深圳地区男科就诊患者精液质量与其他地区精液质量的分析

目的 分析不同地区精液质量的地区性差别及影响因素.方法 研究对象来自深圳地区、成都、遵义及西班牙男科门诊就诊病人,分析指标包括精液量、活动率、活力(A+B).结果 对比成都、遵义地区的相关数据,精子密度下降、精子活动率下降、精子活力下降等精液异常的百分比较高,差别有统计学意义,而无精子症百分比差别有统计学意义.对比西班牙相关数据,a+b级精子百分比无明显差异(P=0.072);精子密度、a+b级精子数目高于西班牙(P<0.01);精液量、年龄、禁欲时间、精子总数低于西班牙指标,差别有显著意义(P<0.01).精液量、年龄、禁欲时间、精子总数低于西班牙指标,差别有显著意义(P<0.01).结论 深圳地区就诊男科患者精液质量低于成都地区及遵义地区水平,与西班牙比较精液质量无明显下降.     

2343例男科就诊患者精子动态参数分析

目的探讨精子动态参数在评价男性生育能力方面的应用价值。方法严格按照WHO技术规范，用计算机辅助精液分析（CASA）系统对本院2343例男科门诊就诊的患者精液进行常规指标和精子动态参数分析。结果①正常精液组和异常精液组各项精子动态参数比较，均存在统计学差异；②随着精子存活率的下降，曲线速度（VCL）、直线速度（VSL）、平均路径速度（VAP）、平均移动角度（MAD）、侧摆幅度（ALH）、前向性（STR）下降明显，鞭打频率（BCF）呈上升趋势，而直线性（LIN）、摆动性（WOB）差异无显著性；③与密度活力正常组比较：少精组除LIN、STR有所增加，MAD、BCF有所下降，差别有统计学意义外，其余五项参数差别无统计学意义；弱精组除MAD无统计学差异外，其余八项参数均有统计学差异；少弱精组除MAD和ALH无统计学差异外，其余七项参数均有统计学差异。结论精子动态参数是评估精液质量的重要指标，为男性不育的诊断、治疗和研究提供了充分的依据。     

不育门诊就诊男性精液质量与影响因素分析

目的探讨湖北省鄂州地区男性精液的质量及影响男性精液质量的危险因素,指导男性健康的生活方式,提高男性的生育能力。方法对993例男性进行问卷调查、体格检查,并取其精液用计算机辅助精液分析系统(CASA)结合传统手工方法对精液液化时间、精子浓度、精子存活率、精子活动力和精子形态等参数进行分析检测。结果不良生活习惯(如长期吸烟、酗酒、熬夜)和某些特殊职业(暴露计算机辐射、高温和挥发性化学物质)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,差异具有统计学意义(P0.05)。结论不良生活习惯和某些特殊职业及男性泌尿生殖系统炎症感染等因素是影响鄂州地区男性精液质量下降的重要原因。     

464例随州地区正常生育力男性精液质量分析

我们在2006年5月-2007年5月对随州地区464例有正常生育力的男性精液进行调查分析，了解目前随州地区男性精液质量情况，建立适合本地区的参考范围，也可为“中国男性生殖资源数据库”课题开展各地区各民族男性精液质量的研究提供基础数据。     

男性不育患者精液质量与精子顶体酶活性关系分析

目的:分析男性不育患者精液参数与精子顶体酶活性变化,探讨精液质量与顶体酶活性的关系。方法:对214例男性不育患者的精液作精子顶体酶活性、弹性蛋白酶、果糖、α葡糖苷酶、锌、酸性磷酸酶、精子尾部低渗肿胀试验检测,同时精子质量检测仪作精液分析。以检出精子顶体酶活性正常的(48.2~218.7μIU/106精子)111例作为对照组,与顶体酶活性异常(<48.2μIU/106精子)的103例精液参数作对比分析。结果:两组精液参数的精子密度、精子活动率、a+b级精子百分率、精子尾部低渗肿胀试验差异均有非常显著性(P<0.001)。弹性蛋白酶差异有显著性(P<0.05)。果糖、α葡糖苷酶差异亦有显著性(P<0.05)。精液量、锌、酸性磷酸酶差异无显著性(P>0.05)。结论:精子顶体酶活性与精液质量关系密切,精子顶体酶活性是反映精液质量的一项可靠指标。     

