超声鉴别梗阻性与非梗阻性无精子症的临床价值  

The Value of Ultrasonography in Differential Diagnosis of Obstructive and Non-obstructive Azoospermia

作　　者：田密苏 赵慧霞 郑波 TIAN Misu;ZHAO Huixia;ZHENG Bo(Xingtai Infertility Specialist Hospital,Xingtai 054001,China)

机构地区：[1]邢台不孕不育专科医院,邢台054001

出　　处：《宁夏医科大学学报》2020年第8期819-823,共5页Journal of Ningxia Medical University

基　　金：邢台市科技进步获奖项目(201479-01)。

摘　　要：目的探讨超声在鉴别诊断梗阻性无精子症与非梗阻性无精子症的临床价值。方法 175例无精子症患者进行睾丸活检前均进行经阴囊和经直肠超声检查,根据睾丸活检病理结果分为梗阻性无精子症与非梗阻性无精子症患者。将超声下睾丸体积的大小及超声下有无梗阻征象,与病理诊断结果分别进行比较,并进行数据统计分析。结果根据睾丸体积诊断梗阻性无精子症,灵敏度为75.4%,特异度为77.3%。超声下睾丸体积和病理诊断梗阻性无精子症的结果差异无统计学意义(χ~2=1.976,P=0.160),进行Kappa一致性检验,一致性一般(Kappa=0.512);根据超声显示精道梗阻诊断梗阻性无精子症,灵敏度为86.2%,特异度为96.4%。超声显示梗阻征象和病理诊断的结果差异无统计学意义(χ~2=1.231,P=0.267),进行Kappa一致性检验,一致性较好(Kappa=0.838);超声诊断梗阻性无精子症的灵敏度为89.2%,特异度为98.2%,超声和病理诊断梗阻性无精子症的结果差异无统计学意义(χ~2=1.778,P=0.182),进行Kappa一致性检验,一致性较好(Kappa=0.888)。结论超声下睾丸体积大小结合梗阻征象鉴别诊断梗阻性与非梗阻性无精子症灵敏度及特异度较高,一致性较好。Objective To explore the value of ultrasonography in differential diagnosis of obstructive azoospermia and non-obstructive azoospermia. Methods Totally 175 cases of azoospermia were examined by scrotal and transrectal ultrasound before testicular biopsy. The pathological results of testicular biopsy were divided into obstructive azoospermia and non-obstructive azoospermia. The size of testis under ultrasound and whether there were signs of obstruction under ultrasound were compared with pathological diagnosis,and the data were statistically analyzed to speculate the significance of testis volume and whether there were signs of obstruction under ultrasound in the diagnosis of obstructive azoospermia. Results The sensitivity and specificity of testicular volume in the diagnosis of obstructive azoospermia were 75.4% and 77.3%,respectively.There was no significant difference between testicular volume and pathological diagnosis of obstructive azoospermia under ultrasound(χ~2=1.976,P=0.160). Kappa consistency test showed poor consistency(Kappa =0.512);according to ultrasound,the sensitivity and specificity of diagnosis of obstructive azoospermia were86.2% and 96.4%,respectively. There was no significant difference between the results of ultrasound and pathological diagnosis(χ~2=1.231,P=0.267). Kappa consistency test showed good consistency(Kappa=0. 838);the sensitivity of ultrasound diagnosis of obstructive azoospermia was 89.2%,the specificity was 98.2%. There was no significant difference between ultrasound and pathological diagnosis of obstructive azoospermia(χ~2=1.778,P=0.182),the consistency was good(Kappa=0.888). Conclusion The sensitivity, specificity and consistency of testicular volume and signs of obstruction in the differential diagnosis of obstructive azoospermia and non-obstructive azoospermia were high.

关 键 词：梗阻性无精子症 非梗阻性无精子症 睾丸活检 精道梗阻 

分 类 号：R698.2[医药卫生—泌尿科学] R445.1[医药卫生—外科学]