男科实验室精液分析的质量控制

随着男性不育症的增加,精液分析已成为评价男性生育功能的最基本的常规测试,同时自动化分析仪的推广,计算机辅助精液分析具有较好的可靠性、重复性和稳定性。     

绍兴地区男性不育患者精液质量分析

目的 分析绍兴地区男性不育患者精液质量。方法 选择2020年在本院就诊的167例男性不育者及214例健康查体者,比较两组间精液常规参数的差异性。结果 两组在年龄、禁欲天数、精液量、精液液化时间及液化状态间比较,差异均无统计学意义（P>0.05）;对两组（共381例）的精液量和禁欲时间进行相关性分析,相关系数r=0.18,存在正相关,即随着禁欲时间的延长,精液量随之增加;不育组中精子密度、精子活力、精子活率均显著低于健康查体组,差异有统计学意义（P<0.001）,其中不育组a级精子数下降最为明显。结论 2020年绍兴地区不育男性精液质量以精子密度、精子活力和精子活率减低为主,其中a级精子数减少最为明显,而与年龄、禁欲时间、精液量无关。不良的生活方式、不健康的生活习惯以及环境质量下降等可影响精液质量。     

单侧隐睾史男性精液质量及精子形态学的研究

目的研究单侧隐睾史男性精液质量及精子形态学状况。方法 26例幼年曾确诊为单侧隐睾并行睾丸固定术的男性,成年后分别检测精子密度、精子活率、精子活力及进行精子形态学分析。对照组为无隐睾病史的体检正常男性30例。结果两组男性的精子密度、精子活率无明显差异（P〉0.05）,而单侧隐睾史男性精子活力低于对照组（t=4.43,P〈0.01）,精子畸形率较高（t=4.29,P〈0.01）。精子畸形的类型以头部缺陷为主。结论单侧隐睾史男性成年后精液质量下降。幼年阶段及早手术治疗有利于成年后的精子发生。     

严重白细胞精子症患者精液质量分析

目的分析白细胞数量对精液质量状况的影响。方法根据精液中白细胞数量将患者分为3组，A组：白细胞数量小于1×10^6／ml 60例；B组：白细胞数量1×10^6／ml-7×10^6／ml 50例；C组：白细胞数量大于7×10^6／ml 28例，回顾性分析a级精子（快速向前运动），a＋b级精子（快速向前运动＋慢速向前运动），精液量，密度，畸形率的差异。结果C组精液a，a＋b级精子均低于A组和B组；C组精液量和密度均少于A组和B组；C组畸形率最高，和其他两组差异有统计学意叉。结论严重白细胞精子症患者精液各项指标均比其他两组差。应重视精液中白细胞增多现象，可进一步行细菌培养检查。     

放射免疫分析室内质量控制分析

本文采用自制的四批非定值质控品,对我科常规体外放免项目——甲状腺功能测定中的六个项目进行内部质量控制,共收集了2008年全年241个工作日的完整质控数据,通过统计学分析,探讨多批次自制质控血清在RIA中应用的合理可靠性。     

精液中白细胞与精子动态参数相关性研究

目的探讨精液中白细胞数量与精子动态各参数的相关性。方法选择28例白细胞精子症男性不育精液标本,用精子检测系统定量测定其精子动态参数,并与精液中白细胞数量进行相关性分析。结果精液动态参数中VCL、VSL、VAP等与白细胞数目成正相关。结论精子的动态参数是评估男性不育的重要指标,而精液中的白细胞数目对精子动态参数的影响可能是导致男性不育的一个因素。     

精索静脉曲张患者手术前后精液质量及精子形态变化的研究

目的探讨精索静脉曲张患者手术治疗前后精液质量及精子形态的变化。方法选择我院泌尿外科精索静脉曲张患者70例,分别在手术前和手术后进行精液常规分析和精子形态学分析。结果 70例精索静脉曲张患者手术后精子密度、活率和A级精子活力百分率较术前明显提高,精子畸形率明显降低,两组差别有显著性意义（P〈0.05）。结论精索静脉曲张可对男性生殖功能产生不良影响。     

