精液/精子质量与复发性流产关系的病例对照研究

目的:分析精液常规参数与复发性流产间的关系。方法:采用1∶1配对病例对照研究,比较复发性流产患者配偶与健康体检男性间的精液相关参数。结果:相对于对照组,病例组的精液量[(1.95±1.11)mlvs(2.74±1.43)ml]、精子浓度[(48.68±20.07)×106/ml vs(59.26±25.35)×106/ml]、b级精子百分率[(12.07±3.34)%vs(16.18±6.74)%]、果糖含量[(1.73±0.64)g/L vs(2.21±0.75)g/L]、顶体酶活性[(84.34±26.69)U/mg prot vs(94.20±26.35)U/mg prot]、α-葡糖苷酶(α-GLU)[(36.28±15.98)U/ml vs(44.45±12.54)U/ml]和酸性磷酸酶(ACP)[(68.55±35.45)U/ml vs(84.78±51.10)U/ml]的含量较低(P<0.05),头部畸形精子百分率[(47.36±4.59)%vs(46.50±6.32)%]、尾部畸形精子百分率[(7.56±2.27)%vs(7.28±3.10)%]和弹性硬蛋白酶[(885.64±1 272.30)ng/ml vs(661.08±764.64)ng/ml]的含量较高(P<0.05);判别分析结果显示,精液量、b级精子百分率、混合畸形精子百分率、果糖含量、α-GLU含量和ACP含量可用于复发性流产男性精液/精子质量的判断。结论:常规精液/精子质量相关检测对于评价复发性流产精液因素具有一定的意义,但需要综合分析,特异性不够;精液/精子质量相对较差与复发性流产发生相关。

Recurrent miscarriage and the quality of semen and sperm: a case-control study

Objective： To analyze the relation between recurrent miscarriage and routine semen parameters. Methods： We compared the semen parameters of normal healthy men with those of the spouses of recurrent miscarriage women through 1 ：1 agematched case-control study. Results： Compared with the healthy controls, the men of the case group showed a significantly lower mean semen volume （ [ 1.95 ± 1.11 ] ml vs [ 2.74 ± 1.43 ] ml）, sperm concentration （ [ 48.68 ± 20.07 ] × 10^6/ml vs [ 59.26 ± 25.35] × 10^6/ml）, percentage of grade b sperm （ [ 12.07 ± 3.34] % vs [ 16.18 ± 6.74] % ）, fruit-sugar content （ [ 1.73 ± 0. 64 ] g/L vs [ 2.21 ± 0.75] g/L）, acrosomal enzyme activity （ [ 84.34 ± 26.69 ] U/rag prot vs [ 94.20 ± 26.35 ] U/mg prot）, α-glucuronidase （α-GLU） content （[36.28 ±15.98] U/ml vs [44.45 ± 12.54] U/ml）, and acid phosphatase （ACP） content （[68.55 ±35.45] U/ml vs [84. 78 ± 51.10] U/ml） （P 〈 0. 05）, but remarkably bigber percentages of bead teratosperm （[47.36 ± 4.59] % vs [46.50 ＋ 6.32] %） and tail teratosperm （[7.56 ± 2.27] % vs [7.28 ±3.10] %）, and elastase content （ [ 885.64 ±1 272.30 ] ng/ml vs [ 661.08 ± 764.64 ] ng/ml） （P 〈 0.05）. Based on the results of discriminant analysis, the semen volume, percentages of grade b sperm and combined teratosperm, and contents of fruit-sugar, α-GLU and ACP could be used to evaluate the semen and sperm quality of the spouses of recurrent miscarriage women. Conclusion ： Routine semen and sperm tests might help evaluate the seminal factors of recurrent miscarriage, but they lack specificity and need comprehensive analysis. Poorer semen quality is associated with higher incidence of recurrent miscarriage.