特发性弱精子症线粒体功能和超微结构研究

目的观察特发性弱精子症的精子线粒体功能和超微病变结构,探讨线粒体在精子活力特性中的作用。方法根据特发性弱精子症诊断标准,筛选特发性弱精子症患者151例,根据A级精子活动力分成3组,15％≤A组〈25％、5％≤B组〈15％、C组〈5％。3组精子线粒体均作功能检测和电子显微镜观察,并与53例正常已育男性作比较。结果A、B、C3组线粒体琥珀酸脱氢酶（SDH）着色率、线粒体膜电位（MMP）着色率与正常组比较差异有统计学意义（t=28．12、38．82、64．71;t=21．34、33．60、44．99,均P〈0．01）。各组间线粒体结构病变出现的频率差异有统计学意义（x^2=60．85,P〈0．01）。病变线粒体数量随着精子活力的减低而增加（回归x^2=479．72,回归系数b=0．86,P〈0．01）。随着精子活力的下降,线粒体病变程度也随之加剧（回归x^2=435．89,回归系数b=0．80,P〈0．01）。结论特发性弱精子症的精子线粒体存在多种不同性质的病变及功能障碍,精子活力与线粒体结构及功能密切相关。

Ultrastructure and function of mitochondria in idiopathic asthenospermia: study of 151 cases

OBJECTIVE: To explore the ultrastructure and function of mitochondria in idiopathic asthenospermia and the role thereof in the sperm activity. METHODS: Samples of sperm were collected from 151 idiopathic asthenospermia patients, 25% of whose sperms were classified as lower than grade A, were subdivided into 3 groups: Group A with the proportion of grade A sperms between 15% and 25%, Group B, with the proportion of grade A sperm between 15% and 5%, and Group C with the proportion of grade A sperm < 5%. Transmission electron microscopy was used to observe the ultrastructure of the mitochondria in the sperms. Samples of sperm were collected from 53 normal patients as control group. The levels of succnate dehydrogenase (SDH) and mitochondrial membrane potential (MMP) were detected. RESULTS: The expression rates of SDH and MMP were decreased according to the sequence of the control group, group A, Group B, and Group C with significant between any two groups (all P < 0.01). Various mitochondrial pathological changes (MPCs) emerged in Groups A, B and C, however with different frequencies of occurrence for specific MPC in specific group (chi2 = 60.85, P < 0.01). The amount of abnormal mitochondria increased significantly according to the sequence of the control group, Groups A, B and C (chi2 = 479.72, b = 0.86, P < 0.01). The severity degree of MPC increased along with the decrease of sperm viability (chi2 = 435.89, b = 0.80, P < 0.01). CONCLUSION: Various MPCs exist in idiopathic asthenospermia. There is a close association between the sperm viability and mitochondrial ultrastructure and mitochondrial function.