精浆氧化还原电位和精子DNA碎片指数与精子运动参数的相关性分析及对少弱精子患者的临床价值分析  

Correlation of seminal plasma oxidation reduction potential and sperm DNA fragmentation index to sperm motion parameters and their predictive value for oligoasthenozoospermia

作　　者：陈莉莎 张宁 刘星池 张倩 李栗妍 于月新 CHEN Li-sha;ZHANG Ning;LIU Xing-chi;ZHANG Qian;LI Li-yan;YU Yue-xin(Department of Reproductive Medicine,General Hospital of Northern Theater Command,Shenyang,Liaoning 110016,China)

机构地区：[1]北部战区总医院生殖医学科,辽宁沈阳110016

出　　处：《中华男科学杂志》2025年第1期11-18,共8页National Journal of Andrology

基　　金：辽宁省科技计划联合计划(自然科学基金-面上项目)(2024-MSLH-523)。

摘　　要：目的:探讨精浆氧化还原电位(ORP)、归一化氧化还原电位(nORP)、精子DNA碎片指数(DFI)与精子运动参数的相关性分析,及对少弱精子症患者的临床价值。方法:选取2024年3~5月到北部战区总医院生殖医学科男科门诊就诊的433例患者作为研究对象。根据精子浓度和前向运动精子百分率,将研究对象分成4组:对照组、少精子组、弱精子组、少弱精子组。采用电极法检测精浆ORP,并计算出nORP=ORP/精子浓度[mV/(106·ml)];采用流式细胞精子染色质结构分析法(SCSA)检测DFI和高DNA染色性精子(HDS)。比较4组的年龄、禁欲天数、精液量、精子总数、精子浓度、前向运动精子数、前向运动精子百分率、非前向运动精子数、非前向运动精子百分率、不动精子数、不动精子百分率、精子总活动率、曲线速度(VCL)、直线速度(VSL)、平均速度(VAP)、线性指数(LIN)、直性指数(STR)、振动指数(WOB)、DFI、HDS、ORP及nORP。利用受试者工作特征(ROC)曲线评估DFI、ORP及nORP对少弱精子症的预测价值。利用Pearson及Spearman分析DFI、ORP及nORP与精子运动参数的关系。结果:统计学分析提示:组间精液量、禁欲天数、精子总数、精子浓度、前向运动精子数、前向运动精子百分率、非前向运动精子数、非前向运动精子百分率、不动精子数、不动精子百分率、精子总活动率、VCL、VSL、VAP、STR、DFI、HDS、ORP及nORP差异具有统计学意义(P<0.05);年龄、LIN和WOB差异没有统计学意义。DFI对弱精子症预测价值的ROC曲线,曲线下面积为0.880,临界值为8.920,灵敏度为74.8%,特异性为88.2%;ORP对弱精子症预测价值的ROC曲线,曲线下面积0.698,临界值为155.375,灵敏度为70.6%,特异性为64.7%;nORP对少精子症预测价值的ROC曲线,曲线下面积0.999,临界值为9.844,灵敏度为98.3%,特异性为99.2%。Pearson及Spearman相关性分析提示,DFI与年龄、禁欲天数、精液量、不动精Objective:To investigate the correlation of seminal plasma oxidation reduction potential(ORP),normalized oxidation-reduction potential(nORP)and sperm DNA fragmentation index(DFI)to sperm motion parameters,and their clinical predictive value for oligoasthenozoospermia(OAZ).Methods:This study included 433 male subjects visiting the Clinic of Andrology in our hospital from March to May 2024.According to sperm concentration and the percentage of progressively motile sperm(PMS),we divided them into a normal control(n=119),an oligozoospermia(OZ,n=118),an athenozoospermia(AZ,n=119)and an OAZ group(n=77).Using the electrode method,we measured the seminal plasma ORP,calculated nORP=ORP/sperm concentration(mV/[106/ml]),and determined DFI and high DNA chromatin sperm(HDS)by flow cytometry based on sperm chromatin structure assay(SCSA),followed by comparison among the four groups in age,abstinence days,semen volume,total sperm count,sperm concentration,PMS,non-progressively motile sperm(NPMS),immotile sperm(IMS),curvilinear velocity(VCL),straight line velocity(VSL),average path velocity(VAP),linearity(LIN),straightness(STR),wobble(WOB),DFI,HDS,ORP and nORP.Using the receiver operating characteristic(ROC)curve,we assessed the predictive value of DFI,ORP and nORP for OAZ,and analyzed the correlation of DFI,ORP and nORP to sperm motion parameters by Pearson and Spearman analyses.Results:Statistical analysis revealed statistically significant differences among the four groups in semen volume,abstinence days,total sperm count,sperm concentration,PMS,NPMS,IMS,total sperm motility,VCL,VSL,VAP,STR,DFI,HDS,ORP and nORP(P<0.05),but not in age,LIN and WOB(P>0.05).The area under the ROC curve(AUC)for the predictive value of DFI for OAZ was 0.880,with the critical value of 8.920,sensitivity of 74.8%and specificity of 88.2%;that of ORP for AZ was 0.698,with the critical value of 155.375,sensitivity of 70.6%and specificity of 64.7%;and that of nORP for OZ was 0.999,with the critical value of 9.844,sensitivity of 98.3%and specificity of 99.

关 键 词：精子DNA碎片指数 精浆氧化还原电位 少弱精子症 精子运动参数 氧化应激 

分 类 号：R698[医药卫生—泌尿科学]