不育男性不同影响因素与精子质量参数的关系研究

目的:对门诊就诊不育男性的身体质量指数(body mass index,BMI)、不良生活习惯、特殊工作环境、泌尿系统炎症感染与精子质量参数的关系进行研究。方法:选择2014年1月至2015年12月来院就诊的男性不育患者510例,测量患者身高体重,进行问卷调查,并结合计算机辅助精液分析系统(CASA)及试剂盒对精液液化时间、p H值、精液浓度、精子活率活力、精子形态和精子DNA碎片化指数(DNA fragmentation index,DFI)等参数进行分析。结果:按照BMI标准分组后显示低体重组、超重组、肥胖组、重度肥胖组在精子浓度、精子活率、精子正常形态率、精子DFI指数方面与标准体重组比较均有降低或升高的趋势,且差异显著,有统计学意义(P0.05);不良生活习惯(如长期吸烟、酗酒、熬夜)和某些特殊职业(高温、辐射和挥发性化学物质)及男性泌尿生殖系统炎症感染等因素对精液质量下降影响较大,差异显著,有统计学意义(P0.05);个别组在精液液化时间、精液量及精液p H方面存在差异,有统计学意义(P0.05)。结论:BMI指数异常、不良生活习惯、特殊职业及男性泌尿生殖系统炎症感染等因素可引起精子质量多项参数改变,是影响男性精液质量下降的重要原因。该研究为男性不育症发生机制的探索及诊治方向的判断提供理论参考。

Relationship of different influencing factors and sperm quality parameters in infertile men

Objectives:To study the relationship of body mass index (BMI),bad living habits,special working conditions,urinary tract inflammation infection and sperm quality parameters in outpatients with infertility.Methods:510 infertile patients from January 2014 to December 2015 were selected.The body weight and height were measured;questionnaire survey was conducted;Computer-aided Semen Analysis System (CASA) and kit was adopted to analyze the parameters of semen liquefaction time,pH value,semen concentration,sperm motility rate vitality,sperm morphology and DNA fragmentation index (DFI).Results:The patients were grouped into five groups according to the BMI.The sperm concentration,sperm motility,normal sperm morphology rate and sperm DFI index between low body weight group,overweight and obesity group and severe obesity group all changed compared with those in the normal weight group,with statistically significant difference (P ＜ 0.05).Bad habits (such as smoking,drinking,staying up late) and some special occupation (high temperature,radiation and volatile chemicals) and male genitourinary system inflammation,infection and other factors all had significant influence on the decrease of the quality of semen,with statistically significant difference (P ＜ 0.05).Differences in semen liquefaction time,sperm quantity and sperm pH were statistically significant among groups (P ＜ 0.05).Conclusion:Abnormal BMI,unhealthy living habits,special occupation and male urological and reproductive system inflammation factors can cause changes in a number of parameters of sperm quality,which are important factors for the decrease of the quality of semen.This study provides a theoretical reference for the exploration of the mechanism of male infertility and its diagnosis and treatment.