精子质量综合评估指标的建立  

The Establishment of a Comprehensive Assessment of Sperm Quality Indicators

作　　者：赵洪鑫[1,2] 王会[1] 武俊青[2] 袁瑶[2] 吴晓芸[2] 施惠娟[2] 

机构地区：[1]复旦大学,200032 [2]上海市计划生育科学研究所,200032

出　　处：《中国卫生统计》2012年第1期77-80,83,共5页Chinese Journal of Health Statistics

基　　金：国家科技基础条件平台计划-人类遗传资源平台(2005DKA21300);上海市浦江人才计划项目(06PJ14078)

摘　　要：目的建立精子质量综合评估指标以辅助男性不育的诊断。方法对273例不育男性和35例已育志愿者用计算机精液分析系统进行常规精液检查,用荧光复染法进行质膜完整性检测,用化学发光法检测精液活性氧水平;对资料进行主成分分析和受试者工作特征曲线分析;用多变量线性组合法建立联合预测因子。用建立的综合指标参考值模拟诊断另外100例不育男性和30例已育志愿者,计算预测的灵敏度和特异度。结果由主成分分析的结果建立精液质量得分(SQ);SQ诊断男性不育的ROC曲线下面积为81.5%,大于单一常规精液参数;用SQ与精液活性氧水平联合预测因子诊断男性不育,ROC曲线下面积为87.1%。在模拟预测中,SQ的灵敏度为72.00%,特异度为83.33%;联合预测因子的灵敏度为93.00%,特异度为73.33%。结论和单独常规精液参数比较,SQ辅助诊断男性不育的价值更高;在有条件检测精液活性氧的实验室,将SQ与活性氧水平用于联合诊断,准确性更高。Objective To establish a comprehensive assessment of sperm quality indicators for diagnosis of male infertility.Methods Semen samples collected form 273 infertile men and 35 fertile volunteers were tested with computer-aided sperm analysis（CASA）;plasma membrane integrity were detected with dual fluorescence staining;reactive oxygen species（ROS） levels were detected with chemiluminescence.Principal component analysis,ROC analysis and multi-variable linear combination model were implemented to establish a joint predictor.The joint predictor was used to diagnose another group of 100 infertile men and 30 donors.Results Semen quality score（SQ） was calculated from the principal component analysis;the area under the ROC curve of SQ is 81.5%.It＇s greater than the conventional semen parameters alone.The area under the ROC curve of the joint predictor（SQ combined with ROS） is 87.1%.When SQ was used for predicting infertility,the sensitivity is 72.00%,the specificity is 83.33%.As for the joint predictor,the sensitivity is 93.00%,the specificity is 73.33%.Conclusion Compared with conventional semen parameters alone,SQ is more valuable to diagnose male infertility.In the laboratories where ROS levels can be detected,a joint predictor（SQ combined with ROS） can be selected in order to promote the accuracy to diagnose the male infertility.

关 键 词：精子质量 质膜完整性 活性氧 主成分分析 多变量线性组合 ROC曲线 

分 类 号：R698.2[医药卫生—泌尿科学]