生殖激素水平和睾丸体积对非梗阻性无精症患者精子存在的预测价值

发布时间：2018-06-20 00:20

本文选题：非梗阻性无精子症 + 促卵泡生成素　；参考：《第三军医大学学报》2015年01期

【摘要】：目的探讨非梗阻性无精症(non-obstructive azoospermia,NOA)患者生殖激素水平、睾丸体积等参数对睾丸内是否存在精子的预测价值,以及可用于预测经皮睾丸精子抽吸术(testicular sperm aspiration,TESA)结果的切点值。方法将我中心男科门诊就诊的133例NOA患者按TESA的结果分为有精子组(n=33)和无精子组(n=100),测定生殖激素水平、睾丸体积、精浆果糖、中性-ɑ糖苷酶、染色体、AZF等。结果有精子组和无精子组左侧睾丸体积分别为(9.12±2.25)、(6.25±2.63)m L,右侧睾丸体积分别为(9.23±2.02)、(6.47±2.48)m L,促卵泡生成素(follicle-stimulating hormone,FSH)分别为(9.82±2.09)、(22.62±15.00)m IU/m L,总睾酮(total testosterone,TT)分别为(5.19±0.68)、(4.15±1.82)ng/m L,总睾酮/黄体生成素(T/LH)分别为:0.61±0.19、0.57±0.35,总睾酮/雌激素(T/E2)分别为:162.40±16.66和141.40±93.40。无精子组血清FSH显著高于有精子组,优选的FSH水平切点值为13.31 m IU/m L时,其敏感度为74.1%,特异性为96.2%。FSH水平ROC曲线的AUC为0.850,表明其诊断准确性中等。结论就单一因素而言,FSH水平对于NOA患者预测睾丸内是否有精子发生具有相当重要的价值,并且明显优于睾丸体积;两者的联合应用对非梗阻性无精子症患者预测其睾丸内精子存在更有意义。
[Abstract]:Objective to investigate the predictive value of reproductive hormone level and testicular volume in non-obstructive azoospermia (NOAA) patients with testicular spermatozoa, and to evaluate the cutoff point of testicular sperm aspiration in patients with non-obstructive azoospermia. Methods 133 patients with NOA were divided into two groups according to the results of TESA. The reproductive hormone level, testicular volume, seminal fructose, neutral glucosidase and chromosome AZF were measured in azoospermia group and azoospermia group. Results the left testicular volume of spermatozoa group and azoospermia group were 9.12 卤2.25 卤2.63 mL, the right testis volume was 9.23 卤2.02mL, the follicle-stimulating hormone FSH was 9.82 卤2.09m / mL, the total testosterone TTT was 5.19 卤0.68 卤4.15 卤1.82)ng/m / L, respectively, and the total testosterone / luteinizing hormone TLH was 5.19 卤0.68 卤4.15 1.82)ng/m / L, respectively. The total testosterone / estradiol T / E _ (2) was 0.61 卤0.19 卤0.57 卤0.35, and the ratio of T / E _ (2) was 141.40 卤93.40 and 162.40 卤16.66, respectively. Serum FSH in azoospermia group was significantly higher than that in spermatozoa group. The sensitivity of the selected FSH level was 74.1 and the specificity was 96.20.The AUC of ROC curve of FSH level was 0.850, which indicated that the diagnostic accuracy was moderate. Conclusion in terms of single factor, FSH level is of great value in predicting spermatogenesis in the testis of NOA patients, and is superior to testicular volume. The combined use of the two methods is more significant in predicting the presence of spermatozoa in the testis of patients with non-obstructive azoospermia.
【作者单位】：河南省人民医院生殖中心;
【基金】：河南省卫生厅科技攻关项目(2011020127)~~
【分类号】：R698.2

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