男性不育患者SOD2表达与精液参数的关系及对IVF-ET结局的预测  

Relationship between SOD2 expression and semen parameters in male infertility patients and prediction of IVF-ET outcome

作　　者：陈甫 和帅军 王一任 刘斌[1] CHEN Fu;HE Shuaijun;WANG Yiren;LIU Bin(Department of Obstetrics and Gynecology,the Sixth Medical Center of PLA General Hospital,Beijing 100037,China)

机构地区：[1]解放军总医院第六医学中心妇产科,北京100037

出　　处：《中国优生与遗传杂志》2024年第5期971-978,共8页Chinese Journal of Birth Health & Heredity

摘　　要：目的探究男性不育患者超氧化物歧化酶2(SOD2)表达与精液参数的关系及对IVF-ET结局的预测作用。方法选取2020年1月—2023年9月于解放军总医院第六医学中心就诊的男性不育患者274例为观察组(少精组130例,弱精组144例),同时选取同时期入院检查的健康男性患者为对照组(120例)。比较三组患者临床资料及精液参数,采用LOWESS法分析SOD2 mRNA相对表达量与精液参数的曲线关系,对不同影响因素SOD2 mRNA相对表达量水平进行分层回归分析,分析患者SOD2 mRNA相对表达量水平与IVF-ET结局的关系。采用赤池信息准则(AIC)筛选影响IVF-ET结局的临床因素,构建相应预测模型并进行评价。结果多因素Logistic回归分析结果显示三组患者在年龄、DNA碎片率(DFI)、SOD2、精子正常形态率(NSMR)、前向运动精子(PR)、曲线速度(VCL)、直线速度(VSL)、平均路径速度(VAP)方面的差异均有统计学意义(P<0.05),IVF-ET参数方面,三组患者受精率差异具有统计学意义(P<0.05),SOD2 mRNA相对表达量与NSMR和PR存在线性关系。不同影响因素SOD2 mRNA相对表达量水平分层回归分析结果显示,年龄会对SOD2 mRNA相对表达量产生负向影响,NAMR、PR、受精率会对SOD2 mRNA相对表达量产生显著的正向影响(P<0.05)。赤池信息准则(AIC)分析得出:PR、SOD2、DFI、年龄和受精率是影响IVF-ET结局排名前5的因素,联合以上5个因素构建的模型:Logit(P)=–2.13+0.55×PR+0.60×SOD2+0.55×DFI–0.65×年龄+1.43×受精率。经检验,P=0.90时,约登指数最高,预测效果相对最好,预测准确度为87.95%,灵敏度为91.60%,特异度为84.30%。结论男性不育患者SOD2表达与精液参数中的NSMR和PR存在线性关系,是患者IVF-ET失败的保护因素。PR、SOD2、DFI、年龄和受精率是影响IVF-ET结局的关键因素,并成功构建预测模型。Objective To investigate the relationship between Superoxide dismutase 2(SOD2)expression and semen parameters in male infertility patients and to predict the outcome of in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 274 male infertility patients admitted to the Sixth Medical Center of the PLA General Hospital from January 2020 to September 2023 were selected as the observation group(130 cases in the oligospermia group and 144 cases in the asthenospermia group),and 120 healthy male patients admitted to the same hospital during the same period were selected as the control group.The clinical data and semen parameters of the three groups of patients were compared,and the curve relationship between the relative expression level of SOD2 mRNA and semen parameters was analyzed by LOWESS method.Hierarchical regression analysis was performed on the relative expression level of SOD2 mRNA of different influencing factors,and the relationship between the relative expression level of SOD2 mRNA and the outcome of IVF-ET was analyzed.Akaike Information criterion(AIC)was used to screen the clinical factors affecting the outcome of IVF-ET,and the corresponding prediction model was constructed and evaluated.Results Multivariate Logistic regression analysis showed that there were statistically significant differences in age,DFI(DNA-fragmetation-index),SOD2(superoxide dismutase 2),NSMR(Normal sperm morphology rate),PR(progressive motility),VCL(curvi linear velocity),VSL(linear velocity)and VAP(average path velocity)among the three groups(P<0.05).In terms of IVF-ET parameters,there were statistically significant differences in fertilization rate among the three groups(P<0.05).There was a linear relationship between the relative expression of SOD2 mRNA and NSMR and PR.Hierarchical regression analysis of the relative expression level of SOD2 mRNA for different influencing factors showed that age had a negative effect on the relative expression level of SOD2 mRNA,while NAMR,PR and fertilization rate had a significant p

关 键 词：不育症 超氧化物歧化酶2 精液参数 体外受精-胚胎移植 

分 类 号：R698.2[医药卫生—泌尿科学]