Lu Wen-Hong, Gu Yi-Qun, Li Hong, Wang Xiao-Wei, Chen Zhen-Wen, Liang Xiao-Wei
Department of Male Clinical Research, National Research Institute for Family Planning/WHO Collaborating Center for Research in Human Reproduction, Beijing 100081, China.
Zhonghua Nan Ke Xue. 2011 Jul;17(7):601-5.
To establish the methods for training green-hand laboratorians in standard semen analysis and evaluating the training results, and afford some reference for internal quality control and training in andrology laboratories in China.
We trained the green-hand technicians in standard semen analysis recommended by WHO Laboratory Manual for the Examination and Processing of Human Semen (5th ed), and evaluated the training results by assessing the trainees' performance in the examination of sperm concentration and motility by statistic analysis.
After training, the coefficients of variation of the semen samples with high, middle and low sperm concentration achieved by the trainees were 7.72% and 3.38% and 4.49%, and those with high, middle and high motility were 7.82%, 8.09% and 6.62%, respectively. We used Bland-Altman's method to evaluate the consistency between the results obtained by the trainees and those by the trainers. For sperm concentration, 4.77% of the datum points were out of the 95% consistency interval, and the absolute value of the biggest difference between the trainees and trainers was 8 x 10(6)/ml within the 95% consistency interval. For sperm motility, 7.15% of the data points were out of the 95% consistency interval, and the absolute value of the biggest difference between the trainees and trainers was 10% within the 95% consistency interval. Two-way analysis of variance showed no significant differences in the results of sperm concentration and motility analyses between the trainees and trainers (P > 0.05).
Training in standard semen analysis significantly improved the precision of semen analysis among the green-hand laboratorians. The training and assessment methods we established proved to be effective and feasible.
建立男科实验室新手检验师精液常规分析培训及效果评估方法，为我国男科实验室内部质量控制及培训提供参考。
按照世界卫生组织《人类精液检查与处理实验室手册》（第5版）推荐的精液常规分析方法培训新手检验师，采用统计学分析方法，通过评估检验师对精子浓度和活动率检测结果，评价培训效果。
培训后，检验师检测高、中、低精子浓度精液样本的变异系数分别为7.72%、3.38%、4.49%，检测高、中、高活动率精液样本的变异系数分别为7.82%、8.09%、6.62%。采用Bland-Altman法分析检验师与带教老师检测结果的一致性，精子浓度检测结果中4.77%的数据点超出95%一致性界限，在95%一致性界限内检验师与带教老师检测结果的最大差异绝对值为8×10⁶/ml；精子活动率检测结果中7.15%的数据点超出95%一致性界限，在95%一致性界限内检验师与带教老师检测结果的最大差异绝对值为10%。两因素方差分析显示检验师与带教老师精子浓度和活动率检测结果差异无统计学意义（P>0.05）。
精液常规分析培训可显著提高男科实验室新手检验师精液分析的精密度，所建立的培训及评估方法有效可行。
