不同睾丸活检术对睾丸功能及抗精子抗体的影响

发布时间：2018-02-26 14:11

本文关键词： 睾丸活检术血清抑制素B 抗精子抗体卵泡刺激素睾酮　出处：《中华男科学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的:研究不同睾丸活检术对无精子症患者血清抑制素B(INHB)、血清抗精子抗体(As Ab)、卵泡刺激素(FSH)、睾酮(T)的影响。方法:选取无精子症患者210例,根据不同的睾丸活检手术方式,分为睾丸切开活检取精术(TESE)组50例、睾丸穿刺抽吸取精术(TESA)组56例、睾丸细针穿刺抽吸取精术(TEFNA)组64例、显微睾丸切开取精术(micro-TESE)组40例,分别检测睾丸活检术前及术后1、3个月患者血清INHB、FSH、T水平和As Ab阳性率。结果:4组患者术后1、3个月FSH与术前比较均无显著性差异[TESE:(8.76±3.07)IU/L、(7.24±3.32)IU/L vs(8.51±4.34)IU/L;TESA:(7.90±4.57)IU/L、(8.04±3.65)IU/L vs(7.70±2.72)IU/L;TEFNA:(6.08±2.70)IU/L、(6.10±3.32)IU/L vs(6.04±3.17)IU/L;micro-TESE:(6.89±1.78)IU/L、(6.75±2.57)IU/L vs(6.59±2.74)IU/L,P均0.05]。TESE组和micro-TESE组术后1个月As Ab Ig M阳性率(14.00%和15.00%)较术前(0.00和2.50%)明显升高(P0.05)。TESE组和micro-TESE组患者术后1个月T水平[(9.25±5.76)nmol/L和(8.23±4.12)nmol/L]较术前[(16.52±6.25)nmol/L和(14.16±5.45)nmol/L]明显下降(P均0.05)。TESE、TESA、TEFNA、micro-TESE4组患者术后1、3个月血清INHB较术前均明显下降[TESE:(42.63±15.34)pg/ml、(44.05±18.47)pg/ml vs(70.56±23.17)pg/ml;TESA:(40.55±20.51)pg/ml、(42.11±19.34)pg/ml vs(68.71±14.74)pg/ml;TEFNA:(46.31±19.28)pg/ml、(48.32±20.54)pg/ml vs(76.81±27.04)pg/ml;micro-TESE:(45.27±18.83)pg/ml、(47.64±28.34)pg/ml vs(74.74±28.35)pg/ml,P均0.05],但不同方法组组间无统计学差异(P0.05)。结论:不同睾丸活检术对无精子症患者睾丸功能及As Ab有影响,且存在一定差异。
[Abstract]:Objective: to study the effects of different testicular biopsy on serum inhibin INHBN, serum anti-sperm antibody (as Aba), follicle stimulating hormone (FSH) and testosterone (T) in patients with azoospermia. Methods: 210 patients with azoospermia were selected according to different methods of testicular biopsy. The patients were divided into testicular biopsy group (50 cases), testicular aspiration group (56 cases), fine needle aspiration group (64 cases) and micro-testicular extraction group (40 cases). The serum INHBFSHT level and Asab positive rate were measured before testicular biopsy and 1 and 3 months after testicular biopsy respectively. Results there was no significant difference in serum INHBFSHT level and Asab positive rate between 1 and 3 months after operation in the four groups. Results there was no significant difference in FSH between the 4 groups after operation [TESE:(8.76 卤3.07 vs(8.51 卤4.34 IUL vs(8.51 卤3.32 vs(8.51 卤4.34 IUL vs(8.51 7.90 卤4.57 vs(8.51 卤8.04 卤3.65 vs(7.70 卤2.72IUL vs(7.70 卤2.70 FSH 6.08 卤2.70 TESE:(8.76 vs(6.04 6.10 卤3.32? The positive rate of Asab IgM (14.00% and 15.00%) was significantly higher than that before operation (P < 0.05). Tese group and micro-TESE group were significantly higher than those before operation [9.25 卤5.76nmol / L and 8.23 卤4.12nmol / L] significantly lower than those before operation [16.52 卤6.25nmol / L and 14.16 卤5.45nmol / L] (P = 0.05N. TESATEFNAmicro-TESE4 group), and the serum INHB was decreased significantly at 3 months after operation (P = 0.05nmol / L, P = 0.05nmol / L, P = 0.05nmol / L, P = 0.05N / L, P < 0.05). The serum INHB level was significantly lower at 3 months after operation than that before operation [16.52 卤6.25nmol / L and 14.16 卤5.45nmol / L]. [TESE:(42.63 卤15.34 vs(68.71 卤14.74 PG / ml TEFNAV 44.05 卤18.47 PG / ml vs(70.56 卤23.17 p / g / ml TESAN 40.55 卤20.51 PG / ml 42.11 卤19.34 vs(68.71 卤14.74 g / ml TEFNAG / ml TEFNAV 46.31 卤19.28 PG / ml 48.32 卤20.54pg / ml vs(76.81 卤27.04pgmlmicro-TESAN 45.27 卤18.83pgml / ml 47.64 卤28.34pgml vs(74.74 卤28.35pgmlml P 0.05 respectively] conclusion: testicular microtesticular microtest has an effect on testicular function in patients with azoospermia (45.27 卤18.83pgml-1 + 47.64 卤28.34pgml 卤28.35pgmlml P 0.05). And there are some differences.
【作者单位】：温州医科大学附属第二医院生殖医学中心;
【分类号】：R698.2

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