男性不育症初诊患者治疗前精液参数波动规律探讨  

Investigation on the Fluctuation of Semen Parameters of First-Visit Male Patients with Infertility before Treatment

作　　者：张敏建[1] 邓日森 张新安[1] 程宛钧[1] 史亚磊[1] 潘日润 林勇[1] Zhang Minjian;Deng Risen;Zhang Xinan;Cheng Wanjun;Shi Yalei;Pan Rirun;Lin Yong(Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350004,China)

机构地区：[1]福建中医药大学附属人民医院,福建福州350004

出　　处：《中国男科学杂志》2020年第4期26-31,共6页Chinese Journal of Andrology

基　　金：张敏建福建省名老中医药专家传承工作室项目(闽卫办中医发明电[2018]216号);第六批全国老中医药专家学术经验继承工作项目(国中医药人教发[2017]29号);国家自然科学基金面上项目(81573743);国家自然科学基金青年科学基金资助项目(81403246)。

摘　　要：目的探讨男性不育初诊患者治疗前精液参数波动规律及可能的影响因素。方法收集142例按要求每周检查1次精液并完成≥4次的男性不育初诊患者精液参数(精子密度、a级精子及(a+b)级精子),观察性激素、血生化、精浆生化和VC等可能的影响因素。以精液参数波动的绝对值(最大值-最小值)大小进行分组分析。精子密度波动分组(A、B、C三组),A组密度波动幅度≥10(1表示1×10^6/m L),B组密度波动3≤幅度<10,C组密度波动幅度<3;a级精子波动分组(D、E、F三组),D组波动幅度≥10%,E组波动5%≤幅度<10%,F组波动幅度<5%;(a+b)级精子波动分组(G、H、I三组),G组波动幅度≥10%,H组波动5%≤幅度<10%,I组波动幅度<5%;密度与活力同时波动分组(J、K二组),J组密度波动幅度≥3及a级精子波动幅度≥5%,K组密度波动幅度≥3同时(a+b)级精子波动幅度≥5%。结果1、精液参数波动情况:142例精液参数均存在依次递减、依次递增、交叉增减的波动和单次出现极值0的现象。(1)精子密度波动:依次递减6例占4.23%,依次递增9例占6.34%,交叉增减127例占89.43%,B组交叉增减率占比高,与A、C组比较有统计学意义(P<0.05),表明精子密度交叉增减在中度波动组明显。(2)精子活力波动:精子活力表现a级精子依次递减5例占3.52%,依次递增5例占3.52%,交叉增减132例占92.96%,单次出现0值31例占21.83%;(a+b)级精子依次递减8例占5.63%,依次递增5例占3.52%,交叉增减129例占90.85%,单次出现0值18例占12.68%。其中E组a级精子交叉增减率较高与D、F组比较有统计学意义(P<0.05),表明a级精子交叉增减波动在中度波动组多见;(a+b)级精子交叉增减发生率G、H、I三组逐渐减少,有统计学意义(P<0.05),提示(a+b)级精子波动幅度越大越表现为交叉增减。2、影响因素:A组LH、PRL降低伴随UA升高与B组比较有统计学意义(P<0.05),同时发现B组LH、UA降低伴随T、TC升高与C组比较�Objective To explore the fluctuation rules of semen parameters of the first-visit male patients with infertility before treatment and the possible influence factors.Methods Collecting the data of semen parameters(sperm density,grade a sperm and grade(a+b)sperm)from 142 male infertility patients in their first diagnosis who had completed asemen examination each week and completed four or more times as required.Observing the influence factors of sex hormone,blood biochemistry,seminal plasma biochemistry and VC.The absolute value(difference between maximum and minimum)of semen parameters fluctuation was used for grouping and analyzing:Based on the fluctuation range of sperm density(it was divided into group A,B and C),group A--fluctuation range≥10(1=1×10^6/mL),group B--3≤fluctuation range<10,and group C--fluctuation range<3;Based on grade a sperm motility(it was divided into group D,E and F),group D--fluctuation range≥10%,group E--5%≤fluctuation range<10%,group F--fluctuation range<5%;Based on grade(a+b)sperm motility(it was divided into group G,H and I),group G--fluctuation range≥10%,group H--5%≤fluctuation range<10%,and group I--fluctuation range<5%.Based on the co-fluctuation of sperm density and motility(it was divided into group J and K):group J,with the fluctuation range of Sperm density≥3 and the fluctuation range of grade a sperm≥5%;and group K,with the fluctuation range of Sperm density≥3 and the fluctuation range of grade(a+b)sperm≥5%.Results 1.Fluctuation of semen parameters:In all 142 cases,the semen parameters fluctuated with decreasing progressively,increasing progressively,cross increasing and decreasing,and the single occurrence of extreme value 0.①Sperm density:It’s found that the sperm density decreased progressively in 6 cases(4.23%),increased progressively in 9 cases(6.34%),cross increased and decreased in 127 cases(89.43%);The high percentage of cross increase and decrease in group B comparing with group A andgroup C was of statistically significance(P<0.05),indicating t

关 键 词：不育 男性 精液分析 

分 类 号：R698.2[医药卫生—泌尿科学] R349.29[医药卫生—外科学]