中华医学遗传学杂志
中華醫學遺傳學雜誌
중화의학유전학잡지
CHINESE JOURNAL OF MEDICAL GENETICS
2014年
1期
60-64
,共5页
费前进%黄航%金建远%黄学锋
費前進%黃航%金建遠%黃學鋒
비전진%황항%금건원%황학봉
精子%DNA损伤%男性不育
精子%DNA損傷%男性不育
정자%DNA손상%남성불육
Spermatozoa%DNA damage%Infertility
目的 探讨精子DNA损伤(sperm DNA fragmentation,SDF)在男性不育症中的诊断价值.方法 将本院生殖中心就诊的299例男性分为两组:原发性不育患者157例及正常生育对照组142人.根据世界卫生组织标准(1999年)对其进行常规精液参数(精子浓度、精子活动力和精子形态)测定,采用精子染色质扩散试验检测其SDF水平,即精子DNA碎片指数(DNA fragmentation index,DFI).结果 原发性不育组和正常生育对照组的精子DFI分别为(17.1±9.3)％和(14.2±9.0)％,两者相比差异有统计学意义(P＜0.01),两组男性的年龄、配偶年龄及精液常规参数比较差异均无统计学意义(P＞0.05).精子DFI诊断男性不育的受试者工作特征曲线下面积为0.861,95％可信区间为0.814～0.907,诊断阈值为15.1％,敏感性为81.8％,特异性为88.2％.根据精子DFI对男性不育的诊断阈值,将299例男性分为DFI≥15.1％(A组)120例和DFI＜ 15.1％(B组)179例,两组不育男性的百分率分别为79.2％和34.6％,两者比较差异有统计学意义(P＜0.01),两组男性发生不育的优势比为7.2(95％可信区间为4.2～12.3).结论 高水平SDF可降低男性的生育能力,精子DFI对男性不育有重要的诊断价值.
目的 探討精子DNA損傷(sperm DNA fragmentation,SDF)在男性不育癥中的診斷價值.方法 將本院生殖中心就診的299例男性分為兩組:原髮性不育患者157例及正常生育對照組142人.根據世界衛生組織標準(1999年)對其進行常規精液參數(精子濃度、精子活動力和精子形態)測定,採用精子染色質擴散試驗檢測其SDF水平,即精子DNA碎片指數(DNA fragmentation index,DFI).結果 原髮性不育組和正常生育對照組的精子DFI分彆為(17.1±9.3)％和(14.2±9.0)％,兩者相比差異有統計學意義(P＜0.01),兩組男性的年齡、配偶年齡及精液常規參數比較差異均無統計學意義(P＞0.05).精子DFI診斷男性不育的受試者工作特徵麯線下麵積為0.861,95％可信區間為0.814～0.907,診斷閾值為15.1％,敏感性為81.8％,特異性為88.2％.根據精子DFI對男性不育的診斷閾值,將299例男性分為DFI≥15.1％(A組)120例和DFI＜ 15.1％(B組)179例,兩組不育男性的百分率分彆為79.2％和34.6％,兩者比較差異有統計學意義(P＜0.01),兩組男性髮生不育的優勢比為7.2(95％可信區間為4.2～12.3).結論 高水平SDF可降低男性的生育能力,精子DFI對男性不育有重要的診斷價值.
목적 탐토정자DNA손상(sperm DNA fragmentation,SDF)재남성불육증중적진단개치.방법 장본원생식중심취진적299례남성분위량조:원발성불육환자157례급정상생육대조조142인.근거세계위생조직표준(1999년)대기진행상규정액삼수(정자농도、정자활동력화정자형태)측정,채용정자염색질확산시험검측기SDF수평,즉정자DNA쇄편지수(DNA fragmentation index,DFI).결과 원발성불육조화정상생육대조조적정자DFI분별위(17.1±9.3)％화(14.2±9.0)％,량자상비차이유통계학의의(P＜0.01),량조남성적년령、배우년령급정액상규삼수비교차이균무통계학의의(P＞0.05).정자DFI진단남성불육적수시자공작특정곡선하면적위0.861,95％가신구간위0.814～0.907,진단역치위15.1％,민감성위81.8％,특이성위88.2％.근거정자DFI대남성불육적진단역치,장299례남성분위DFI≥15.1％(A조)120례화DFI＜ 15.1％(B조)179례,량조불육남성적백분솔분별위79.2％화34.6％,량자비교차이유통계학의의(P＜0.01),량조남성발생불육적우세비위7.2(95％가신구간위4.2～12.3).결론 고수평SDF가강저남성적생육능력,정자DFI대남성불육유중요적진단개치.
Objective To assess the diagnostic value of sperm DNA fragmentation (SDF) for male infertility.Methods Two hundred and ninety-nine males attending infertility clinic were classified into 157 primary infertile cases and 142 fertile controls.Semen analysis was performed as recommended by the World Health Organization (WHO).SDF was assessed by sperm chromatin dispersion (SCD) assay,and the results were expressed as DNA fragmentation index (DFI).Results The DFI was significantly higher in infertile males than that in fertile controls [(17.1 ± 9.3) ％ vs.(14.2 ± 9.0) ％] (P＜0.01).No significant difference was detected in the age of male and female partners,seminal volume,sperm count,motility and morphology between infertile males and fertile controls (P＞0.05).The area under the receiver operating characteristic curve (AUC) was 0.861[95％ confidence interval (CI)=0.814-0.907] for 15.1％ of SDF.The threshold level of 15.1％ was derived as cut-off value to discriminate infertile men from fertile controls.By this threshold,specificity was 88.2％ and sensitivity was 81.8％.The 299 men were divided into group A (n=120) with DFI≥15.1％ and group B (n=179) with DFI＜15.1％ based on the cut-off value.The percentage of infertile men in group A was significantly higher than that in group B (79.2％ vs.34.6％)(P＜0.01).The odds ratio (OR) for infertility in the two groups was 7.2 (95％ CI=4.2-12.3).Conclusion Sperms with high-level of DNA fragmentation can impair male fertility.DFI can be used as a good diagnostic marker for male infertility.
