国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2010, Vol. 29 ›› Issue (3): 215-220.

• 论著 • 上一篇    下一篇

中国118 家实验室精液分析状况的调查

陆金春;张红烨;胡毓安;黄宇峰;吕年青   

  1. 210028 南京，武警江苏总队医院南京分院检验科(陆金春）；南京医科大学附属南京第一医院检验科（张红烨）；南京军区总医院（胡毓安，黄宇峰）；江苏省计划生育研究所（吕年青）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-05-15 发布日期:2010-05-15

A Survey on the Status of Semen Analysis in 118 Laboratories in China

LU JC;ZHANG HY;HU YA;HUANG YF;LV NQ   

  1. Department of Laboratory Science,Nanjing Hospital,Jiangsu Corps,The Armed Police Force,PLA,Nanjing 210028,China (LU JC);Department of Laboratory Science,Affiliated Nanjing First Hospital of Nanjing Medical University,Nanjing 210006,China (ZHANG HY);Department of Reproduction and Genetics,School of Medicine,Jinling Hospital,Nanjing University,Nanjing 210002,China (HU YA,HUANG YF);Jiangsu Family Planning Research Institute,Nanjing 210036,China(LV NQ)
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-05-15 Online:2010-05-15

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摘要： 为在实验室内和实验室间实现精液分析标准化和进行质量控制，必须了解目前男科实验室精液分析的状况。为此，对中国大陆地区的部分精液分析实验室进行了调查。设计的“男科实验室精液
分析调查表”，包含36 个问题，涉及精液分析的相关内容。本研究发放调查表145 份，回收有效调查表118份。调查显示，53.6%（59/110）的实验室采用目测法检测精液量；对液化不全精液，70.9%（73/103）的实验室未作任何处理；精子密度、活动率、存活率及形态学分析以手工普通光学显微镜分析和计算机辅助精液分析（CASA）系统检测并存；精子染色方法达5 种以上；精子自身抗体检测以酶联免疫吸附试验（ELISA）为主；仅有27.1%（32/118）的实验室开展了精浆生化项目检测。而且，在参与调查的所有实验室中，无一家实验室开展精液分析的室内和室间质量控制。总之，在中国大陆，男科实验室精液分析的方法和报告方式很不统一。采用的精液分析方法与《世界卫生组织人类精液分析实验室手册》第4 版推荐的方法也不一致。本研究提示，为使不同实验室的检测结果具有可比性且有意义，中国男科实验室目前使用的精液分析方法急需标准化和质量控制。

关键词: 实验室, 质量控制, 调查表, 精液分析, 标准化

Abstract: Collecting baseline information on how laboratories perform testing is a reasonable first step towards establishing intra-and inter-laboratory standardization and quality control for semen analysis. We carried out a survey of the laboratories performing the testing in Mainland China. A questionnaire，composed of 36 questions covering all aspects of semen analysis，was designed，and a copy was distributed to each of the 145 laboratories. Of these，118 laboratories completed the questionnaires. The survey results showed that semen volume was measured visually in 53.6%（59/110）of the responding laboratories，and 70.9%（73/103）of laboratories analysed incompletely liquefied semen without any treatment. In addition， both manual-microscopic and computer-assisted semen-analysis systems were applied to analyse sperm concentration，motility and morphology. However，more than five methods were employed in routine sperm staining. An enzyme-linked immunosorbent assay was commonly used for determining whether antisperm antibodies were present. Several seminal biochemical markers were analysed in only 27.1%（32/118）of the responding laboratories. Generally，there was a lack of intra-and inter-laboratory quality control measures for semen analysis in all laboratories responding to this survey. In conclusion，the methods of semen analysis and the interpretation of test results in the surveyed laboratories differed markedly. In particular，many laboratories employed methods other than those recommended by the World Health Organization Laboratory Manual for the Examination of Human Semen and Spermcervical Mucus Interaction（1999）. These findings suggest an urgent need for the standardization of semen analysis with acceptable quality controls for each parameter to make the
results repeatable and meaningful.

Key words: Laboratory, Quality control, Questionnaire, Semen analysis, Standardization