不同病因非梗阻性无精子症患者睾丸显微取精获精率的初步研究  

Preliminary study on the SRR of M-TESE for patients with different etiological types of non-obstructive azoospermia

作　　者：王先龙 马刚[1] 陈砼 白刚 庞清洋 张太健 李晓[1] 卢少明[1] 张浩波[1] 王学胜 WANG Xianlong;MA Gang;CHEN Tong;BAI Gang;PANG Qingyang;ZHANG Taijian;LI Xiao;LU Shaoming;ZHANG Haobo;WANG Xuesheng(Urinary Department and Male Reproductive Department,Center for Reproductive Medicine of Shandong University,Jinan 250001,Shandong,China;Department of General Surgery,Shanghai Children's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200062,China)

机构地区：[1]山东大学生殖医学研究中心泌尿外科和男性生殖科,济南250001 [2]上海交通大学附属儿童医院普外科,上海200062

出　　处：《中国性科学》2020年第9期13-16,共4页Chinese Journal of Human Sexuality

基　　金：国家自然基金面上项目(81471498);山东省科技发展计划项目(2014GSF118129)。

摘　　要：目的初步探讨不同病因非梗阻性无精子症患者睾丸显微取精的获精率。方法选取2018年1月至2019年5月山东大学生殖医学研究中心完成睾丸显微取精的67例非梗阻性无精子症患者进行回顾性分析。统计分析获精率与患者年龄、睾丸体积、生殖内分泌激素水平、不同病因的相关性。结果睾丸显微取精术总体获精率为40.30%(27/67),按照手术是否获取精子,分为未获精组(n=40)与获精组(n=27),两组患者在年龄、睾丸体积、生殖内分泌激素水平比较,差异无统计学意义(P>0.05);按照不同病因分为六组:获精率分别为腮腺炎合并睾丸炎后组100.00%(7/7)、隐睾下降固定术后组42.86%(3/7)、AZFc缺失组37.5%(3/8)、克氏综合征组36.36%(4/11)、特发性无精子症组30.30%(10/33)和低促性腺激素型性腺功能减退综合征组0%(0/1),不同病因之间整体比较,差异具有统计学意义(P<0.05),六组间,腮腺炎合并睾丸炎后组与特发性无精子症组之间比较,差异具有统计学意义(P=0.001),其余各组间比较,差异无统计学意义(P>0.05)。结论睾丸显微取精术是治疗非梗阻性无精子症的一种有效手段,获精率与年龄、睾丸体积、生殖内分泌激素水平无明显相关性,不同病因的非梗阻性无精子症之间,获精率存在显著差异,腮腺炎合并睾丸炎后的患者较特发性无精子症患者有更高的获精率。Objective To investigate preliminarily the sperm retrieval rate(SRR)of microdissection testicular sperm extraction(M-TESE)for non-obstructive azoospermia(NOA)patients with different etiologies.Methods 67 patients with NOA who underwent M-TESE in Center for Reproductive Medicine of Shandong University from January 2018 to May 2019 were retrospectively collected.The correlation of the SRR with the ages,testicular volumes,hormonal parameters and different etiologies was analyzed.Results The SRR was 40.30%(27/67)overall.The 67 patients were divided into the unacquired sperm group and the acquired sperm group by the out-comes of surgery.There were no significant differences in the SRR and the ages,testicular volumes and hormonal parameters between the two groups(P>0.05).All the patients were divided into 6 groups according to different etiologies,the SRR was 100.00%(7/7)in patients with mumps and orchitis,42.86%(3/7)in patients underwent cryptorchidism,37.5%(3/8)in those with AZFc deletion,36.36%(4/11)in those with Klinefelter syndrome,30.30%(10/33)in those with idiopathic azoospermia and 0%(0/1)in those with low gonadotropin-type hypogonadism syndrome,with statistically significant differences among different etiologies(P<0.05).There was a statistically significant difference between the group of patients with mumps and orchitis and the group of idiopathic azoospermia(P=0.001)and no significant differences between the other groups.Conclusions M-TESE is an effective method for the treatment of NOA.There is no significant correlation between the SRR and the ages,testicular volumes,hormonal parameters.There are significant differences in the SRR among NOA patients with different etiologies.Patients with mumps and orchitis have a higher SRR than patients with idiopathic azoospermia.

关 键 词：非梗阻性无精子症 睾丸显微取精术 获精率 男性不育症 

分 类 号：R697[医药卫生—泌尿科学]