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目的为临床使用计算机辅助精子分析(CASA)系统的精液分析参数提供参考。方法对48例人类冷冻复温精液和116例临床进行丈夫人工授精(AIH)的新鲜精液体外获能前后CASA检测结果,分组进行配对资料t-检验和独立样本t-检验。结果所有实验组精子体外获能后的曲线运动速度(VCL)、直线运动速度(VSL)、平均路径速度(VAP)、精子头侧摆幅度(ALH)和鞭打频率(BCF)显著提高(P<0．01);除冻存精液精子体外获能后的运动前向性(STR)和头部椭圆度外,其余各组精液精子获能后的STR、直线性(LIN)和头部椭圆度显著下降(P<0,01)。行AIH治疗的精液标本,无论获能前后,已孕组精子VAP、LIN和头部椭圆度显著高于未孕组(P<0．05),而BCF和头部面积低于未孕组(P<0.05);获能前两组的(a+b)级精子百分率无显著性差异,获能后差异显著(P<0．05)。结论体外获能处理可显著提高精子的各种运动速度,但精子运动的前向性和直线性降低;精液常规分析结果中的精子运动等级和速度不直接反映精子的受精能力。
Objective To provide a reference for the semen analysis parameters of computer assisted sperm analysis (CASA) system in clinical practice. Methods CASA test results of 48 cases of human cryopreservation semen and 116 cases of artificial insemination (AIH) fresh seminal fluid in vitro were analyzed by paired t-test and independent sample t-test. Results The results showed that the VCL, VSL, VAP, ALH and BCF of sperm motility in all experimental groups were significantly increased (P < 0.01). In addition to the kinematic forward (STR) and head ovality after cryopreserved sperm were capacitated in vitro, STR, linearity (LIN) and head ovality Significantly decreased (P <0,01). The semen samples of AIH-treated sperm showed significantly higher VAP, LIN and head ovality than the non-pregnant group (P <0.05), while the BCF and head area were lower than those of the non-pregnant group (P <0.05). There was no significant difference in the percentage of (a + b) sperm between the two groups before harvesting. CONCLUSIONS: In vitro capacitation treatment can significantly increase sperm motility, but the motility and linearity of spermatozoa decrease. The sperm motility and velocity in sperm routine analysis do not directly reflect sperm fertilization ability.