目的研究杭州市萧山区男性精液质量及各项精子动态参数在评价男性生殖方面的临床应用价值。方法对本院2 583例男科门诊就诊的患者精液用计算机辅助精液分析(CASA)系统进行常规指标和精子动态参数检测。结果 2 583例精液标本中,无精子和死精子142例,其余按照WHO正常精液评判标准,七项指标均正常的精液1 268例,占49.09%;一项指标异常314例,占12.16%;二项指标异常216例,占8.36%;≥三项以上指标异常643例,占24.89%。1173例异常精液中(不包括死精子和无精子),活力异常749例,检出率63.85%;活率异常608例,检出率51.83%;密度异常406例,检出率34.61%。活力、活率异常组与正常组动态参数比较,曲线速度(VCL)、直线速度(VSL)、直线性(LIN)、摆动性(WOB)、平均路径速度(VAP)、平均移动角度(MAD)、前向性(STR)下降明显;密度异常组中VCL、VSL、LIN、WOB、VAP与正常组比较有统计学差异;鞭打频率(BCF)在3个异常组中均呈上升趋势。结论杭州市萧山区男性精子活率、活力和密度异常所致不育的情况较精液量、液化时间、酸碱度异常及畸精子症致不育的情况更常见;精子动态参数是评估精液质量的良好指标,为男性不育的诊断、治疗和研究提供了充分的依据。 Objective To study the clinical value of male sperm quality and sperm dynamic parameters in evaluating male reproductive performance in Xiaoshan District of Hangzhou. Methods The sperm samples from 2 583 male outpatient clinics in our hospital were tested by routine computer assisted semen analysis (CASA) system and sperm dynamic parameters. Results There were 142 cases of spermatozoa and spermatozoa without sperm and dead sperm in 2 583 semen samples. The remaining semen samples were all normal in accordance with the criteria of WHO sperm evaluation, including 1 268 cases (49.09%) and 314 indicators (12.16%). Two indexes were abnormal in 216 cases, accounting for 8.36%. Three or more indicators were abnormal in 643 cases, accounting for 24.89%. In 1173 cases of abnormal semen (excluding dead sperm and azoospermia), 749 cases were abnormal vitality with a detection rate of 63.85%; 608 cases were abnormal in survival rate, with a detection rate of 51.83%; and 406 cases with abnormal density, with a detection rate of 34.61%. (VCL), linear velocity (VSL), linearity (LIN), WOB, VAP and MAD were compared between the normal group and the normal group. (STR) decreased significantly. In the group with abnormal density, VCL, VSL, LIN, WOB and VAP had statistical difference compared with normal group. Whipping frequency (BCF) showed an upward trend in all three abnormal groups. Conclusions Male infertility caused by abnormal sperm motility, vitality and density in Xiaoshan District of Hangzhou City is more common than seminal fluid volume, liquefaction time, acidity and alkalinity, and infertility caused by teratospermia. The sperm dynamic parameters are good for evaluating semen quality Indicators, for male infertility diagnosis, treatment and research to provide ample basis.