复发性流产与精液常规参数、精子畸形率和DNA完整性的相关性  

Correlation of recurrent miscarriage with semen parameters,teratozoo-spermia and DNA integrity

作　　者：张洲[1,2] 师娟子 邢俊平[2] 霍涌玮[2] 邱曙东[2] 

机构地区：[1]陕西省妇幼保健院生殖中心,西安710003 [2]西安交通大学医学院生殖医学研究中心,西安710061

出　　处：《第三军医大学学报》2010年第16期1788-1792,共5页Journal of Third Military Medical University

基　　金：陕西省科技厅资助项目(2009k18-01)~~

摘　　要：目的探讨复发性流产与丈夫精液常规参数、精子畸形率以及DNA完整性的相关性。方法①按纳入标准将研究对象分成复发性流产患者丈夫组(流产组,n=49)、孕前常规检查组(孕检组,n=60)和正常生育男性组(生育组,n=39),对精液进行常规分析,采用改良巴氏染色法,按照严格Kruger标准检测研究对象精子畸形率。②对上述流产组和生育组部分标本通过上游法进行优选,并采用精子染色质结构分析对优选前后的标本分别检测精子DNA完整性。结果①3组间两两比较,流产组总畸形率和头部畸形率与孕检组及生育组比较差异均有统计学意义(P<0.01),流产组精子密度、活动率、前向运动率与孕检组及生育组比较差异有统计学意义(P<0.05,P<0.01);孕检组精子密度、头部畸形率和总畸形率与生育组比较,差异有统计学意义(P<0.05),精子活动率和前向运动率与生育组比较,差异无统计学意义(P>0.05)。②流产组精子DNA完整性指标(cellsoutsidethemainpopulation,COMP)在上游法优选前[(16.57±6.32)%]与生育组[(12.56±5.00)%]相比,差异有统计学意义(P<0.05);优选后流产组COMP为(13.46±3.51)%,与生育组相比,差异无统计学意义(P>0.05)。③COMP与精子密度、活动率、前向运动率、a级百分率、b级百分率、c级百分率、总畸形率和头部畸形率呈中度相关性(r值分别为-0.421、-0.652、-0.569、-0.457、-0.511、-0.453、0.474、0.513,P<0.01)。结论复发性流产与丈夫精子质量存在相关性。Objective To study the correlation of recurrent miscarriage with semen parameters,teratozoo-spermia and DNA integrity.Methods Based on the inclusion criteria,sperm specimens collected in our hospital from April 2007 to April 2009 were divided into 3 groups：the recurrent miscarriage group （n=49）,the pregestational group （n=60） and the normal fertility group （n=39）.The semen morphology was observed by papanicolaou’s staining using Kruger’s strict criteria,in the meanwhile,semen was also studied using CASA technology.Some specimens of the recurrent miscarriage group and the normal fertility group were optimized through the swim-up method,and sperm chromatin structure assay was used to measure the levels of the sperm DNA integrity of the specimens before and after the optimization.Results There was a very significant difference in the total malformation rate,and head malformation rate between the pregestational group and the normal fertility group （P0.01）,a significant difference in the concentration and mobility and forward mobility of sperm between the recurrent miscarriage group and the pregestational group （P0.05）,and a very significant difference in these between the recurrent miscarriage group and the normal fertility group （P0.01）.A significant difference was found in the concentration,the head and total malformation rate between the pregestational group the normal fertility group （P0.05）,and no significant difference in the mobility and forward mobility of sperm between the 2 groups （P0.05）.The sperm DNA damage index COMP in the recurrent miscarriage group [（16.57±6.32）%] before optimization with swim-up method showed a significant difference with that in the normal fertility group [（12.56±5.00）%] （P0.05）,and no significant difference was found between recurrent miscarriage group [（13.46±3.51）%] after optimization and normal fertility group （P0.05）.There was a moderate correlation between COMP and concentration,mobility,forward mobility of sperm,the

关 键 词：复发性流产 严格Kruger标准 精子畸形率 DNA完整性 

分 类 号：R741.21[医药卫生—神经病学与精神病学] R321.1[医药卫生—临床医学]