不育夫妇中男性精子DNA碎片指数变异的研究  

Variation of sperm DNA fragmentation index in male partners from infertile couples

作　　者：费前进[1] 金建远[1] 倪吴花[1] 黄学锋[1] 

机构地区：[1]浙江省温州医学院附属第一医院生殖中心,325000

出　　处：《中华医学遗传学杂志》2013年第3期357-361,共5页Chinese Journal of Medical Genetics

摘　　要：目的探讨不育夫妇中男性精子DNA碎片指数（DNAfragmentationindex，DFI）的变异程度。方法2009年4月至2012年4月，将539对不育夫妇中的539例男性纳入本研究。根据世界卫生组织标准（1999年），应用精子染色质扩散（spermchromatindispersion，SCD）试验对每名男性进行至少1次的重复精液常规分析和DFI检测，计算DFI的变异系数（coefficientofvariation，CV），对DFI的变异程度及其影响因素进行统计分析。结果539例男性中，有473例、59例、6例和1例分别行1次、2次、3次和4次重复精液常规分析和DFI检测，共计613次重复检测，重复检测和首次检测的间隔时间为0．5～34个月，中位数3．0（1．0～11．0）个月。539份首次检测样本间的DFI变异系数（between-samplecoefficientofvariation，CVB）为71．2％。与首次检测间隔0．5～3个月、3～12个月和12~34个月的DFI与首次检测的DFI比较，差异均有统计学意义（P〈O．01）。以18％作为男性生育力的DFI阈值，539例男性中有142例（26．3％，95％cI：22．6％～30．0％）的首次和重复检测DFI值分别位于阈值两侧。539例男性自身DFI的变异系数（within—subjectcoefficientofvariation，CVw）为0．0～110．5％，中位数为26．0％（12．6％～42．8％），精子总数、精子浓度、精子活动力和精子形态的CVw的中位数分别为41．9％（21．8％～72．6％）、31．9％（15．1％～62．5％）、29．4％（13．2％～55．4％）和46．0％（22．4％～87．1％），各精液常规参数的CVw分别与DFI的CVw比较，差异均有统计学意义（P〈0．01）。DFI的CVw与精子总数、精子浓度和DFI重复检测的间隔时间密切相关（P〈O．05）。结论不育夫妇中的男性精子DFI是一个变异较大的参数，应对每例男性的DFI进行重复检测才能反映其精子DNA损伤的水平。Objective To investigate variation of sperm DNA fragmentation index （DFI） in male partners of infertile couples. Methods A total of 539 males between April 2009 and April 2012 were analyzed. At least one repeated routine semen analysis and sperm DNA fragmentation test were performed for each sample by sperm chromatin dispersion （SCD） analysis following World Health Organization guidelines. Coefficient of variation （CV） for DFI was calculated. Results Respectively, 1, 2, 3 and 4 repeated SCD analyses were carried out on 473, 59, 6 and 1 semen samples. The median interval between the first and repeated SCD measurements was 3.0 （1.0-11.0） months. For the first tested samples, the between-sample coefficient of variation （CV~） for DFI was 71.2%. A significant difference had been found between DFI of the first measurement and DFI of repeated measurement in 0.5 to 3 months, 3 to 12 months and 12 to 34 months （P〈0.01）. Compared with the first test, 26.3% of males were on both sides of the cut-off point of 18%. The median within-subject coefficient of variation （CVw） for DFI of 539 men was 26.0% （12.6%-42.8%）. And the median CVw DFI was significantly lower compared with CVw of sperm count, concentration, progressive motility and normal morphology （P〈0.01）. Significant correlations were found between the CVw DFI and sperm count, concentration and interval among the samples （P〈0.05）. Conclusion DFI of male partners for infertile couples is a parameter with substantial variation, repeated SCD measurements are therefore recommended.

关 键 词：精子 不育 DNA碎片指数 变异 

分 类 号：R698.2[医药卫生—泌尿科学]