探讨血清卵泡刺激素预测非梗阻性无精子症患者精子发生的切点值  

The cut-off value of serum follicle-stimulating hormone predicts spermatogenesis of non-obstructive azoospermic patients

作　　者：黄永汉[1] 廖黎黎[1] 何磊[1] 梁小丽[1] 徐杰伟[1] 

机构地区：[1]中山大学附属佛山医院,佛山市第一人民医院生殖医学中心,佛山528000

出　　处：《中国男科学杂志》2014年第10期31-33,36,共4页Chinese Journal of Andrology

摘　　要：目的：利用受试者工作特征曲线（receiver operator characteristic curve ROC曲线）探讨血清卵泡刺激素（FSH）的切点值，以预测非梗阻性无精子症患者睾丸的精子发生。方法选取104例非梗阻性无精子症患者测定其血清FSH（IU/L）值，行经皮睾丸取精子术（TESA）并根据睾丸活检报告分为有精子组（1组）和无精子组（2组）。结果 FSH≤7有52例（50%），找到精子51例，其概率为98.08%（51/52）；7＜FSH≤14有20例（19.23%），找到精子17例，其概率为85%（17/20）；14＜FSH≤21有13例（12.50%），找到精子3例，其概率为23.08%（3/13）；FSH＞21有19例（18.27%），找到精子6例，其概率为31.58%（6/19）。利用ROC曲线优选的血清FSH切点值是13.78IU/L，该点其敏感性为85.2%，特异性为88.3%，血清FSH水平的ROC曲线下面积为0.895，表明其诊断准确性较高。结论非梗阻性无精子症患者血清FSH水平对预测睾丸精子发生有重要意义。Objective To explore the cut-off value of the serum follicle-stimulating hormone （FSH） by using receiver operator characteristic curve（ROC curve） for prediction of spermatogenesis in the testis of the non-obstructive azoospermic patients. Methods Levels of serum FSH （IU/L） in 104 non-obstructive azoospermic patients were first measured. Based on the results of testicular sperm aspiration （TESA）, the patients were divided into sperm group （No.1 group） and non-sperm group （No.2 group）. Results In 52 （50%） of 104 patients, level of their serum FSH was lower than 7, and 51 patients（98.08%） of them were positive in sperm retrieval; in 20/104 （19.23%） patients, level of their serum FSH ranged from 7 to 14, and 17 patients（85%） were positive in sperm retrieval; In 13/104（12.50%）patients, level of their serum FSH range from 14 to 21, and 3 patients （23.08%）were positive in sperm retrieval; In 19/104（18.27%） patients, level of their serum FSH more than 21, and 6 patients （31.58%）were positive in sperm retrieval; The cut-off value is 13.78IU/L for FSH, with sensitivity of 85.2% and specificity of 88.3%, The area under curve（AUC） was 0.895, indicating a high diagnostic accuracy. Conclution Serum FSH level of non-obstructive azoospermic patients is very important in predicting spermatogenesis in the testis.

关 键 词：ROC曲线 卵泡刺激素 无精子症 

分 类 号：R698.2[医药卫生—泌尿科学]