血清抑制素B检测在无精子症患者经睾丸抽吸术结局预评估中的应用  

Level of serum inhibin B for predicting the results of testicular sperm extraction in azoospermia patients

作　　者：石亮[1] 李卫巍[2] 周雪[1] 徐志鹏[1] 张春华 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿男科,江苏南京210008 [2]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002 [3]南京医科大学第一附属医院临床研究院,江苏南京210029

出　　处：《中华男科学杂志》2016年第12期1095-1098,共4页National Journal of Andrology

摘　　要：目的：探讨血清抑制素B（INHB）检测在无精子症患者经睾丸抽吸术（TESE）结局预评估中的意义。方法：根据研究需要将受试者分为3组：梗阻性无精子症（OA）组（n=191）,非梗阻性无精子症（NOA）组（n=360）,精液参数正常对照组（n=100）。NOA组根据TESE结局分为TESE无精子组（TESE-,n=127）和TESE有精子组（TESE＋,n=233）。血液标本均于上午8：00-10：00收集,测定其INHB值。采用受试者工作特征曲线（ROC）分析评价血清INHB预测TESE结局的敏感性和特异性。结果：TESE-组的血清INHB水平[（19.7±34.8）pg/ml]显著低于OA组[（106.8±66.2）pg/ml]、TESE＋组[（98.2±62.4）pg/ml]及精液参数正常对照组[（108.3±65.0）pg/ml]（P〈0.01）,TESE＋组的血清INHB水平与OA组、精液参数正常对照组无显著性差异（P〉0.05）。ROC曲线分析显示,血清INHB最佳分割点为19.1 pg/ml,此时ROC曲线下面积（AUCROC）为0.88,敏感性为90.1%,特异性为84.2%,诊断准确性达88.1%。结论：血清INHB是一种良好的非侵入性的精子生成预测指标,无精子症患者TESE前应该常规行血清INHB检测以评估其TESE结局。Objective： To investigate the value of serum inhibin B （InhB） in predicting the results of testicular sperm extrac- tion （TESE） in patients with azoospermia. Methods： This study included 191 cases of obstructive azoospermia （OA）, 360 eases of nonobstructive azoospermia （NOA） , and 100 male controls with nol-nal semen parameters. According to whether sperm was found in TESE, the NOA patients were divided into a sperm-absence group （TESE - , n = 127） and a sperm-presence group （TESE＋ , n = 233 ）. Blood samples were collected from the subjects between 8：00 and 10：00 am for measurement of the levels of serum InhB. The specificity and sensitivity of serum InhB predicting TESE outcome were analyzed with receiver operating characteristics curve （ROC）. Results： The serum InhB level was significantly lower in the TESE - group （ [19.7 ± 34.8] pg/ml） than in the OA （ [ 106.8 ± 66.2 ] pg/ml）, TESE ± （ [ 98.2 ± 62.4 ] pg/ml） and normal control group （ [ 108.3 ± 65.0 ] pg/ml） （ P 〈 0.01 ）, but there were no statistically significant differences among the latter three groups （P 〉 0.05）. Analysis of ROC showed that the best cut-off value of serum InhB was 19. 1 pg/ml. Under the cut-off value, AUC^ROC was 0. 88, specificity 84.2% , sensitivity 90. 1%, and accuracy 88.1%. Conclusion ： The serum InhB level is a good and non-invasively obtained index of spermatogenesis and should be measured for predicting the results of TESE.

关 键 词：血清抑制素B 无精子症 经睾丸抽吸术 

分 类 号：R698.2[医药卫生—泌尿科学]