重庆市部分地区男性精液质量现状分析

目的:了解三峡库区重庆段男性精液质量现状及其地域分布特点,评估三峡库区重庆段男性生殖健康现状。方法:选择重庆市境内长江流经的6个区县(南岸区、沙坪坝区、忠县、万州区、云阳县、巫山)的1 976例男性,按照WHO第四版精液分析标准采取精液,现场进行精液质量分析,利用精液质量来评估男性生殖健康现状。结果:重庆市6区县的男性的精液参数(精液量、精子密度、精子总数、精子活动率、精子形态正常率)均值都在正常范围;精子活力(a+b)%正常仅见于沙坪坝区、云阳县和忠县男性,其他3个区的男性精子活力(a+b)%异常。6区县男性精液参数比较,差异具有显著性(P<0.05);各区县健康男性精液参数[酸碱度、液化时间、精液体积、精子密度、前向运动精子(a%)、活力(a+b)%、活动率]均正常的不足50%,正常率最高的是云阳县,为47%;而万州区,仅仅16%的男性上述精液参数完全正常。利用G IS软件将精液参数作空间分布图,6区县男性精液质量分布呈现地域性差异,云阳县男性精液质量最好,万州区和巫山县最差。结论:三峡库区重庆段男性精液质量水平较低,并随长江流向呈现地域性差异。     

精液生精细胞检查与男科疾病

目的：探讨精液生精细胞检查与疾病的关系。方法：采用端－姬染色法观察精液生精细胞形态、数量及存在比例。结果：化疗、放疗病人出现生精细胞形态异常；长期服用雷公藤药物生精停滞皇初级精毒细胞阶段，长期接触高温、肾功能不全而行血透者生精细胞停滞于初级精母细胞及精子细胞阶段；双侧隐睾及Ｋｌｉｎｅｆｅｌｔｅｒ综合征病人精液中无精子及生精细胞；阴囊鞘膜积液约２０％的病人生精停清点于精子细胞阶段，精索静脉曲张精液中     

尿毒症患者精液质量的变化

目的 :分析肾移植术前尿毒症患者精液质量的变化。　方法 :对 2 4例尿毒症患者和 12例正常男性的精液进行常规分析。　结果 :尿毒症患者的精液体积、精子活动力、存活率、精子密度及精子正常形态百分率分别为 (2 .5± 0 .4 )ml、(13.4± 3.9) %、(2 5 .4± 5 .6 ) %、(2 0 .6± 4 .5 )× 10 6/ml和 (16 .8± 2 .1) % ,明显低于正常对照组 (P均 <0 .0 1)。　结论 :尿毒症患者精液质量显著降低 ,生精功能受到严重影响。     

低渗精浆与精液质量的相关分析

精浆渗透压对男性生育力的影响已有文献报道[1,2 ] ,均认为许多不育症是由精浆渗透压增高所致。然而 ,本文在 10 6 9例受检精液样本中发现有 85例精浆渗透压下降 (下称低渗精浆 )。通过与正常对照组进行比较 ,低渗精浆对精液质量有非常明显的影响。1　材料和方法1.1　材料　ＦＭ 6型全自动冰点渗透压计 (上海医科大学仪器厂生产 )。4 5例正常生育男性精液均为本院产科待产产妇的丈夫所供 ,年龄 2 4～ 38岁 ,平均 2 6 .9岁。 85例低渗精浆从 10 6 9例不育精液样本中筛选而得 ,病人均为与其配偶同居 2年以上一直未育 (配偶经妇科检查正常 ) ,…     

