精子DNA碎片化对男性不育症的诊断价值分析  

Analysis of the diagnostic value of sperm DNA fragmentation in male infertility

作　　者：翁光明 吴友科 吴燕 黄惠兰 何悦枝 WENG Guangming;WU Youke;WU Yan(Department of Clinical Laboratory,Heyuan Maternal and Child Health Hospital,Heyuan 517000,China;不详)

机构地区：[1]河源市妇幼保健院检验科,广东河源517000 [2]河源市妇幼保健院男科门诊,广东河源517000 [3]河源市妇幼保健院妇科门诊,广东河源517000

出　　处：《医师在线》2025年第2期39-42,共4页Journal of Doctors Online

摘　　要：目的探讨精子DNA碎片化对男性不育症的诊断价值,以期为临床早期诊断提供参考。方法回顾性选取2023年12月~2024年4月82例在我院就诊的男性不育症患者作为研究组,另选取同期82例健康体检男性作为对照组,两组均行精子DNA完整性检测,比较两组精子DNA碎片指数(DFI)、精液相关参数(精子活力、精子浓度、正常形态精子百分率、前向运动精子百分率、顶体反应率),并比较不同DFI患者的精液相关参数,分析DFI与精液相关参数的相关性,采用受试者工作特征(ROC)曲线分析DFI对男性不育症的诊断价值。结果研究组DFI高于对照组,精子活力、精子浓度、正常形态精子百分率、前向运动精子百分率、顶体反应率低于对照组(P<0.05)。不同DFI患者精液相关参数存在显著差异(P<0.05),DFI≥30%患者的精子浓度、精子活力、正常形态精子百分率、前向运动精子百分率、顶体反应率更低(P<0.05)。Pearson相关性分析显示,DFI与精子活力、精子浓度、正常形态精子百分率、前向运动精子百分率、顶体反应率均呈负相关(P<0.05)。ROC曲线结果显示,DFI对男性不育症患者诊断的ROC曲线下面积(AUC)为0.860(95%CI:0.797~0.909),截断值为19.92%,灵敏度为92.68%,特异度为73.17%。结论DFI可用于男性不育症的诊断,且DFI与精子活力、精子浓度、正常形态精子百分率、前向运动精子百分率、顶体反应率均呈负相关,可为该病的早期诊断、评估精液质量提供参考。Objective To explore the diagnostic value of sperm DNA fragmentation in male infertility in order to provide reference for early clinical diagnosis.Methods A total of 82 male infertility patients who were treated in our hospital from December 2023 to April 2024 were retrospectively selected as the study group,and 82 healthy males who underwent physical examination during the same period were selected as the control group.Sperm DNA integrity testing was performed in both groups.Sperm DNA fragmentation index(DFI)and semen related parameters(sperm motility,sperm concentration,percentage of morphologically normal sperm,percentage of forward motile sperm,acrosomal response rate)of the two groups were compared,and semen related parameters of different DFI patients were compared to analyze the correlation between DFI and semen related parameters,and the diagnostic value of DFI in male infertility was analyzed by receiver operating characteristic(ROC)curve.Results The DFI of the study group was higher than that of the control group,and the sperm motility,sperm concentration,percentage of morphologically normal sperm,percentage of forward motile sperm and acrosome response rate were lower than those of the control group(P<0.05).There were significant differences in semen related parameters among patients with DFI(P<0.05),and the sperm concentration,sperm motility,percentage of morphologically normal sperm,percentage of forward motile sperm and acrosome response rate were lower in patients with DFI≥30%(P<0.05).Pearson correlation analysis showed that DFI was negatively correlated with sperm motility,sperm concentration,percentage of morphologically normal sperm,percentage of forward motile sperm and acrosome response rate(P<0.05).The ROC curve results indicated that the diagnostic area under the ROC curve(AUC)of DFI for male infertility patients was 0.860(95%CI:0.797~0.909),with a cut-off value of 19.92%,a diagnostic sensitivity of 92.68%,and a specificity of 73.17%.Conclusion DFI can be used in the diagnosis of male inf

关 键 词：男性不育症 精子DNA DNA完整性 DNA碎片化 

分 类 号：R698.2[医药卫生—泌尿科学]