血清卵泡刺激素、抑制素B水平在不同睾丸体积非梗阻性无精子症中的表达  

Expression of serum FSH and inhibin B level in different testicular volume of non-obstructive azoospermia

作　　者：杨琳[1] 杨长海[2] 宋学茹[1] 穆晓环 

机构地区：[1]天津医科大学总医院妇产科生殖医学中心,300052 [2]天津医科大学总医院泌尿外科,300052

出　　处：《中华临床医师杂志（电子版）》2015年第15期8-11,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的检测不同睾丸体积的非梗阻性无精子症[唯支持细胞综合征(SCOS)和生精功能阻滞(SA)]患者血清卵泡刺激素(FSH)和抑制素B(Inh B)水平,探讨两者在不同睾丸体积中与严重睾丸生精功能损害的关系及意义。方法入组病例包括SCOS 121例、SA 27例,每组疾病按睾丸体积≤5 ml,5 ml<睾丸体积<10 ml和睾丸体积≥10 ml分成三组进行血FSH和Inh B检测,比较不同睾丸分组间两种激素表达水平的差异,以相同体积的重度少精子症或隐匿性无精子症匹配作为对照(50例);考察不同疾病间睾丸体积与FSH和Inh B的相关性;结合ROC曲线法对SCOS进行分析评价。结果当睾丸体积≤5 ml时,FSH和Inh B在试验组和对照组之间表达均无统计学差异,而当睾丸体积>5 ml时,FSH在三种疾病中表达有统计学差异;FSH在SA和对照组中与睾丸体积呈正相关性,Inh B与睾丸体积无相关性;SCOS组中的睾丸体积与FSH和Inh B均没有相关性;FSH诊断睾丸体积>5 ml SCOS的切点值为11.53 m IU/ml,敏感度为87.4%,特异度为88.3%。结论在评价FSH与严重生精功能损害的程度时应与其睾丸体积相结合,当睾丸体积≥5 ml时,血清FSH水平有助于评估睾丸生精功能状况。Objective To detect the levels of serum FSH and inhibin B in different testicular volume（TV） of patients with non-obstructive azoospermia （NOA）, and to explore the relationship and significance of FSH and inhibin B for severe spermatogenesis damage.Methods 121 patients of Sertoli cel only sydrome, 27 of spermatogenic arrest were colected according to their classifications of testicular biopsy with histopathological examination, quantitative examination of serum FSH and inhibin B was performed in al patients to compare the association with different TV （TV≤5 ml, 5 ml〈TV〈10 ml and TV≥10 ml） , severe oligozoospermia and cryptozoospermia were matched with same TV as control group. Bivariate correlation analysis was performed to identify the relevance of different TV with the levels of FSH and inhibin B. ROC curves were drawn for analyzing SCOS.Results Serum FSH levels differed with statistical significance in all of the patients with TV≥5 ml; the levels of FSH were positive related to SA and the control group; neither serum FSH nor inhibin B had relationship with SCOS. When testicular volume≥5 ml, sensitivity and specificity for FSH as a predictive diagnostic tool for SCOS were 87.4% and 88.3%, respectively, at the cutoff value of 11.53 mIU/ml.Conclusion The assessment of FSH level on severe spermatogenesis damage should be combined with the testicular volume, when testicular volume≥5 ml, serum FSH level help the evaluation on testicular spermatogenesis function.

关 键 词：无精子症 唯支持细胞综合征 卵泡刺激素 抑制素B 生精功能阻滞 睾丸体积 

分 类 号：R698.2[医药卫生—泌尿科学]