2061例不同民族不育男性精液质量与DFI比较分析

Comparative Analysis of Semen Quality and DFI in 2061 Infertile Men of Different Nationalities

摘要: 目的：分析2061例不同民族不育男性精液质量状况，探讨不同民族间不育男性精液质量与精子DNA碎片指数(DFI)的相关性，为保护不同民族不育男性生育力提供理论依据。方法：回顾性分析2019年1月至2022年1月在我院生殖医学中心门诊就诊的2061例的少数民族不育男性患者精液标本，采用计算机辅助精液质量分析技术、改良巴氏染色法、伊红苯胺黑法、精子染色质扩散法检测精液质量、精子存活率、精子形态正常率及精子碎片指数等参数，比较了精液质量与DFI的相关性。结果：2061例不同民族不育男性精液质量分析中正常精液903例(43.8%)，异常精液1158例(56.2%)，异常精液主要表现为精子活力低45.3% (933例)，而无精症8.9% (184例)高于周边地区。其中回族、东乡族患者与其他民族在前向运动(PR)精子活力、精子存活率、精子形态正常率均低于其他各组，而东乡族精子DFI均高于其他各族，差异有统计学意义(P < 0.01)。藏族患者排精量低于其他各组差异有统计学意义(P < 0.05)。蒙古族形态正常率低于其他各组差异有统计学意义(P < 0.01)。维吾尔族患者与其他民族在PR精子活力、精子浓度均高于其他各族，差异有统计学意义(P < 0.01)。精子DFI与不育男性年龄(r = 0.164, P < 0.01)、禁欲天数(r = 0.067, P < 0.05)呈正相关性。而DFI与PR精子活力(r = −0.29)、精子存活率(r = −0.066)、精子形态正常率(r = −0.319)均呈负相关性，有统计学意义(P < 0.01)。但DFI与精液体积(r = −0.007, P = 0.75)、pH值(r = 0.015, P = 0.24)、精子浓度(r = 0.028, P = 0.717)无相关性(P > 0.05)。结论：本地区不同民族精液质量异常主要表现在精子活力低。而早检查、早预防、早治疗是少数民族不育男性生育力保护的关键。同时，精子DFI作为精液质量评价的重要指标，与年龄、禁欲天数、精子活力、精子存活率、精子形态正常率均有显著相关性。因此，对不育男性精液质量常规检查与精子DFI结果的综合分析，可能有助于准确评估男性生育能力，对不育男性生育力保护有利。

Abstract: Objective: To analyze the semen quality of 2061 infertile men from different nationalities, and ex-plore the correlation between semen quality and sperm DNA fragment index (DFI) of infertile men from different nationalities, so as to provide a theoretical basis for protecting the fertility of infertile men from different nationalities. Methods: The semen samples of 2061 infertile male patients from minority nationalities who visited our Reproductive Medical Center from January 2019 to January 2022 were analyzed retrospectively. The semen quality, sperm survival rate, normal rate of sperm morphology, sperm fragment index and other parameters were detected by computer aided semen quality analysis technology, modified Papanicolaou staining, eosin aniline black method, sperm chromatin diffusion method, and the correlation between semen quality and DFI was compared. Results: Among 2061 infertile men of different nationalities, 903 (43.8%) were normal semen and 1158 (56.2%) were abnormal semen. The abnormal semen mainly showed low sperm vitality of 45.3% (933 cases), while the azoospermia of 8.9% (184 cases) was higher than that of the sur-rounding areas. Among them, the sperm vitality, sperm survival rate and normal sperm morpholo-gy of Hui, Dongxiang and other nationalities in forward motion (PR) were lower than those of other groups, while the sperm DFI of Dongxiang was higher than that of other nationalities, with a statis-tically significant difference (P < 0.01). The seminal output of Tibetan patients was significantly lower than that of other groups (P < 0.05). The normal rate of Mongolian morphology was lower than that of other groups (P < 0.01). The sperm activity and sperm concentration in PR of Uygur pa-tients and other nationalities were higher than those of other nationalities, and the difference was statistically significant (P < 0.01). Sperm DFI was positively correlated with age (r = 0.164, P < 0.01) and abstinence days (r = 0.067, P < 0.05) of infertile men. However, DFI was negatively correlated with PR sperm vitality (r = −0.29), sperm survival rate (r = −0.066) and sperm morphology normal rate (r = −0.319), with statistical significance (P < 0.01). However, there was no correlation between DFI and semen volume (r = −0.007, P = 0.75), pH (r = 0.015, P = 0.24), sperm concentration (r = 0.028, P = 0.717) (P > 0.05). Conclusion: The abnormal semen quality of different nationalities in this region is mainly manifested in the low sperm vitality. Early examination, early prevention and early treatment are the keys to protecting the fertility of ethnic infertile men. At the same time, as an important indicator of semen quality evaluation, sperm DFI is significantly related to age, days of abstinence, sperm vitality, sperm survival rate, and normal sperm morphology. Therefore, the comprehensive analysis of routine semen quality inspection and sperm DFI results of infertile men may be helpful to accurately evaluate male fertility and protect the fertility of infertile men.