精子核蛋白组型转换在预测复发性流产中的价值  

Values of sperm nucleoprotein transformation in predicting recurrent abortion

作　　者：段礼 陈勇 邱青虹 刘刚 蒋文辉 唐洪波 袁野 葛仁山 田二坡 温子娜 DUAN Li;CHEN Yong;QIU Qinghong;LIU Gang;JIANG Wenhui;TANG Hongbo;YUAN Ye;GE Renshan;TIAN Erpo;WEN Zina(Department of Reproductive Andrology,Sichuan Jinxin Xi′nan Women and Children Hospital,Bi Sheng Courtyard,Chengdu 610023,Sichuan;Department of Reproductive Andrology,Maternal and Child Health Hospital of Jinjiang District,Chengdu 610011,Sichuan,China)

机构地区：[1]四川锦欣西囡妇女儿童医院毕昇院区生殖男科,成都610023 [2]成都市锦江区妇幼保健院生殖男科,成都610011

出　　处：《临床检验杂志》2023年第10期749-752,共4页Chinese Journal of Clinical Laboratory Science

基　　金：四川省医学会医学科研课题(S21080);成都市科技局技术创新研发项目(2022-YF05-01601-SN);成都市卫生健康委员会医学科研课题(2020199,2021241,2021387)。

摘　　要：目的 探讨精子核蛋白组型转换在复发性流产中的预测价值。方法 选取2019—2022年在本院生殖医学门诊就诊的生育检测指标完整的不孕症夫妇521对,其中男性年龄23~56岁。排除导致复发性流产的因素,包括女性的年龄、体质指数、代谢性疾病、抗磷脂综合征、子宫及附件异常、剖宫产史、宫内肌瘤/宫颈锥切等手术史、男女外周血染色体异常、吸烟/酗酒等不良生活史。根据流产情况分为复发性流产组(自然流产≥2次)、自然流产1次组和未流产组,应用GraphPad6.0统计软件进行Tukey多重比较各组精子核蛋白组型转换的差异;采用Pearson法分析精子核蛋白组型转换与复发性流产的相关性;采用敏感性、特异性、阳性预测值、阴性预测值、Youden指数和比值比分析精子核蛋白组型转换对复发性流产的预测价值。结果 复发性流产组(42例)的精子核蛋白组型转换异常率[(33.31±13.83)%]显著高于未流产组[(26.85±15.38)%]和流产1次组[(28.20±12.50)%,P<0.05]。Pearson相关分析结果显示,精子核蛋白组型转换异常率与复发性流产呈显著正相关。精子核蛋白组型转换预测复发性流产的敏感性为45.24%、特异性为73.64%。阳性预测值(15.70%)、阴性预测值(92.53%)、Youden指数(18.88%)及比值比(2.31)均高于高DNA可染色性(HDS)的阳性预测值(10.64%)、阴性预测值(90.31%)、Youden指数(1.05%)及比值比(1.11)。结论 在复发性流产患者的配偶中,精子核蛋白不成熟度显著升高,且其与复发性流产呈显著正相关。同时精子核蛋白组型转换异常可能是复发性流产的重要男性因素,其对临床中复发性流产的预测价值较高。Objective To investigate the values of nucleoprotein transformation in sperm for predicting recurrent abortion.Methods A total of 521 infertile couples with complete test indicators on fertility were selected from the reproductive medical clinic of our hospital from 2019 to 2022,among which the ages of the male were from 23 to 56 years old.The following factors causing recurrent abortion were excluded,including the age of woman,body mass index,metabolic disease,antiphospholipid syndrome,uterine and accessory abnormalities,history of caesarean section and intrauterine myoma/cervical conectomy,peripheral blood chromosome abnormalities of both the couple,and adverse life history,such as smoking/alcohol abuse.According to the abortion situation,they were divided into the recurrent abortion group(≥two spontaneous abortions),one spontaneous abortion group and no abortion group.Tukey′s multiple comparison was performed to compare the differences of nucleoprotein transformation of sperm in each group by using GraphPad6.0 statistical software.The Pearson method was used to analyze the correlation between nucleoprotein transformation and recurrent abortion.The predictive values of nucleoprotein transformation in recurrent abortion were analyzed by the parameters of sensitivity,specificity,positive predictive value,negative predictive value,Youden index and odd ratio.Results The percentages of abnormal nucleoprotein transformation in recurrent abortion group[(33.31±13.83)%]were significantly higher than those in nonabortion group[(26.85±15.38)%]and the one abortion group[(28.20±12.50)%,P<0.05].Pearson correlation analysis showed that there was a significant positive correlation between abnormal nucleoprotein transformation and recurrent abortion.The sensitivity and specificity of nucleoprotein transformation for predicting recurrent abortion were 45.24%and 73.64%,respectively.All of the data of positive predictive value(15.70%),negative predictive value(92.53%),Youden index(18.88%)and odd ratio(2.31)of nucleoprotein

关 键 词：精子核蛋白组型转换 精子核不成熟度 复发性流产 不孕症 

分 类 号：R71[医药卫生—妇产科学]