何海洪??郭伟权??柯娟玉??兰希??吴润安??周义文

[摘要] 目的 探讨同型半胱酸、精子DNA碎片指数与严重生精障碍男性的精子计数之间的相关性研究。 方法 2015年12月～2017年2月期间在医院就诊的严重生精障碍男性患者56例，按WHO标准分为严重无、少精子症组25例和弱精子症组31例，对照组为无生育障碍的男性27例。对所有纳入研究者进行精子参数、精子DNA碎片指数和血清Hcy水平的检测。结果 严重生精障碍男性的精子DNA碎片指数和Hcy均高于正常对照组。精子DNA碎片指数与血清Hcy水平、精子浓度呈正相关，而Hcy水平和精子浓度呈负相关。结论 Hcy水平和精子DNA碎片指数的升高，可能是严重生精障碍男性的重要病因，但其具体机制有待进一步研究。

[关键词] 男性；精子DNA碎片指数；同型半胱氨酸；精子

[中图分类号] R698.2 [文献标识码] A [文章编号] 2095-0616（2017）11-14-04

Research and analysis of sperm DNA fragmentation index and Hcy level of males with severe spermatogenesis dysfunction

HE Haihong GUO Weiquan KE Juanyu LAN Xi WU Run'an ZHOU Yiwen

Clinical Laboratory Center， Shenzhen Hospital of Southern Medical University， Shenzhen 518110， China

[Abstract] Objective To explore research on correlation between homocysteine， sperm DNA fragmentation index and sperm count of males with severe spermatogenesis dysfunction. Methods 56 male patients with severe spermatogenesis dysfunction who were treated in our hospital from December 2015 to February 2017 were selected. According to WHO standard， they were divided into the severe azoospermia and oligospermia group with 25 cases and the asthenospermia group with 31 cases. In the control group， there were 27 males without fertility barrier. Sperm parameters， sperm DNA fragmentation index and serum Hcy level of all included research objects were detected. Results Sperm DNA fragmentation index and Hcy level of males with severe spermatogenesis dysfunction were both significantly higher than those of the normal control group. Sperm DNA fragmentation index was positively correlated with serum Hcy level and sperm concentration while Hcy level was negatively correlated with sperm concentration. Conclusion Improvements of Hcy level and sperm DNA fragmentation index may be the main causes for males with severe spermatogenesis dysfunction but concrete mechanism needs to be further studied.

[Key words] Males； Sperm DNA fragmentation index； Homocysteine； Sperm

在發达国家大约有8%～10%的夫妇患有不育症，而发展中国家的数据更高，有研究报道国内不育率达到18%[1]，在这些不育夫妇中大约有30%～55%是由于男方因素造成的[2]。在男性生殖领域，精子发生是一个复杂的过程，受感染、性激素失衡、吸烟、饮酒、染色体异常、Y染色体微缺失、易位、囊性纤维化跨膜传导调节因子基因突变和其他的遗传因素等多种因素的影响[3]。近年来，国外一些研究发现，严重生精子障碍男性的同型半胱氨酸（homocysteine，Hcy）浓度明显高于正常男性，同时证实精液中的Hcy水平升高可以损害精子的质量并引起出生缺陷[4-5]。而国内却鲜见Hcy和严重生精障碍男性的相关性研究。有……