肾阳虚、肾阴虚型男性不育患者精液常规参数、精子DNA损伤及精子凋亡的研究

发布时间：2018-03-12 12:23

  本文选题：精子DNA损伤　切入点：精子凋亡　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对89例精液常规、精子凋亡率及精子DNA碎片化指数的检测,探讨肾阳虚、肾阴虚型男性不育症患者与其他不育症患者之间精液常规、精子凋亡率、精子DNA碎片化指数的差异,以及男性不育症患者精子凋亡率与精子DNA碎片化指数之间的相关性。方法:按照纳入标准分别收集肾阳虚组(n=30)、肾阴虚组(n=30)及对照组(n=29)共89例男性不育患者精液标本,分别使用计算机辅助精液分析技术(computer-assisted semen analysis,CASA)检测各组精液常规参数,流式细胞术(Flow Cytomentry,FCM)结合吖啶橙染色法(acridine orange,AO),检测精子凋亡率(sperm apoptosis)及精子DNA碎片化指数(sperm DNA Fragmentation Index,DFI)。统计使用SPSS20.0统计软件对已收集的数据进行统计学分析,计量资料以均数±标准差(X±S)表示。组间比较采用两独立样本的t检验。精子凋亡率与DFI相关性根据数据的正态分布或偏态分布,采用Pearson相关性分析进行统计学分析。P0.05认为差异有统计学意义,P0.01为差异有明显的统计学意义。结果:1.肾阳虚组、肾阴虚组在年龄分布与对照组相比较P0.05(P=0.581),无统计学差异;肾阳虚组、肾阴虚组与对照组在病史时间上相比较P0.05(P=0.404),无统计学差异。2.肾阴虚组、肾阳虚组精液量、精子密度与对照组相比较,P0.05(肾阴虚组P=0.823,肾阳虚组P=0.419)无统计学差异;肾阴虚组的a级精子活力百分比、a+b级精子活力百分比低于对照组,P0.05(a级精子百分比P=0.013,a+b级精子百分比P=0.042)具有统计学差异,精子活动率高于对照组,P0.05(P=0.181)无统计学差异;肾阳虚组的a级精子活力百分比、a+b级精子活力百分比、精子活动率全部低于对照组,其中a级精子活力百分比有显著的统计学差异P0.01(a级精子百分比P=0.000),a+b级精子百分比、精子活动率有统计学差异P0.05(a+b级精子百分比P=0.050,精子活动率P=0.047)。3.肾阴虚组精子凋亡率高于对照组,P0.05(P=0.028)有统计学差异,DNA碎片化指数高于对照组,P0.01(P=0.000)有显著统计学差异;肾阳虚组精子凋亡率、精子DFI指数均高于对照组,P0.01(精子凋亡率P=0.010,精子DFI指数P=0.000)差异有显著统计学意义。4.全部受试对象的精子凋亡率与DFI结果经过Spearman相关性分析,计算相关系数得r:0.285,P=0.007,具有显著的统计学差异。结论:1.肾阳虚、肾阴虚型不育症患者精子活力、精子活率均低于其他男性不育症患者,DNA碎片化程度、精子凋亡率均高于其他男性不育症患者,提示肾阳虚、肾阴虚型男性不育症患者与其他不育症患者相比精子活力及生育力更低。2.男性不育症患者精子DNA碎片率与精子凋亡率呈显著正相关线性关系,提示精子DNA损伤可能与精子细胞的凋亡有关。
[Abstract]:Objective: to investigate the semen routine, sperm apoptosis rate and sperm apoptosis rate between male infertility patients and other infertility patients with deficiency of kidney yang and kidney yin deficiency by detecting sperm routine, sperm apoptosis rate and DNA fragmentation index in 89 cases of male infertility with kidney yang deficiency and kidney yin deficiency. The difference of sperm DNA fragmentation index, And the correlation between sperm apoptosis rate and sperm DNA fragmentation index in male infertile patients. Methods: according to the inclusive criteria, the semen samples of 89 male infertile patients were collected according to the inclusive criteria, respectively, in the kidney-yang deficiency group, the kidney-yin deficiency group, and the control group. The semen parameters of each group were detected by computer-assisted semen analysis (CASA). Flow Cytomentry (FCM) and acridine orange staining (Acridine orange staining) were used to detect sperm apoptosis rate and sperm DNA fragmentation index (Sperm DNA Fragmentation index). The collected data were statistically analyzed by SPSS20.0 software. The measurement data were expressed as mean 卤standard deviation X 卤S. T test of two independent samples was used for the comparison between the two groups. The correlation between sperm apoptosis rate and DFI was based on the normal distribution or skewness distribution of the data. The Pearson correlation analysis showed that the difference was statistically significant (P0.01). Results: 1. There was no significant difference in age distribution between kidney-yang deficiency group and kidney-yin deficiency group compared with control group (P 0.05), but there was no significant difference between kidney yang deficiency group, kidney yang deficiency group and control group. There was no statistical difference between the kidney yin deficiency group, the kidney yang deficiency group and the control group in the time of the disease history. 2. There was no statistical difference between the kidney yin deficiency group, the kidney yang deficiency group and the control group in the quantity of spermatozoa and the sperm density (P 0. 05) (P 0. 823 in the kidney yin deficiency group, P 0. 419 in the kidney yang deficiency group). The percentage of spermatozoa motility in the group of kidney yin deficiency was lower than that in the control group (P < 0.05). There was no significant difference in the percentage of spermatozoa activity between the two groups. There was no significant difference in the percentage of spermatozoa activity between the two groups (P _ (0.05) P _ (0.181)) and the percentage of sperm motility was higher than that of the control group (P _ (0.05) P _ (0.181)). The percentage of spermatozoa motility of grade a and the percentage of sperm motility of grade a were all lower than those of the control group, among which there was significant difference between the percentage of sperm motility of grade a and the percentage of spermatozoa of grade a, among them, the percentage of spermatozoa of grade a was significantly different from that of the control group (P0. 01). There was significant difference in sperm motility rate (P0.05A / b), percentage of spermatozoa (P < 0.050) and sperm motility (P _ (0.047) 路3.The rate of sperm apoptosis in the group of kidney yin deficiency was higher than that in the control group (P _ (0.05) P _ (0.028)). The fragmentation index of DNA was significantly higher than that of the control group (P _ (0.01) P _ (0.000)). The sperm apoptosis rate and sperm DFI index were significantly higher in the kidney-yang deficiency group than in the control group (P0. 010, P0. 010, P0. 000). There was a significant difference between the sperm apoptosis rate and the DFI results in all subjects by Spearman correlation analysis. The correlation coefficient was r: 0.285 and P = 0.007, with significant statistical difference. Conclusion: 1. The sperm motility and sperm motility rate of infertility patients with deficiency of kidney yang and yin deficiency of kidney are lower than those of other male infertility patients, and the degree of DNA fragmentation is lower than that of other male infertility patients. The rate of spermatozoa apoptosis was higher than that of other male infertility patients, suggesting deficiency of kidney yang, The sperm motility and fertility of male infertility patients with kidney yin deficiency type were lower than those of other infertility patients. 2. There was a significant positive correlation between sperm DNA fragment rate and sperm apoptosis rate in male infertile patients. These results suggest that DNA damage may be related to the apoptosis of sperm cells.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R698.2
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本文编号：1601545