中国组织工程研究与临床康复
中國組織工程研究與臨床康複
중국조직공정연구여림상강복
JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
2010年
18期
3310-3313
,共4页
李涛%郭庆华%田金徽%张伟%郭柏鸿%李国平%罗能钦%李朝彬%姜雷%贾文琴%李仁举%张朋%陈一戎
李濤%郭慶華%田金徽%張偉%郭柏鴻%李國平%囉能欽%李朝彬%薑雷%賈文琴%李仁舉%張朋%陳一戎
리도%곽경화%전금휘%장위%곽백홍%리국평%라능흠%리조빈%강뢰%가문금%리인거%장붕%진일융
官腔内人工授精%上游法%密度梯度离心法%精子优选法%系统评价
官腔內人工授精%上遊法%密度梯度離心法%精子優選法%繫統評價
관강내인공수정%상유법%밀도제도리심법%정자우선법%계통평개
背景:精子体外优选方法很多,最常见的是上游法和密度梯度离心法.采用何种方法来减少体外处理过程对精子的不良刺激,优选出具有良好受精潜能的精子,目前尚无定论.目的:系统评价上游法和密度梯度离心法在宫腔内人工授精中的应用,比较两种精子优选法的优劣.方法:计算机检索PubMed、Cochrane Library、EMBASE等数据库,手工检索专业相关期刊,检索时间为1966-01/2009-02.纳入关于两种精液优选法在宫腔内人工授精中应用的随机对照试验或半随机对照试验,评价纳入研究的方法学质量,并提取有效数据用RevMan 5.0.软件进行Meta分析.结果与结论:纳入6个研究,包括4个随机对照试验和2个半随机对照试验,共486例患者,1099个周期(优选精子的次数).Meta分析结果显示,上游法与梯度离心法相比,周期妊娠率[OR=1.11,95%CI(0.8,1.55)]、流产率[OR=0.31,95%CI(0.09,1.04)]、精子密度[WMD=-0.89,95%CI(14.17,12.38)]、精子活力[WMD=2.31,95%CI-7.27,2.65)],4项测最指标差异均无显著性意义.尽管与其他精子优选法相比,上游法与梯度离心法的周期妊娠率较高,但是该系统评价结果还不能提示这两种方法在宫腔内人工授精应用中何者临床效果更好.建议今后进行更多高质量的随机双盲对照试验为临床提供最佳证据,并且增加处理前后精子的质量对比,包括精子活力、精子密度以及精子功能等指标测量,以全面考察两种方法的优劣.
揹景:精子體外優選方法很多,最常見的是上遊法和密度梯度離心法.採用何種方法來減少體外處理過程對精子的不良刺激,優選齣具有良好受精潛能的精子,目前尚無定論.目的:繫統評價上遊法和密度梯度離心法在宮腔內人工授精中的應用,比較兩種精子優選法的優劣.方法:計算機檢索PubMed、Cochrane Library、EMBASE等數據庫,手工檢索專業相關期刊,檢索時間為1966-01/2009-02.納入關于兩種精液優選法在宮腔內人工授精中應用的隨機對照試驗或半隨機對照試驗,評價納入研究的方法學質量,併提取有效數據用RevMan 5.0.軟件進行Meta分析.結果與結論:納入6箇研究,包括4箇隨機對照試驗和2箇半隨機對照試驗,共486例患者,1099箇週期(優選精子的次數).Meta分析結果顯示,上遊法與梯度離心法相比,週期妊娠率[OR=1.11,95%CI(0.8,1.55)]、流產率[OR=0.31,95%CI(0.09,1.04)]、精子密度[WMD=-0.89,95%CI(14.17,12.38)]、精子活力[WMD=2.31,95%CI-7.27,2.65)],4項測最指標差異均無顯著性意義.儘管與其他精子優選法相比,上遊法與梯度離心法的週期妊娠率較高,但是該繫統評價結果還不能提示這兩種方法在宮腔內人工授精應用中何者臨床效果更好.建議今後進行更多高質量的隨機雙盲對照試驗為臨床提供最佳證據,併且增加處理前後精子的質量對比,包括精子活力、精子密度以及精子功能等指標測量,以全麵攷察兩種方法的優劣.
배경:정자체외우선방법흔다,최상견적시상유법화밀도제도리심법.채용하충방법래감소체외처리과정대정자적불량자격,우선출구유량호수정잠능적정자,목전상무정론.목적:계통평개상유법화밀도제도리심법재궁강내인공수정중적응용,비교량충정자우선법적우렬.방법:계산궤검색PubMed、Cochrane Library、EMBASE등수거고,수공검색전업상관기간,검색시간위1966-01/2009-02.납입관우량충정액우선법재궁강내인공수정중응용적수궤대조시험혹반수궤대조시험,평개납입연구적방법학질량,병제취유효수거용RevMan 5.0.연건진행Meta분석.결과여결론:납입6개연구,포괄4개수궤대조시험화2개반수궤대조시험,공486례환자,1099개주기(우선정자적차수).Meta분석결과현시,상유법여제도리심법상비,주기임신솔[OR=1.11,95%CI(0.8,1.55)]、유산솔[OR=0.31,95%CI(0.09,1.04)]、정자밀도[WMD=-0.89,95%CI(14.17,12.38)]、정자활력[WMD=2.31,95%CI-7.27,2.65)],4항측최지표차이균무현저성의의.진관여기타정자우선법상비,상유법여제도리심법적주기임신솔교고,단시해계통평개결과환불능제시저량충방법재궁강내인공수정응용중하자림상효과경호.건의금후진행경다고질량적수궤쌍맹대조시험위림상제공최가증거,병차증가처리전후정자적질량대비,포괄정자활력、정자밀도이급정자공능등지표측량,이전면고찰량충방법적우렬.
BACKGROUND: There are many in vitro selection method of sperm, and swim-up and density gradient centrifugation are commonly used. It remains unclear which method minimizes bad stimulation to the sperm and select sperm with high fertilization potential. OBJECTIVE: To evaluate the effectiveness of swim-up and gradient centrifugation preparation techniques on intrauterine insemination (IUI).METHODS: A computer-based online search of Cochrane Library, PubMed, EMBASE databases was performed, and some related journals were manually searched for related articles published between January 1966 and February 2009. The quality of included randomized controlled trials (RCT) and q-randomized trials (Q-RCT) was evaluated and Meta-analysis was conducted by the Cochrane Collaboration's software RevMan5.0. Experts.RESULTS AND CONCLUSION: A total of 6 studies were included, involving 4 RCTs and 2 Q-RCTs. A total of 486 patients (1 099 IUI cycles) were enrolled. The Meta-analysis indicated that there was no difference between swim-up and gradient centrifugation preparation techniques for the IUI in terms of cycle pregnancy rates [OR = 1.11, 95%CI(0.8,1.55)], miscarriage rates [OR = 0.31, 95%CI(0.09,1.04)], sperm count [the weight mean difference (WMD) =-0.89, 95%CI(-14.17,12.38)], sperm motility [WMD = -2.31, 95%CI(-7.27,2.65)]. There is insufficient evidence to confirm which is the best method in the two specific preparation techniques. The quality of study methods should be improved. And more measure parameters should be included when comparing it before or after treatment, such as sperm motility, sperm count, sperm function.
