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计算机辅助精子分析用精液样本的稀释条件及标准化研究

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目的 探讨计算机辅助精子分析(CASA)系统检测高浓度精液样本的稀释条件及标准.方法 当精子浓度<50×106/mL时不稀释;当≥50× 106/mL时,按1∶[n/(50×106)]的比例[n为精子浓度,n/(50× 106)向下取整]用生理盐水稀释至50× 106/mL以下.采用CASA系统和10 μm深度一次性计数板检测精液样本,分为未稀释组(组1∶精子浓度<50×106/mL)、50×106/mL≤精子浓度<100× 106/mL组(组2)、精子浓度≥100× 106/mL组(组3),稀释前后分析各组精子浓度、前向运动精子百分率(PR)、非前向运动精子百分率(NP)、精子活动率(PR+NP)和不活动精子百分率(IM)等,比较稀释前后结果的一致性.采用ROC曲线预测最佳稀释阈值.结果 随着精子浓度的增加,稀释前后各参数差异逐渐增大.ROC曲线分析结果显示,分别用精子浓度、PR+NP、PR、NP、IM预测时,精液标本的最佳稀释阈值分别为133.05× 106/mL、101.75× 106/mL、118.60× 106/mL、90.90× 106/mL、111.83× 106/mL.结合高浓度精液样本未稀释检测时对精子浓度和NP的影响最大,确定最佳稀释阈值为125.08×106/mL.结论 建议当精子浓度>125×106/mL时,应对精液样本进行生理盐水稀释.
Dilution conditions and standardization study for semen samples using computer-aided sperm analysis
Objective To explore the dilution conditions and standards in detecting the semen samples with high sperm concentration using computer-aided sperm analysis(CASA)systems.Methods CASA systems with 10 μm depth disposable counting chambers were used for the examination.The samples were divided into undiluted group(Group 1∶sperm concentration<50×106/mL)and diluted groups(Group 2∶50×106/mL≤ sperm concentration<100× 106/mL;Group 3∶sperm concentration≥100× 106/mL).When sperm concentration<50×106/mL,no dilution was performed.When sperm concentration≥50× 106/mL,the samples were diluted with saline at 1∶n/(50×106)ratio(n=sperm concentration,n/[50×106]rounded down)to<50×106/mL of sperm concentration.The sperm concentration,progressive motility(PR),non-progressive motility(NP),total motility(PR+NP)and immotile sperm percent-age(IM)were analyzed before and after dilution.The consistency of results pre-and post-dilution was compared.ROC curve was used to analyze the optimal dilution threshold.Results The differences in the parameters pre-and post-dilution gradually rosed with the increased sperm concentration.ROC curve analysis showed optimal dilution thresholds were 133.05 × 106/mL,101.75 × 106/mL,118.60×106/mL,90.90×106/mL,111.83×106/mL for the sperm concentration,PR+NP,PR,NP and IM respectively.Considering sperm concentration and NP were most affected the undiluted high concentration samples,the optimal comprehensive dilution threshold was determined as 125.08× 106/mL.Conclusion When sperm concentration exceeds 125×106/mL,it is recommended to dilute semen sample with normal saline.

computer assisted sperm analysissperm concentrationsemen dilutionnormal saline

伍细言、郝瑞龙、李维娜

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湖南省妇幼保健院生殖医学中心,长沙 410008

湖南师范大学附属光琇医院,长沙 410205

中信湘雅生殖与遗传专科医院男科学部,长沙 410221

计算机辅助精子分析 精子浓度 精液稀释 生理盐水

湖南省自然科学基金面上项目湖南省卫生健康委科研项目中信湘雅科研基金湖南省妇幼保健院锐新项目

2022JJ30018B202301037899YNXM-2022192021RX30

2024

临床检验杂志
江苏省医学会

临床检验杂志

CSTPCD
影响因子:0.746
ISSN:1001-764X
年,卷(期):2024.42(2)
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