弱精子症患者DFI的预测价值及精液常规处理方法对精子DFI的影响

发布时间：2018-06-25 16:07

  本文选题：弱精子症 + 精子DNA碎片　； 参考：《中南大学》2014年硕士论文

【摘要】：目的：1.研究弱精子症患者精子DNA碎片率(DNA fragmentation index, DFI)与精液常规参数、受精结局、胚胎发育及精子非整倍体率的相关关系,以评价弱精子症患者中精子DFI的临床预测价值；2.比较上游、密度梯度离心、密度梯度离心联合上游三种常规精液处理方法对精子DFI的影响,对临床精液处理方法的选择起到指导作用。 方法：1.收集82例弱精子症患者的新鲜精液标本,每份标本进行精液常规参数检测后均分为三份,分别进行①DFI检测(吖啶橙染色法)；②卵胞浆内单精子注射,并记录受精及胚胎发育情况；③精子荧光原位杂交检测(26例)非整倍体(18/21/X/Y)。根据DFI指数分组：A组(DFI≤15%,n=18)、B组(15%DFI30%, n=38)、C组(DFI≥30%,n=26)。2.收集38例精子完整性差(DFI≥30%)患者的新鲜精液标本,每份标本均分为三份,分别进行上游(CSW)、密度梯度离心(DGC)、密度梯度离心联合上游(DGC+CSW)处理,检测三种方法处理前后精液常规参数和DFI指数。 结果：1.C组的前向运动精子百分率(PR,%)及精子总活力(PR+NP,%)均显著低于A组和B组(P0.05)；C组的优胚率及精子非整倍体率均显著低于A组(P0.05)；精子DFI与PR、PR+NP负相关(P0.05),与精子非整倍体率正相关(P0.05)。2.CSW、DGC、DGC+CSW三种方法处理后精子PR、PR+NP均升高(P0.05),浓度均降低(P0.05)。CSW、DGC+CSW处理后DFI均降低(P0.05),但DGC处理后DFI升高(P0.05)；三种方法处理结果两两比较时,CSW、DGC+CSW处理后PR、PR+NP均高于DGC(P0.05),但浓度均低于DGC(P0.05), DGC+CSW处理后DFI显著低于CSW(P0.05)。 结论：1.弱精子症患者精子DFI指数具有一定的临床预测价值；2.与单纯上游或密度梯度离心法相比,密度梯度离心联合上游法能更有效筛选出活力好,DNA完整的精子。
[Abstract]:Purpose 1. To evaluate the clinical predictive value of sperm fragmentation fragment rate (DFI) in patients with asthenospermia, we studied the relationship between sperm fragmentation fragment rate and semen routine parameters, fertilization outcome, embryo development and sperm aneuploidy rate in order to evaluate the clinical predictive value of sperm fragmentation rate in patients with asthenospermia. Compared with the upstream, density gradient centrifugation combined with the upstream three conventional semen treatment methods on sperm DFI, the selection of clinical semen processing methods play a guiding role. Method 1: 1. Fresh semen samples from 82 patients with asthenospermia were collected. Each specimen was divided into three samples after routine semen parameters were measured. The sperm was injected into oocytes by 1DFI (acridine orange staining). The fertilization and embryo development were recorded by fluorescence in situ hybridization (26 cases) and aneuploidy (18 / 21% X / Y). According to DFI index, group A (DFI 鈮，

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