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目的:探讨梗阻性无精子症(OA)患者精子的顶体完整性及其与卵胞质单精子注射(ICSI)治疗临床结局之间的关系。方法:选取梗阻性无精子症患者共37例为试验组,同期进行体外受精治疗且精液常规参数正常的男性33例为对照组,应用荧光标记的豌豆凝集素法(PSA-FITC)检测精子顶体完整性,巴氏染色法分析精子形态,比较试验组与对照组的顶体完整率(AIR)、正常形态率(NFR)、受精率(FR)、卵裂率(CR)及优质胚胎率(OER),并将AIR与FR、NFR与FR进行相关性分析。结果:试验组的AIR、NFR、FR显著低于对照组(P<0.01),CR、OER试验组与对照组相比无统计学差异(P>0.05)。试验组AIR与FR呈显著正相关(r=0.595,P<0.01),NFR与FR显著正相关(r=0.463,P<0.01);对照组AIR与FR显著正相关(r=0.683,P<0.01),NFR与FR呈显著正相关(r=0.205,P<0.01)。结论:梗阻性无精子症患者的精子AIR较低。行皮下附睾抽吸术(PESA)-ICSI的梗阻性无精子症患者精子其AIR高则受精率也会高。
OBJECTIVE: To investigate the acrosome integrity of sperm in patients with obstructive azoospermia (OA) and its relationship with the clinical outcome of treatment with oocyte cytoplasmic sperm injection (ICSI). Methods: Thirty-seven patients with obstructive azoospermia were selected as the experimental group. 33 males with normal fertilization and normal sperm parameters were selected as the control group. PSA-FITC was used to detect sperm top Body integrity and sperm morphology were analyzed by Papanicolaou staining. The ratio of acrosome integrity (AIR), normal morphology (NFR), fertilization rate (FR), cleavage rate (CR) (OER), and AIR and FR, NFR and FR correlation analysis. Results: AIR, NFR and FR in the experimental group were significantly lower than those in the control group (P <0.01). There was no significant difference between the experimental group and the control group (P> 0.05). There was a significant positive correlation between AIR and FR in the experimental group (r = 0.595, P <0.01), NFR and FR (r = 0.463, P <0.01) 0.01). There was a significant positive correlation between NFR and FR (r = 0.205, P <0.01). Conclusion: Patients with obstructive azoospermia have lower sperm AIR. Subcutaneous epididymo-suction (PESA) -ICSI obstructive azoospermia in patients with high sperm AIR fertilization rate will be high.