本文選題：非梗阻性無(wú)精子癥 + 促卵泡生成素��； 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2015年01期

【摘要】：目的探討非梗阻性無(wú)精癥(non-obstructive azoospermia,NOA)患者生殖激素水平、睪丸體積等參數(shù)對(duì)睪丸內(nèi)是否存在精子的預(yù)測(cè)價(jià)值,以及可用于預(yù)測(cè)經(jīng)皮睪丸精子抽吸術(shù)(testicular sperm aspiration,TESA)結(jié)果的切點(diǎn)值。方法將我中心男科門(mén)診就診的133例NOA患者按TESA的結(jié)果分為有精子組(n=33)和無(wú)精子組(n=100),測(cè)定生殖激素水平、睪丸體積、精漿果糖、中性-ɑ糖苷酶、染色體、AZF等。結(jié)果有精子組和無(wú)精子組左側(cè)睪丸體積分別為(9.12±2.25)、(6.25±2.63)m L,右側(cè)睪丸體積分別為(9.23±2.02)、(6.47±2.48)m L,促卵泡生成素(follicle-stimulating hormone,FSH)分別為(9.82±2.09)、(22.62±15.00)m IU/m L,總睪酮(total testosterone,TT)分別為(5.19±0.68)、(4.15±1.82)ng/m L,總睪酮/黃體生成素(T/LH)分別為:0.61±0.19、0.57±0.35,總睪酮/雌激素(T/E2)分別為:162.40±16.66和141.40±93.40。無(wú)精子組血清FSH顯著高于有精子組,優(yōu)選的FSH水平切點(diǎn)值為13.31 m IU/m L時(shí),其敏感度為74.1%,特異性為96.2%。FSH水平ROC曲線的AUC為0.850,表明其診斷準(zhǔn)確性中等。結(jié)論就單一因素而言,FSH水平對(duì)于NOA患者預(yù)測(cè)睪丸內(nèi)是否有精子發(fā)生具有相當(dāng)重要的價(jià)值,并且明顯優(yōu)于睪丸體積;兩者的聯(lián)合應(yīng)用對(duì)非梗阻性無(wú)精子癥患者預(yù)測(cè)其睪丸內(nèi)精子存在更有意義。
[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 鹵2.25 鹵2.63 mL, the right testis volume was 9.23 鹵2.02mL, the follicle-stimulating hormone FSH was 9.82 鹵2.09m / mL, the total testosterone TTT was 5.19 鹵0.68 鹵4.15 鹵1.82)ng/m / L, respectively, and the total testosterone / luteinizing hormone TLH was 5.19 鹵0.68 鹵4.15 1.82)ng/m / L, respectively. The total testosterone / estradiol T / E _ (2) was 0.61 鹵0.19 鹵0.57 鹵0.35, and the ratio of T / E _ (2) was 141.40 鹵93.40 and 162.40 鹵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.
【作者單位】： 河南省人民醫(yī)院生殖中心;
【基金】：河南省衛(wèi)生廳科技攻關(guān)項(xiàng)目(2011020127)~~
【分類(lèi)號(hào)】：R698.2

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