精液黏度增高对混合抗球蛋白反应(MAR)检测结果的影响及对策

目的:探讨精液黏度增高对混合抗球蛋白反应(mixed agglutination reaction,MAR)检测结果的非特异性影响及处理措施。方法:①连续监测高黏度组(n=23)及正常黏度组(n=22)精液标本黏度逐渐降低时MAR检测结果的伴随变化;②分别在31例黏度正常的活动精子中添加高黏度精浆以制备高黏度精液标本,同时应用设立空白测定对照法(A法)、洗涤精子法(B法)和加入纤维蛋白溶酶法(C法)3种方法同步处理制备的高黏度精液标本,比较处理后标本MAR检测结果与加入高黏度精浆前MAR测定值("真值")的差异性。结果:①高黏度组标本黏度与MAR检测结果呈明显相关性(r=0.912,P<0.001),正常组标本黏度变化与MAR检测结果无相关性(r=0.120,P>0.05);高黏度组较正常组MAR检测结果显著增高(P<0.001),但当高黏度组标本黏度降至正常后,其MAR检测结果与正常组无显著性差异(P>0.05);②采用A法或C法,其MAR检测结果与"真值"间均无显著性差异(P>0.05)。结论:精液黏稠度增高可导致MAR检测结果假阳性,在高黏度精液标本中添加纤维蛋白溶酶或设立空白测定对照可克服此影响。

Phenomenon and Solutions of Non-specific Results of Mixed Agglutination Reaction (MAR) Test with High Viscosity Semen

Objective: To study the non-specific influences and solutions of high viscosity semen on mixed agglutination reaction (MAR) test. Methods: While specific viscositise of semen samples were reduced gradually in high viscosity group(n=23) and normal viscosity group (n=22), the concomitant changes were traced of antisperm antibodies detected by MAR test. Various high viscosity seminal plasma was added into another 31 normal viscosity semen samples to make up high viscosity semen specimens.The latter was treated by setting up an assay blank control (method A), washing spermatozoa (method B) and pipetting fibrinolysin into specimen(method C), respectively.The MAR test results of post-treated high viscosity samples and normal viscosity samples where high viscosity seminal plasma was not added were compared. Results: The results of MAR test were associated with viscosity in high viscosity group (r=0.912, P<0.001). However, no such correlation was detected in normal viscosity group(r=0.120. P>0.05). In general, MAR results were significant higher in high viscosity group than in normal viscosity group (P<0.001), but the MAR results were the same between the two groups when viscositise of high viscosity group was decreased to normal(P>0.05). Compared with the homogeneous sperm which high viscosity seminal plasma was not inserted, MAR results of post-treated high viscosity samples were not significant different by method A and method C (P>0.05). Conclusion: Semen specimen of high viscosity can result in false position consequence of MAR test. This influence can be removed by pipetting fibrinolysin into high viscosity semen or setting up an assay blank control.