三种精液检测工具的比较与评价

本文报告了用Ｍａｃｒｏ精子计数权与Ｍａｋｌｅｒ精子计数板及血细胞计数板分别就精子密度，活动精子百分率和精子运动速度进行了分析，统计结果表明，三种计数板在精子密度计数上有极了的一致性；Ｍａｃｒｏ板和Ｍａｋｌｅｒ板对活动精子百分率和精子运动速度的分析也无显著性差异。作者认为：国产Ｍａｃｒｏ板可以取代血细胞计数板和Ｍａｋｌｅｒ板用于精液分析，在推广普及后将有助于我国精液检查的标准化。     

Poor semen quality from patients with malignancies does not rule out sperm banking

Cancer therapy can further impair the already poor semen quality in cancer patients. This study evaluated the prefreeze and postthaw semen quality before treatment of patients with malignancies to examine the rationale for sperm banking for these men. Records of nine patients with different malignant tumors, who had been referred for sperm cryopreservation between 1982 and 1997, were reviewed and the results were compared with those of 50 normal healthy donors. Patients did not differ from donors in age, ejaculate volume, or duration of sexual abstinence. The total motile sperm count (median and interquartile range) was significantly different between patients and donors for prefreeze specimens (P=0.026) and postthaw specimens (P=0.008). Also, the percent motility was significantly lower in the patients as compared with the donors in prefreeze (P=0.035) and postthaw specimens (P=0.005). The percentage change in motility after thawing was also larger for patient samples (−54% versus −47%,P=0.39). Other sperm motion characteristics did not significantly differ between the two groups except for postthaw curvilinear velocity (P=0.01). This study concludes that fresh and frozen–thawed semen from patients with malignant tumors is poor in quality but is still adequate for assisted reproductive techniques. As cancer therapy may further impair semen quality, patients should be offered the chance to bank sperm before undergoing cancer therapy. Received: 25 October 1999 / Accepted: 22 May 2000     

浙江省人类精子库供精者精液参数及精子耐冻性变化分析

目的 了解供精者捐精过程中精液参数、精子耐冻性变化以及为人类精子库实验室质量控制提供部分依据;方法 13261份精液样本均来自2006年9月至2010年12月浙江省人类精子库的1513例合格的供精者,年龄20～42周岁,职业以学生为主,对所有精液标本进行精液常规分析;达到冷冻标准的精液标本进行冷冻及冷冻复苏后精液常规分析.结果 1513例供精者中,每次捐精均合格的为343例,占22.7%;每次捐精(至少连续3次)均不合格的为68例,占4.5%;捐赠精液至少一次不合格的为1102例,占72.8%.捐赠的13261份精液中,有10158份冷冻复苏后达到外供标准,占76.6%;不合格的捐赠精液为3103份,占23.4%,其中,未达到冷冻标准的为1565份,占所有捐赠精液的11.8%;冷冻复苏后未达到外供标准(不耐冻精液)为1538份,占所有捐赠精液的11.6%.结论 人类精子库供精者每次捐赠的精液不仅精液参数变化较大,其耐冻性变化也很大;所捐赠的精液不合格比例较高.     

Comparison of semen quality in older and younger men attending an andrology clinic

The effects of age on semen quality were analysed in patients referred to an andrology outpatient clinic in a retrospective study covering a period of 3 years. Semen analyses of older men (n = 66; > or = 50 years; median: 53) were compared with those of young patients (n = 134; 21-25 years; median 24). The duration of sexual abstinence was longer among older patients (median: 5.5 vs. 5.0 days; + 10%, P < 0.05). Even after adjustment for duration of sexual abstinence, progressive motility (- 27%, P < 0.01), percentage of morphologically normal spermatozoa (- 44%, P < 0.01) and semen volume (- 29%, P < 0.0005) were significantly lower in older than in younger men. Impaired sperm morphology was mainly attributed to abnormal staining of flagella (+ 50%, P < 0.05) and an increased portion of coiled or bent tails (+ 44%, P = 0.001) indicating epididymal dysfunction. Total sperm count and sperm concentration were unaffected by age. Age-dependent changes in accessory gland function, as indicated by fructose concentration (- 27%, P < 0.05), was correlated with lower semen volume. Moreover, serum testosterone levels were significantly reduced in the group of older men (median: 3.0 vs. 3.6 ng ml-1; -17%, P < 0.005).     

