摘要
2010年出版的《世界卫生组织人类精液分析实验室技术手册》第5版是最为全面的一次修订。本文结合我国男科实验室精液分析的现状,从包括精子计数、精子活力、精子形态学、精子功能、抗精子抗体和精浆生化、以及精液分析的质量保证与质量控制等7个方面,对新出版的WHO手册进行了评论。笔者认为,该手册对精子浓度分析方法和参考值下调的推荐缺乏循证医学依据;精子活力分级标准的修订和精子形态学的严格标准和较低的4%的正常参考值与我国男科实验室目前使用的标准差距较大;精子功能指标尚未完善;抗精子抗体和精浆生化指标的检测方法显然不适合我国男科实验室现状;但精液分析的质量保证和质量控制对我国男科实验室有重要指导作用。需要指出的是,WHO手册中并没有涉及来自占世界人口1/5的中国人的任何临床数据和资料。因此,尽管WHO手册非常重要,它能否适应中国人精液分析实验室参考,仍需要评估。
The 5th edition of WHO Laboratory Manual for the Examination and Processing of Human Semen （2010） represents a comprehensive revision. This article aims to explore the applicability of this manual to andrology laboratories in China mainland in view of sperm count analysis,sperm motility analysis,sperm morphology analysis,sperm function analysis,anti-sperm antibody and seminal plasma biochemical marker analysis,and quality assurance and quality control of semen analysis. The authors deem that its recommendation to the analysis method and lower reference limit of sperm concentration may be a little arbitrary and lack of evidence-based support,that the revised grading sperm motility,the strict criteria and the very low cut-off value of 4% morphologically normal spermatozoa for the evaluation of sperm morphology are not applicable to andrology laboratories in China mainland,that the sperm function markers need to be supplemented,and that the determination methods of anti-sperm antibody and seminal plasma biochemical markers are incompatible with the status of Chinese andrology laboratories. However,its recommended methods for quality assurance and quality control of semen analysis have a significant directive role in China mainland. It is worth to point out that the WHO manual ignored the data obtained from Chinese which accounts for approximate 20% of the world population. Thus,given the importance of the WHO manual,its general applicability should be evaluated in China.
出处
《中华男科学杂志》
CAS
CSCD
北大核心
2010年第10期867-871,共5页
National Journal of Andrology
关键词
精液分析
男科实验室
精子计数
精子活力
精子形态学
抗精子抗体
精浆生化指标
质量控制
semen analysis
andrology laboratory
sperm counting
sperm motility
sperm morphology
anti-sperm antibody
seminal plasma biochemical marker
quality control
