无精子症患者睾丸组织病理分型与血清抑制素B关系的研究  

Relationship Between Pathological Alterations of Spermatogenic Impairment and Serum Inhibin B Concentration in Patients with Azoospermia

作　　者：董志英[1] 张荣莲[1] 贺政新[1] 孙辉臣[1] 

机构地区：[1]解放军白求恩国际和平医院生殖中心,河北石家庄050082

出　　处：《中华男科学杂志》2006年第1期18-20,24,共4页National Journal of Andrology

基　　金：河北省人口与计划生育委员会资助项目(2003-04)

摘　　要：目的:探讨无精子症患者睾丸组织病理分型与血清抑制素B(INH B)水平间的关系,了解血清INH B在评估无精子症患者睾丸生精功能状态的敏感性和特异性。方法:对83例无精子症患者进行睾丸活组织病理检查诊断,根据病理形态的不同分为:唯支持细胞综合征组(n=21)、生精功能低下组(n=20)、生精阻滞组(n=24)和生精功能基本正常组(n=18)。患者睾丸活检前分别测定其血清INH B、卵泡刺激素(FSH)、黄体生成素(LH)及睾酮(T)水平。结果:上述4组血清INH B水平分别为(20.85±18.78)、(67.25±40.98)、(73.63±25.54)和(149.48±27.92)ng/m l。INH B水平在生精阻滞组与生精功能低下组之间差异无显著性(P>0.05),其他各组间以及与上述两组血清INH B水平间差异均有极显著性(P<0.001);FSH水平在生精阻滞组与基本正常组间差异无显著性(P>0.05),其他各组间以及与上述两组血清FSH水平间差异均有显著性(P<0.05);4组血清LH及T水平之间无相关性。结论:血清INH B水平在生精小管生精功能受损时明显降低,唯支持细胞综合征者下降最为显著。血清INH B水平可直接反映睾丸生精功能的总体状态,是判断无精子症患者睾丸生精功能更有效的诊断指标。To investigate the relationship between pathological alterations of spermatogenic impairment in seminiferous tubules and serum inhibin B concentration in patients with azoospermia and to verify the significance of INH B in evaluating spermatogenesis. Methods： Eighty-three cases of azoospermia underwent testicular biopsy for the purpose of diagnosis. In accordance with the pathological alterations of spermatogenesis in seminiferous tubules, the samples were divided into four groups： Sertoli cell-only syndrome（ n = 21 ） ; hypospermatogenesis（ n = 20） ; maturation arrest（ n = 24） and almost normal spermatogenesis（ n = 18 ）. Serum INHB and FSH, LH, T concentrations were tested before testicular biopsy for each patient respectively. Results： The INHB levels were （ 20.85 ± 18.78 ） pg/ml, （ 67.25 ± 40.98 ） pg/ml, （73.63 ± 25.54） pg/ml and （ 149.48 ± 27.92 ） pg/ml in the above four groups, respectively. There was no significant statistical difference in the level of serum INH B between muturation arrest and hypospermatogenesis groups （ P 〉 0.05 ）, and there was a very significant difference in almost normal spermatogenesis group and the other three groups, respectively （P 〈 0. 001 ）. There was no significant difference in the concentration of serum FSH when muturation arrest group compared with spermatogenesis group （ P 〉 0.05 ）, whereas between the other two groups and between each of them and maturation arrest or almost normal spermatogenesis there was a very significant difference in the level of serum FSH（P 〈 0.05） ; The concentrations of LH and T were not significantly different among the four groups （ P 〉 0. 05 ）. Conclusion ： Serum INHB concentration was decreased when spermatogenesis got impaired. It dropped the most markedly in Sertoli cell-only syndrome group. INH B reflects directly the spermatogenic function in seminiferous tubules of the testis. Therefore, it could be considered valuable for spermatogenesis and potential fertility in p

关 键 词：无精子症 抑制素B 睾丸生精功能 卵泡刺激素 黄体生成素 睾酮 

分 类 号：R698.2[医药卫生—泌尿科学]