计算机辅助精子分析用精液样本的稀释条件及标准化研究  

Dilution conditions and standardization study for semen samples using computer-aided sperm analysis

作　　者：伍细言 郝瑞龙 李维娜 WU Xiyan;HAO Ruilong;LI Weina(Center for Reproductive Medicine,Hunan Provincial Maternal and Child Health Care Hospital,Changsha 410008,Hunan;Guangxiu Hospital Affliate to Hunan Normal University,Changsha 410205,Hunan;Department of Andrology,Reproductive and Genetic Hospital of CITIC-Xiangya,Changsha 410221,Hunan,China)

机构地区：[1]湖南省妇幼保健院生殖医学中心,长沙410008 [2]湖南师范大学附属光琇医院,长沙410205 [3]中信湘雅生殖与遗传专科医院男科学部,长沙410221

出　　处：《临床检验杂志》2024年第2期81-84,共4页Chinese Journal of Clinical Laboratory Science

基　　金：湖南省自然科学基金面上项目(2022JJ30018);湖南省卫生健康委科研课题(B202301037899);中信湘雅科研基金(YNXM-202219);湖南省妇幼保健院锐新项目(2021RX30)。

摘　　要：目的探讨计算机辅助精子分析(CASA)系统检测高浓度精液样本的稀释条件及标准。方法当精子浓度<50×10^(6)/mL时不稀释;当≥50×10^(6)/mL时,按1:[n/(50×10^(6))]的比例[n为精子浓度,n/(50×10^(6))向下取整]用生理盐水稀释至50×10^(6)/mL以下。采用CASA系统和10μm深度一次性计数板检测精液样本,分为未稀释组(组1:精子浓度<50×10^(6)/mL).50×10^(6)/mL≤精子浓度<100×10^(6)/mL组(组2)、精子浓度≥100×10^(6)/mL组(组3),稀释前后分析各组精子浓度、前向运动精子百分率(PR)、非前向运动精子百分率(NP)精子活动率(PR+NP)和不活动精子百分率(IM)等,比较稀释前后结果的一致性。采用ROC曲线预测最佳稀释阈值。结果随着精子浓度的增加,稀释前后各参数差异逐渐增大。ROC曲线分析结果显示,分别用精子浓度、PR+NP、PR、NP、IM預測时,精液标本的最佳稀释阈值分别为133.05×10^(6)/mL.101.75×10^(6)/ml.118.60×10^(6)/mL.90.90×10^(6)/m111.83×10^(6)/mL.结合高浓度精液样本未稀释检测时对精子浓度和NP的影响最大,确定最佳稀释固值为125.08×10^(6)/ml。结论建议当精子浓度>125×10^(6)/mL时,应对精液样本进行生理盐水稀释。Objective To explore the dilution conditions and standards in detecting the semen samples with high sperm concentration using computer-aided sperm analysis(CASA)systems.Methods CASA systems with 10μm depth disposable counting chambers were used for the examination.The samples were divided into undiluted group(Group 1:sperm concentration<50×10^(6)/mL)and diluted groups(Group 2:50×10^(6)/mL≤sperm concentration<100×10^(6)/mL;Group 3:sperm concentration≥100×10^(6)/mL).When sperm concentration<50×10^(6)/mL,no dilution was performed.W hen sperm concentration≥50×10^(6)/mL,the samples were diluted with saline at 1:n/(50×10^(6))ratio(n=sperm concentration,n/[50×10^(6)]rounded down)to<50×10^(6)/mL of sperm concentration.The sperm concentration,progressive motility(PR),non-progressive motility(NP),total motility(PR+NP)and immotile sperm percent-age(IM)were analyzed before and after dilution.The consistency of results pre-and post-dilution was compared.ROC curve was used to analyze the optimal dilution threshold.Results The differences in the parameters pre-and post-dilution gradually rosed with the increased sperm concentration.ROC curve analysis showed optimal dilution thresholds were 133.05×10^(6)/mL,101.75×10^(6)/mL,118.60×10^(6)/mL,90.90×10^(6)/mL,111.83×10^(6)/mL for the sperm concentration,PR+NP,PR,NP and IM respectively.Considering sperm concentration and NP were most affected the undiluted high concentration samples,the optimal comprehensive dilution threshold was determined as 125.08×10^(6)/mL.Conclusion When sperm concentration exceeds 125×10^(6)/mL,it is recommended to dilute semen sample with normal saline.

关 键 词：计算机辅助精子分析 精子浓度 精液稀释 生理盐水 

分 类 号：R446[医药卫生—诊断学]