relationship between Ca^2＋ A23187-induced AR rate and semen analysis（P〉0. 05）. ② When induced AR rates were lower 18. 1%, the 1VF fertilization rate will be 0%. ③ Induced AR rates of IUI failure group were significantly lower than those of normal persons. ④ Induced AR rates of unexplained infertile patients were positively correlated to IVF fertilization rates （r= 0. 89, P 〈0. 05）, but no significant correlation to ICSI fertilization rates and cleavage rates （P 〉0. 05）. The fertilization and pregnancy rates of these patients treated with ICSI were higher than those with IVF. ⑤ AR rates were lower in Group-IVF, fertilization rates and high quality embryo rates of Group-IVF were enhanced after ICSI therapy（P〈0. 05）. [Conclusion] Ca^2＋ A23187-induced spermatozoa acrosome reaction can predict the spermatozoa fertilization capability, and will be helpful to diagnosis and treatment for male infertility.

关 键 词：人精子 顶体反应 宫腔内人工授精 体外受精 单精子卵胞浆内注射 

分 类 号：R321.1[医药卫生—人体解剖和组织胚胎学]