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目的:分析部分型圆头精子症患者精液常规参数及精子形态。方法:选取2013年1月至2016年5月100例部分型圆头精子症患者作为病例组,对照组为非圆头精子症的不育患者180例。根据精液中圆头精子所占比例不同将病例组分成5组:1组(25%~40%)、2组(41%~55%)、3组(56%~70%)、4组(71%~85%)、5组(86%~99%),根据WHO《人类精液检查与处理实验室手册》第5版标准对其进行精液常规分析,包括精子浓度、活动率、前向运动精子百分率,及对不同畸形精子进行计数并计算畸形精子指数(TZI)及精子畸形指数(SDI)。结果:病例组与对照组的精子活动率[(35.76±24.88)%vs(62.03±10.20)%]、前向运动精子百分率[(26.11±20.39)%vs(45.62±6.87)%]、正常形态精子百分率[(1.45±1.45)%vs(5.98±2.21)%]和SDI(1.33±0.11 vs1.27±0.57)相比差异均有统计学意义(P均<0.01),两组年龄[(29.82±4.90)岁vs(30.33±3.59)岁]、精子浓度[(46.01±40.38)×10~6/ml vs(54.00±25.15)×10~6/ml]和TZI(1.35±0.11 vs 1.34±0.54)比较差异均无统计学意义(P均>0.05);病例组各组精子活动率、前向运动精子百分率、正常形态精子百分率、TZI和SDI均有统计学差异(P均<0.01),而年龄和精子浓度均无统计学差异(P均>0.05)。随着圆头精子比例的升高,精子头部形态由异质性偏向于均一性。结论:精液中不同比例的圆头精子与精液常规参数和形态学指标密切相关,可对不育患者辅助生殖技术的选择和受精率的预测起一定的提示作用。
Objective: To analyze the sperm parameters and sperm morphology in some patients with round spermatozoa. Methods: From January 2013 to May 2016, 100 patients with partial round spermatozoa were selected as the case group and 180 control subjects as infertile patients with non-round spermatozoa. According to the proportion of round sperm in semen, the cases were divided into five groups: one group (25% -40%), two groups (41% -55%), three groups (56% -70% 71% -85%) and 5 groups (86% -99%). According to the fifth edition of the WHO Manual of Human Semen Inspection and Processing Laboratory, sperm routine analysis including sperm concentration, activity rate, The percentage of sperm, and count the different deformities of sperm and calculate the abnormal sperm index (TZI) and sperm abnormality index (SDI). Results: The sperm motility rate in the case group and the control group [(35.76 ± 24.88)% vs (62.03 ± 10.20)%], the percentage of forward motile sperm [(26.11 ± 20.39)% vs (45.62 ± 6.87)%] There were significant differences in the percentage of sperm [(1.45 ± 1.45)% vs (5.98 ± 2.21)%] and SDI (1.33 ± 0.11 vs 1.27 ± 0.57 respectively) (P <0.01) ± 4.90) years old vs 30.33 ± 3.59 years old, sperm concentration [(46.01 ± 40.38) × 10 ~ 6 / ml vs (54.00 ± 25.15) × 10 ~ 6 / ml and TZI 1.35 ± 0.11 vs 1.34 ± 0.54 (P> 0.05). There was a significant difference in sperm motility, forward motility sperm percentage, normal morphology sperm percentage, TZI and SDI between the two groups (all P <0.01), while the difference was not statistically significant There was no significant difference in age and sperm concentration (P> 0.05). As the proportion of round sperm increases, the sperm head morphology is heterogeneously biased toward homogeneity. CONCLUSIONS: The different proportion of round sperm in semen is closely related to the conventional parameters and morphology of sperm, which may be helpful for the selection of assisted reproductive technology and prediction of fertilization rate in infertile patients.