Counting in regexes is hard to impossible. One way around this is to write a regex that matches ($digits,$upper,$lower)|($digits,$upper,$extra)|....

Since that's no fun, you can generate it by program:

my @chunks = map qr{(?=.*$_)}, (
   qr{\d},
   qr{[a-z]},
   qr{[A-Z]},
   qr{[@#$%^&+=]},
);

my @transformed;
for my $i (0..$#chunks) {
   my $r = '';
   for my $j (0..$#chunks) {
       $r .= $chunks[$j] if $j != $i;
   }
   push @transformed, $r;
}
my $regex = = join '|', @transformed;
$regex = qr{^.*(?=.{10,})(?:$regex)};
[download]

(untested)

But it's much easier to keep the four regexes separate, and in ordinary perl code count how many matched:

my $count = 0;
for (@chunks) {
   $count++ if $str =~ $_;
}
[download]