男性孕前精液质量检测结果分析

目的了解已婚未育孕前体检男性精液质量状况。方法应用WLJY-9000伟力彩色精子质量分析系统对576例已婚未育孕前体检男性精液量、液化时间、精子总数、精子密度、a级精子百分率、b级精子百分率、a＋b级精子百分率、精子活率等方面进行分析。结果已婚未育孕前体检男性的精液量、液化时间、精子总数、精子密度、b级精子百分率、a＋b级精子百分率、和精子活率与正常对照组之间差异无显著性（P〉0.05）;a级精子百分率显著降低（P〈0.05）结论随着全民教育和生活水平的提高,孕前人群的生殖健康知识认知情况很好,比较重视孕前检查。     

精液白细胞含量与精液质量主要参数的关系

目的探讨精液白细胞含量与精液质量主要参数的关系。方法依据世界卫生组织（WHO）的相关标准,精液中白细胞〉1×10^6/ml可诊断为白细胞精子症,据此分为白细胞精子组和精液白细胞≤1×10^6/ml的正常对照组。应用伟力彩色精子质量分析系统检测男性精液量、液化时间、精子总数、精子密度、精子活力、精子活率等参数进行分析。结果当精液中白细胞〉1×10^6/ml时,精液的主要参数液化时间、精子总数、精子密度、a级精子百分率、a＋b级精子百分率、精子活率与正常对照组比较差异具有显著性（P〈0.05）。结论精液中白细胞含量与精液质量有密切的关系,是导致男性不育的重要因素。     

精子DNA甲基化异常与精液质量相关性的研究进展

DNA甲基化是表观遗传学内容之一,在精子发生和胚胎发育中有重要作用。近年来,国内外众多研究发现男性不育症(尤其是精液质量异常)与DNA甲基化异常有关。本文重点阐述了印记基因、一些重复元件和非印记基因异常甲基化与精液质量(包括精子数目、形态和活力)的相关性,旨在进一步研究男性不育的具体机制,为将来临床治疗男性不育症提供新...     

标本采集时间对精液全自动分析各参数的影响

目的 为了了解精液分析中标本获取时间问隔对结果的影响，我们对44个健康受试者的精液进行了测试。方法 受试者48h内留取精液两次，采用伟力全自动精子分析仪对精液进行全自动分析。分别对已婚、未婚。24h、48h结果进行统计学分析。结果 两次取精中第二次精液量明显减少，且差异具有统计学意义。精子运动速度参数vsl、vd、vap，在已婚者中差异具有不同程度的统计学意义。精子密度、a级精子率两次差异均无统计学意义，而b级精子率和c级精子率两次差异均具有不同程度的统计学意义。结论 进行精液常规分析中应要求：取精间隔超过48h。并且最好每次检查前禁欲天数尽量保持一致，从而使检验结果具有可信和可比性。也有利于临床医生的诊断．及治疗效果的比较。     

精液白细胞对精液主要参数及精子功能的影响分析

目的探讨精液白细胞含量与精液主要参数和指标的关系。方法按照WHO人类精液实验室手册要求检测精液中的白细胞、主要参数、精子形态分析、精子顶体酶活性、精浆抗体（AsAb）、解脲支原体等，分析精液白细胞与男性不育相关因素的关系。结果238例男性不育患者中有75例（31．5％）精液中白细胞〉1×10^6个／ml，设为白细胞精子组；163例（68．5％）患者精液中白细胞≤1×10^6个／ml，设为非白细胞精子组。白细胞精子组的精子密度、精子活动率、a＋b级活力精子率、精子顶体酶阳性率均低于非白细胞精子组（P〈0．05）；而精子畸形率、精浆抗体（AsAb）、解脲支原体阳性率均高于非白细胞精子组（P〈0．05）。两组的精液量、pH值和液化时间差异无显著性。结论精液中白细胞含量与精液质量有密切的关系，是导致男性不育的重要原因。     

不良生活习惯对男性精液质量的影响分析

目的探讨不良生活习惯对男性精液质量的影响。方法将258例男性不育患者按照不良生活习惯分为A组（长期吸烟饮酒）、B组（长时间接触电脑）及C组（长时间开车）,正常对照组为98例无不良生活习惯已生育健康男性,对以上各组精液标本的各项主要参数进行对比分析。结果与正常对照组比较,A组、B组及C组的精子密度及活率降低,精子畸形率升高,差异有统计学意义（P〈0.05）。结论不良的生活习惯会对男性精液质量产生一定的影响,可能是导致男性不育的重要因素之一。     

Standardization and quality control of sperm concentration and sperm motility counts in semen analysis