ATP content in human semen and sperm quality

Five semen characteristics (count, motility, normal forms, bovine cervical mucus penetration, and ATP) were evaluated in patients attending the infertility clinic. Multiple regression analysis indicated that the only characteristic independently affecting ATP concentration was sperm count, whereas motility and percent normal forms had no additional contribution to ATP level. Penetration into bovine cervical mucus did not depend on ATP levels. Comparison of semen characteristics in the same group between patients who have impregnated their wives and those who have not indicated that with respect to count, motility, morphology, and ATP the only sperm characteristic independently predicting fertility was motility. ATP measurements have limited value in the evaluation of semen quality.     

PDCA循环在男科实验室中缩短精液样本周转时间的应用

目的:通过对2018年男科实验室精液检测项目样本周转时间(TAT)的现状分析,使用PDCA循环改进方法,降低本男科实验室样本周转时间阈外值率,提高临床及患者满意度. 方法:回顾性分析2018年1季度至2季度男科实验室精液检测项目TAT不合格率,2018年3季度至4季度应用PDCA管理工具,通过头脑风暴法绘制鱼骨图,针对...     

精子质量分析仪检测男性不育精液状况的研究

应用精子质量分析仪对１３１例不育及正常人精液进行精子活力指数（ＳＭＩ）检测，并与常规精液分析进行比较，发现ＳＭＩ与常规方法测得的精液质量参数有很好的相关性。不育组的ＳＭＩ值显著低于正常对照组（Ｐ〈０．０１）。对ＳＭＩ值〈８０．８０￣１６０和〉１６０的精液质量参数进行比较，发现各组间均有显著性差异（Ｐ〈０．０５）。提示用精子质量分析仪测得的ＳＭＩ能客观地反映精液质量和男性生育力状况，使用简单易掌握，     

Diagnostic value of routine semen analysis in clinical andrology

Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.     

解脲脲原体感染史对供精人群精液质量影响的调查研究

目的 探讨供精人群解脲脲原体(ureaplasma urealyticum,UU)感染史对精液质量的影响.方法 供精者精液取出后进行UU检测,按世界卫生组织推荐的方法和标准进行精液分析,资料分析采用非参数检验.结果 UU阳性组和阴性组供精者精液参数包括精液容积、精子密度、活动率及总精子数没有显著差别,但正常形态百分比则UU阴性组略高于阳性组(P=0.006);精液培养阳性组转阴前后供精者的精液质量没有显著变化.UU感染史对供精者精液质量及妊娠结局无显著影响.结论 供精人群UU感染史对精液质量的影响没有统计学意义,经治疗转阴后也不会明显改变精液的受孕能力.     

The effect of cancer on semen quality after cryopreservation of sperm

The results of cryopreservation of sperm from cancer patients were retrospectively reviewed in an effort to better understand the relationship between semen quality and the presence of different kinds of cancer. The semen analysis results for 146 patients referred to our infertility center for sperm banking over a 2-year period were examined. These patients were divided into three groups according to their diagnosis: group I, prevasectomy controls; group II, patients with lymphoma and Hodgkin's disease; and group III, patients with testicular cancer, e.g., seminoma, embryonal cell carcinoma, or teratocarcinoma. The seminal parameters assessed included sperm count and prefreeze and postthaw motility and velocity. For these parameters, significant decrease from control values (P less than 0.05 to P less than 0.01) was seen in groups II and III. The specimens from group I patients retained good motility and velocity after thawing. Our results indicate that semen quality is adversely affected by the presence of cancer in the body.