青岛地区男性精液质量检查结果分析

Analysis of Male Semen Quality Test Results in Qingdao Area

摘要: 目的：通过分析青岛地区近几年男性精液常规检查结果，了解本地区男性精液质量现状，探讨年龄与精液质量的关系。方法：收集2019年1月~2021年12月在青岛市妇女儿童医院进行精液常规检查的27,849例男性患者，根据年龄分为4组：≤30岁组(10,549例)、31~40岁组(15,166例)、41~50岁组(1943例)和>50岁组(191例)。使用计算机辅助精子质量分析系统(CASA)分析精子浓度、活力，采用Diff-Quik快速染色法分析精子形态，按照第5版《WHO人类精液检查与处理实验室手册》对其进行统计分析，并比较各年龄组患者的精液质量。结果：27,849例男性患者中，精液各项参数均正常的占28.9% (8052/27849)，无精子症占3.6% (1005/27849)。各项精液参数中，精子形态异常率最高43.8%，其次分别为前向运动精子百分率(PR%)异常率43.4%和精子总活力[(PR + NP)%]异常率42.3%。对4个不同年龄组男性精液质量比较分析发现：精液量、精子总活力及前向运动精子百分率随着年龄的增加逐渐减少，差异均有统计学意义(P < 0.05)；精子浓度随年龄的增加先增高后下降，在≤30岁组、31~40岁组、41~50岁组，呈增高趋势，各组间差异均有统计学意义(P < 0.05)，>50岁组呈下降趋势，与41~50岁组比较差异有统计学意义(P < 0.05)；精子总数在高龄男性中明显下降，41~50岁组精子总数低于31~40岁组，差异有统计学意义(P < 0.05)，>50岁组精子总数低于≤30岁组、31~40岁组、41~50岁组，差异均有统计学意义(P < 0.05)；正常形态精子百分率随年龄增加呈下降趋势，31~40岁组正常形态精子百分率低于≤30岁组，差异有统计学意义(P < 0.05)；>50岁组正常形态精子百分率低于≤30岁组、31~40岁组、41~50岁组，差异均有统计学意义(P < 0.05)。结论：青岛地区男性精液质量异常主要表现为精子形态异常、前向运动精子百分率及精子总活力异常。同时，随着年龄的增长，尤其是40岁以后，精子质量下降明显，建议男性在40岁前完成生育。

Abstract: Objective: By analyzing the results of routine examination of male semen in Qingdao area in recent years, the present situation of male semen quality in Qingdao area was understood, and the rela-tionship between age and semen quality was discussed. Methods: A total of 27,849 male patients who underwent routine semen examination in Qingdao Women and Children’s Hospital from Janu-ary 2019 to December 2021 were collected and divided into four groups according to age: ≤30 years old group (10,549 cases), 31~40 years old group (15,166 cases), 41~50 years old group (1943 cases) and >50 years old group (191 cases). The sperm concentration and motility were analyzed by com-puter assisted sperm quality analysis system (CASA), and sperm morphology was analyzed by Diff-Quik rapid staining method. Statistical analysis was performed according to the 5th edition of WHO Laboratory Manual for the Examination and Processing of Human Semen, and semen quality of patients in different age groups was compared. Results: Among 27,849 male patients, 28.9% (8052/27849) had normal semen parameters, and 3.6% (1005/27849) had azoospermia. Among the single semen parameters, the abnormal sperm morphology rate was the highest 43.8%, fol-lowed by the abnormal percentage of progressive motility sperm (PR%) 43.4% and total sperm motility [(PR + NP)%)] 42.3%. The comparative analysis of semen quality in 4 different age groups showed that semen volume, total sperm motility and the percentage of progressive motility sperm decreased gradually with the increase of age, and the differences were statistically significant (P < 0.05). Sperm concentration firstly increased and then decreased with the increase of age, and showed an increasing trend in ≤30 years old group, 31~40 years old group and 41~50 years old group. The differences among all groups were statistically significant (P < 0.05), and the >50 years old group showed a decreasing trend, compared with the 41~50 years old group (P < 0.05). The to-tal sperm count in older men was significantly decreased, the total sperm count in 41~50 years old group was lower than that in 31~40 years old group, the difference was statistically significant (P < 0.05), and the total sperm count in >50 years old group was lower than that in ≤30 years old group, 31~40 years old group and 41~50 years old group, and the difference was statistically significant (P < 0.05). The percentage of normal morphologic sperm decreased with age increasing, and the per-centage of normal morphologic sperm in 31~40 years old group was lower than that in ≤30 years old group, and the difference was statistically significant (P < 0.05). The percentage of normal sperm in >50 years old group was lower than that in ≤30 years old group, 31~40 years old group and 41~50 years old group, and the differences were statistically significant (P < 0.05). Conclusion: The abnormal semen quality in Qingdao area mainly showed abnormal sperm morphology, the percentage of progressive motility sperm and abnormal total sperm motility. At the same time, with the increase of age, especially after the age of 40, the quality of sperm decreases significantly, and it is recommended that men finish the fertility before the age of 40.