The paper reports a study of standardization and quality controlof sperm concentration counts and visual motility assessmentsin human semen analyses performed for infertility investigationsand from internal quality control procedures. Sperm concentrationdeterminations were performed in Improved Neubauer haemocytometerson volumetric dilutions made using a positive displacement pipettorfor sampling the liquefied semen. In addition to a standard1+19 dilution a second dilution of either 1+9, 1+19 or 1+49was made according to whether the estimated sperm concentrationwas <20, 20–100 or > 100 x l0⁶/ml respectively.The duplicate determinations of sperm concentration were highlysignificantly correlated (P << 0.001) with <5% variability.Parallel visual sperm motility assessments were made by twopairs of technicians and showed highly significant correlations(P << 0.001) between technicians in the determinationof the percentages of motile and progressive spermatozoa aswell as the subjective rating of sperm progressivity. When thesevalues were incorporated into a calculated motility index whichgave added weight to the progressive spermatozoa and to theirquality of progression the correlations between techniciansremained highly significant (P << 0.001) with averagedifferences of the order of 1.0%. Therefore, provided that sufficientattention is paid to technician training, regular standardizationchecks and the use of only proven reliable procedures, quantitativelyaccurate values for sperm concentration and motility can beobtained in routine semen analyses.     

精液分析中各参数与顶体完整率、畸形率和存活率间相关性研究

目的：考察全自动精子分析中各运动性参数、各物理参数、精子密度和四项激素水平与精子功能性参数顶体完整率、畸形率和存活率间的相关性。方法：我们进行了209份健康受试者精液分析测试，并对以上各参数间进行相关性分析。结果：各参数间关系为中、低度或不相关，可表明各自在男性不育中的作用。结论：从而对精液分析中参数异常与男性不育有了更全面深刻地了解，以临床诊断具有指导意义。     

Mutation analysis for cystic fibrosis to determine carrier status in 167 sperm donors from the Nebraska genetic semen bank

Cystic fibrosis is the most common autosomal recessive disorder in Caucasian populations, with an approximate frequency of 1/2500 live births and a carrier frequency of 1/25. Due to the high rate of predicted carriers (>63,000) in the Nebraska population (1990 U.S. Census = 1,578,358), we analyzed sperm DNA obtained from semen donors at the University of Nebraska Genetic Semen Bank for eight of the more common mutations to determine the frequency and diversity in our population. The subjects included 167 semen donors (31 normal healthy donors, 56 infertility patients, 21 prevasectomy patients, and 59 prechemotherapy or preradiation cancer patients). The mutations analyzed included ΔF508, Rl17H, G542X, S549R/N, G55 1D, R553X, R560T, and W1282X. Analyses were performed using PCR amplified products that were analyzed using polyacrylamide gel electrophoresis, slot blot, and restriction endonuclease digestion. These results were correlated with results from the clinical semen analyses and selected clinical parameters. Results for the total donor population studied showed that the ΔF508 mutation was present in8/167 (4.8%) donors, the R117H mutation was present in 4/167 (2.4%) donors and the G542X mutation was present in 1/167 (0.6%) donors. The observed number of carriers from this population, 13/167 (7.8%), was significantly greater (P = 0.02) than that expected assuming a carrier frequency of 1/25. The excess of carriers was restricted to the subgroup of infertility patients. This suggests that CF carriers may be at higher risk for infertility than the general population. © 1994 Wiley-Liss, Inc.     

Evolution of semen quality in North-eastern Spain: a study in 22,759 infertile men over a 36 year period

A retrospective study was conducted in a large population to determine whether sperm quality has changed in Northeastern Spain between 1960 and 1996. From a total initial population of 22,759 men, two separate groups were studied: men with spermatozoa (n = 20,411) and those with azoospermia (n = 1364). After adjustment for age and sexual abstinence, multiple linear regression analyses were used to assess changes in semen parameters over time. A 0.2% decline was observed in semen volume in the spermatozoa group (P < 0.001). No significant increase (0.04%) in sperm count (x 10(6)/ml) was observed in the spermatozoa group. There was a 0.4% increase in motile spermatozoa in the spermatozoa group (P < 0.001). There was a statistically significant decline in normal spermatozoa (3.6%) in the spermatozoa group (P < 0.001). Of the total population, 1364 men had azoospermia (6.0%). The changes observed in the semen parameters analysed in this large population showed no evidence of a deteriorating sperm quality, although a statistically significant decline was observed in the percentage of normal spermatozoa.