中文摘要：

目的：应用荧光染料SYBR-14/PI双色标记法进行流式细胞术检测精索静脉曲张患者精子质膜的完整性并探讨其临床意义。方法：随机收集120例男性精液标本,其中90例左侧精索静脉曲张患者分为3组：VC1组（精索静脉曲张Ⅰ度,n=30）、VC2组（精索静脉曲张Ⅱ度,n=30）和VC3组（精索静脉曲张Ⅲ度,n=30）,正常生育男性为正常对照组（n=30）。通过计算机辅助精液分析系统进行精液常规分析。精液标本经PBS洗涤处理后用荧光染料SYBR-14/碘化丙锭（PI）双染后上流式细胞仪分析,用发绿色荧光精子百分率（SYBR-14＋/PI-%）表示质膜完整精子（PMI）的比例,检测精子质膜完整性,并预见精子的受精能力。结果：精索静脉曲张各组患者与正常对照组之间SYBR-14＋/PI-%、SYBR-14-/PI＋%均存在统计学差异（P〈0.01）。精索静脉曲张患者（VC1、VC2、VC3）代表精子质膜完整性指标（SYBR-14＋/PI-%）的百分率分别是：[（54.85±3.78）%]、[（45.37±4.12）%]、[（35.14±4.91）%],均显著低于正常对照组[（70.79±6.71）%],其活力顺序为VC3〈VC2〈VC1〈对照组;120例精液标本的相关性分析表明：SYBR-14＋/PI-%与精子活动率呈显著正相关（r=0.965,P〈0.01）,与（a＋b）级精子百分率呈显著正相关（r=0.874,P〈0.01）,与d级精子百分率呈显著负相关（r=-0.965,P〈0.01）,而与pH、精液量和液化时间无显著性差异（P〉0.05）。结论：应用流式细胞术SYBR-14/PI双染法能快速、准确地检测精子质膜完整性,精索静脉曲张引起精子质膜完整性下降,可能是导致男性不育的重要原因之一。

英文摘要：

Objective： To detect the sperm plasma membrane integrity（PMI） of varicocele（VC） patients using SYBR-14/PI fluorescent staining and flow cytometry,and investigate its clinical significance.Methods： We collected semen samples from 120 men,including 30 grade-1 varicocele patients（VC1）,30 grade-2（VC2）,30 grade-3（VC3）,and 30 normal fertile volunteer controls.Conventional semen analyses were performed by computer-assisted semen analysis（CASA）.All the semen samples were washed with PBS and then subjected to SYBR-14/PI staining for the detection of sperm PMI by flow cytometry.The proportion of normal sperm with PMI was indicated as the percentage of sperm emitting green fluorescence（SYBR-14＋/PI-%）,sperm PMI was determined and sperm fertilization capacity predicted.Results： Significant differences were detected in SYBR-14＋/PI-and SYBR-14-/PI＋ between the normal men and varicocele male patients（P0.01）.The percentages of the sperm with PMI（SYBR-14＋/PI-%） were remarkably lower in the VC1,VC2 and VC3 groups（[54.85±3.78]%,[45.37±4.12]% and [35.14±4.91]%） than in the normal controls（[70.79±6.71]%）.SYBR-14＋/PI-% was correlated positively with sperm motility（r=0.965,P0.01） and the percentage of grade a＋b sperm（r=0.874,P0.01）,negatively with the percentage of grade d sperm（r=-0.965,P0.01）,but not significantly with pH,semen volume and liquefaction time（P0.05）.Conclusion： SYBR-14/PI fluorescent staining and flow cytometry can quickly and exactly detect sperm PMI.Varicocele decreases sperm PMI,which might be an important cause of male infertility.