生精细胞与精浆生化联合检测在无精子症鉴别诊断中的价值  

Value of combined detection of seminal plasma biochemistry and spermatogenic cells in azoospermia analysis

作　　者：张炜[1] 蒋昱枫[1] 温端改[1] 浦金贤[1] 吕金星[2] 

机构地区：[1]苏州大学附属第一医院泌尿外科,江苏省215006 [2]苏州大学附属第一医院生殖中心,江苏省215006

出　　处：《江苏医药》2013年第17期2052-2054,共3页Jiangsu Medical Journal

摘　　要：目的探讨精浆生化与生精细胞联合检测在无精子症鉴别诊断中的价值。方法对74例无精子症精液标本行精液常规及精浆生化测定,同时采用改良巴氏染色法检测生精细胞。根据精液量、pH值、果糖含量、中性α-糖苷酶活性及有无生精细胞等指标对无精子症病因分型,并与睾丸穿刺活检结果对照。结果 74例无精子症患者中,68例(91.9%)得到确诊。其中,梗阻性无精症40例(54.1%),睾丸生精功能障碍28例(37.8%)梗阻性无精子症中,输精管缺如或射精管梗阻18.9%(14/74),输精管梗阻或附睾尾梗阻6.8%(5/74),附睾头部梗阻28.4%(21/74)。梗阻性无精子症睾丸穿刺活检阳性率明显高于非梗阻性无精子症(P<0.01)。结论联合应用精浆生化与生精细胞检测,对区分梗阻性与非梗阻性无精子症以及梗阻性无精子症中梗阻部位的判定具有重要的临床价值。Objective To explore the value of combined detection of seminal plasma biochemistry and spermatogenic cells in azoospermia analysis. Methods Plasma biochemical determination standard for routine analysis of semen and sperm bank on the semen of 74 cases with azoospermia, spermatogenic cells were detected by the papanicolaoumethod. According to the semen volume, pH value, the content of fructose, neutrala-glycosylase activity and spermatogenic cells, the causes of azoopermism were typed and compared to the findings from testicular biopsy. Results Of 74 azoopermia patients, 68 cases（91.9 %） were definitely diagnosed, of whom 40 （ 54.1 % ） cases were obstructive azoopermia. Fourteen cases（ 18. 9 %） were absence of deferens or ejaculatory duct obstruction, 5 cases（6.8 %） were deferens obstruction or epididymal obstruction, 21 cases （28.4 % ） were epididymis head obstruction, 28 cases（37.8%） were epididyrnal sperm atogenicdysfuntion. The positive rate of testicular biopsy of obstructive azoospermia group was higher than that of nonobstructive group（P^0. 01）. Conclusion The combined detection of seminal plasma biochemistry and sperrnatogenic cell is valuable for differentiating the obstructive and nonobstructive azoospermia and deciding the location of the obstruction.

关 键 词：无精子症 生精细胞 

分 类 号：R698[医药卫生—泌尿科学]