精子DNA碎片、彈性硬蛋白酶及精液參數(shù)與孕早期流產(chǎn)相關(guān)性的前瞻性研究

張俊　鐘誠　查錢江

【摘要】 目的：探討孕早期流產(chǎn)是否與精子DNA碎片化指數(shù)（DFI）、精漿彈性硬蛋白酶、精子形態(tài)、精子動力學參數(shù)有關(guān)。方法：選取2016年12月-2019年2月于本院生殖中心行人工授精（IUI）或體外受精胚胎移植（IVF-ET）的男性患者120例，根據(jù)術(shù)后配偶妊娠情況，將其分為IUI分娩組、IUI流產(chǎn)組、IVF分娩組、IVF流產(chǎn)組，各30例。比較各組精子濃度、前向運動精子百分率、精子形態(tài)學檢查結(jié)果、精漿彈性硬蛋白酶、精子DFI。結(jié)果：IUI流產(chǎn)組和IUI分娩組精子濃度、前向運動精子百分率、正常形態(tài)精子百分率比較，差異均無統(tǒng)計學意義（P>0.05）;IVF流產(chǎn)組和IVF分娩組精子濃度、前向運動精子百分率、正常形態(tài)精子百分率比較，差異均無統(tǒng)計學意義（P>0.05）;IUI流產(chǎn)組、IVF流產(chǎn)組精漿彈性硬蛋白酶及精子DFI均分別高于IUI分娩組、IVF分娩組，差異均有統(tǒng)計學意義（P<0.05）。

結(jié)論：孕早期流產(chǎn)與精漿彈性硬蛋白酶、精子DFI高有關(guān)，與精子濃度、前向運動精子百分率、正常形態(tài)精子百分率無關(guān)。

【關(guān)鍵詞】 孕早期流產(chǎn); 精子DNA碎片化指數(shù); 彈性硬蛋白酶

Prospective Study on the Relationship between Sperm DNA Fragments，Elastoproteinase and Semen Parameters and Early Pregnancy Abortion/ZHANG Jun，ZHONG Cheng，ZHA Qianjiang.//Medical Innovation of China，2019，16（20）：0-018

【Abstract】 Objective：To explore whether early pregnancy abortion is related to sperm DNA fragmentation index（DFI），seminal plasma elastoproteinase，sperm morphology and sperm dynamics parameters.Method：A total of 120 male patients undergoing artificial insemination（IUI）or in vitro fertilization and embryo transfer（IVF-ET）in the reproductive center of our hospital from December 2016 to February 2019 were selected.According to the pregnancies of spouses after operation，they were divided into IUI delivery group，IUI abortion group，IVF delivery group and IVF abortion group，30 cases in each group.The sperm concentration，forward motility sperm rate，sperm morphology，seminal plasma elastoproteinase and sperm DFI in four groups were compared.

Result：There were no significant differences between IUI abortion group and IUI delivery group in sperm concentration，forward motility sperm rate and normal morphology sperm percentage（P>0.05）.There were no significant difference between IVF abortion group and IVF delivery group in sperm concentration，forward motility sperm rate and normal morphology sperm percentage（P>0.05）.The seminal plasma elastoproteinase and sperm DFI in IUI abortion group and IVF abortion group were higher than those of IUI delivery group and IVF delivery group respectively，the differences were statistically significant（P<0.05）.Conclusion：Early pregnancy abortion is associated with high seminal plasma elastoproteinase and sperm DFI，but not with sperm concentration，sperm motility and normal sperm percentage.

【Key words】 Early pregnancy abortion; Sperm DNA fragmentation index; Elastoproteinase

First-authors address：Central Peoples Hospital of Huizhou，Huizhou 516001，China

doi：10.3969/j.issn.1674-4985.2019.20.004

復發(fā)性流產(chǎn)是育齡婦女的常見病[1]。目前復發(fā)性流產(chǎn)的病因研究主要集中在女性，而對于男性因素的研究很少[2-3]。但是精子因素與胚胎質(zhì)量密切相關(guān)，男性因素與流產(chǎn)的內(nèi)在聯(lián)系目前不是很清楚，值得深入研究[4]。本研究試圖通過比較人工授精（IUI）、體外受精胚胎移植（IVF-ET）兩種不同助孕方式后正常分娩組與配偶孕早期流產(chǎn)組的男性相關(guān)指標，分析孕早期流產(chǎn)是否與精子DNA碎片化指數(shù)（DFI）、精漿彈性硬蛋白酶、精子形態(tài)、精子動力學參數(shù)有關(guān)。現(xiàn)報道如……