浙江省供精者精液分析参考区间的建立

doi:10.3969/j.issn.1673-8640.2020.11.003

摘要/Abstract

摘要：

目的建立浙江省供精者精液分析参考区间,为临床患者生育力评估提供科学实验室判断依据。方法采用世界卫生组织（WHO）第5版《人类精液检查与处理实验室手册》（简称WHO第5版）分析法对2017年1月—2019年8月浙江省人类精子库4 122名初筛健康供精志愿者进行精液常规分析和精子形态学分析,检查精液pH值和体积、精子浓度和总数、前向运动精子百分比、精子正常形态率等参数,确定精液分析参考区间,且与WHO第5版参考区间进行比较。结果浙江省供精者精液分析参考区间为：精液体积≥1.8 mL,精子总数≥51×10⁶/次射精,精子浓度≥16×10⁶/mL,PR精子百分比≥20%,精子正常形态率≥5%,精液pH值≥8.0。结论浙江省供精者精液分析参考区间与WHO第5版相比,PR精子百分比明显偏低,其余各项参考值也略有不同,而从精液各参数数值分布看,健康男性各项精液参数分布与WHO第5版数据范围都有一定差异,高百分位数上（P₅₀以上）明显偏低。随男性年龄的增加,特别是40岁以上,精液质量明显下降。

关键词: 参考区间, 精液分析, 供精者

Abstract:

Objective To investigate the reference interval of semen parameters from sperm donors in Zhejiang,and to provide a reference for fertility evaluation of clinical patients. Methods Semen samples from4 122 sperm donors at Zhejiang Human Sperm Bank were collected from Januray 2017 to August 2019. Routine semen analysis and semen morphology analysis were performed according to the World Health Organization（WHO） the 5th-edition guidelines,and the pH value,volume,sperm concentration,total sperm count,sperm progressive motility and the rate of sperm normal morphology were determined. The reference interval of semen parameters was obtained,which was compared with that of WHO the 5th-edition guidelines. Results The reference intervals of semen parameters were as follows,volume≥1.8 mL,total sperm count ≥51×10⁶/time,sperm concentration ≥16×10⁶/mL,PR≥20%,the rate of sperm normal morphology≥5% and the pH value≥8.0. Conclusions Compared with the reference interval of WHO the 5th-edition guidelines,Zhejiang sperm donors has low PR,and the reference intervals of the other semen parameters were different. The numerical distribution of semen parameters in Zhejiang is slightly different from that of WHO the 5th-edition guidelines,especially in the high percentile above P₅₀. With the increase of sperm donors,especially for males over 40 years old,sperm quality decreases significantly.

Key words: Reference interval, Semen parameter, Sperm donor

中图分类号:

R446.1

吴颖, 宋银莉, 沈晓芳. 浙江省供精者精液分析参考区间的建立[J]. 检验医学, 2020, 35(11): 1094-1098.

WU Ying, SONG Yinli, SHEN Xiaofang. Establishment of biological reference interval of semen parameters in Zhejiang sperm donors[J]. Laboratory Medicine, 2020, 35(11): 1094-1098.

图/表 6

参考文献 17

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项目	例数	百分位数
项目	例数	2.5	5	10	25	50	75	90	95	97.5
WHO第5版	1 941	1.2	1.5	2.0	2.7	3.7	4.8	6.0	6.8	7.6
本研究	4 122	1.4	1.8	2.2	2.9	3.9	5.0	6.1	6.9	7.6
20~29岁	3 383	1.4	1.7	2.2	3.0	3.9	5.0	6.2	7.0	7.8
30~39岁	665	1.4	1.8	2.1	2.9	3.7	4.8	5.8	6.5	7.1
>40岁	74	0.5	1.1	2.0	2.7	3.9	5.0	6.4	7.0	8.7

项目	例数	百分位数
项目	例数	2.5	5	10	25	50	75	90	95	97.5
WHO第5版	1 941	1.2	1.5	2.0	2.7	3.7	4.8	6.0	6.8	7.6
本研究	4 122	1.4	1.8	2.2	2.9	3.9	5.0	6.1	6.9	7.6
20~29岁	3 383	1.4	1.7	2.2	3.0	3.9	5.0	6.2	7.0	7.8
30~39岁	665	1.4	1.8	2.1	2.9	3.7	4.8	5.8	6.5	7.1
>40岁	74	0.5	1.1	2.0	2.7	3.9	5.0	6.4	7.0	8.7

项目	例数	百分位数
项目	例数	2.5	5	10	25	50	75	90	95	97.5
WHO第5版	1 941	23	39	69	142	255	422	647	802	928
本研究	4 122	28	51	78	140	244	328	451	548	653
20~29岁	3 383	30	50	77	138	221	322	448	544	650
30~39岁	665	23	56	86	150	239	340	455	543	648
>40岁	74	21	40	67	143	249	396	620	971	1 376

项目	例数	百分位数
项目	例数	2.5	5	10	25	50	75	90	95	97.5
WHO第5版	1 941	23	39	69	142	255	422	647	802	928
本研究	4 122	28	51	78	140	244	328	451	548	653
20~29岁	3 383	30	50	77	138	221	322	448	544	650
30~39岁	665	23	56	86	150	239	340	455	543	648
>40岁	74	21	40	67	143	249	396	620	971	1 376

项目	例数	百分位数
项目	例数	2.5	5	10	25	50	75	90	95	97.5
WHO第5版	1 859	9	15	22	41	73	116	169	213	259
本研究	4 122	10	16	25	40	58	82	108	131	163
20~29岁	3 383	10	16	24	39	56	80	107	129	160
30~39岁	665	9	17	26	43	63	90	113	140	164
>40岁	74	5	7	22	46	72	116	151	272	304