血清INHB联合激素在无精症和少弱精症诊断中的价值  

The value of serum INHB combined with hormones in the diagnosis of azoospermia and oligospermia

作　　者：周敬华 陈超 默义 陈拽生 王树松 ZHOU Jinghua;CHEN Chao;MO Yi;CHEN Zhuaisheng;WANG Shusong(Hebei Institute of Reproductive Health Science and Technology,Key Laboratory of Family Planning and Eugenics of National Health Commission/Key Laboratory of Reproductive Medicine of Hebei Province,Shijiazhuang,Hebei 050071,China)

机构地区：[1]河北省生殖健康科学技术研究院/国家卫健委计划生育与优生重点实验室/河北省生殖医学重点实验室,河北石家庄050071

出　　处：《中国优生与遗传杂志》2023年第2期372-376,共5页Chinese Journal of Birth Health & Heredity

基　　金：2020年度河北省医学科学研究课题计划(20200227)。

摘　　要：目的测定血清中抑制素B(INHB)及激素水平,评价其在诊断无精症生精功能中的意义和在行卵质内单精子注射技术(ICSI)少弱精症妊娠结局中的价值。方法选取105例男性无精症患者,分为唯支持细胞综合征组、睾丸生精功能低下组、生精功能正常组。选取57例少弱精症患者,根据ICSI妊娠结局分为ICSI妊娠组、ICSI未妊娠组。比较各组血清INHB及卵泡刺激素(FSH)、促黄体生成素(LH)、雌激素(E2)、孕酮(PROG)、泌乳素(PRL)和睾酮(T)水平。采用ROC评价INHB联合激素指标对无精子症患者生精功能的诊断价值,以及对少弱精症患者ICSI妊娠结局的价值。结果与生精功能正常组比较,生精功能低下组和唯支持细胞综合征组在睾丸体积、精液体积、INHB上均有显著性差异(P<0.05)。血清INHB诊断生精功能正常的AUC为0.591,保持敏感度不变,INHB联合E2、INHB联合T诊断生精功能正常的特异性低于单独INHB指标。ICSI妊娠组与ICSI未妊娠组精液体积、INHB有显著性差异(P<0.05)。少弱精症患者INHB与睾丸体积呈极显著正相关,与FSH、LH呈显著负相关(P<0.05)。血清INHB评估ICSI妊娠结局的AUC为0.776,INHB联合FSH评估ICSI妊娠结局的AUC为0.835,敏感度、特异性为95%、70.6%。结论血清INHB在判断无精症生精功能正常的人群中可以作为一个独立的特异性指标。但在少弱精子症行ICSI的人群中,INHB联合FSH可以更好地判断妊娠成功率。Objective To determine the serum levels of inhibin B(INHB)and hormone levels to evaluate their significance in the diagnosis of spermatogenesis in azoospermia and in pregnancy outcomes in oligoasthenospermia by intracytoplasmic sperm injection(ICSI).Methods A total of 105 male patients with azoospermia were selected and divided into sertoli cell syndrome group,low spermatogenesis group and normal spermatogenesis group.Fifty-seven patients with oligoasthenospermia were selected and divided into ICSI pregnancy group and ICSI non-pregnancy group according to ICSI pregnancy outcomes.The serum levels of INHB and follicle-stimulating hormone(FSH),luteinizing hormone(LH),estrogen(E2),progesterone(PROG),prolactin(PRL)and testosterone(T)in each group were compared.ROC was used to evaluate the diagnostic value of INHB combined with hormone indicators on spermatogenesis in patients with azoospermia,and the value of ICSI pregnancy outcomes in patients with oligoasthenospermia.Results There were no significant differences in age,abstinence days,FSH,LH,E2,PROG,PRL,T among the azoospermia groups(P<0.05).The AUC of serum INHB for the diagnosis of normal spermatogenesis was 0.591,and the sensitivity remained unchanged.The specificity of INHB combined with E2 and INHB combined with T in the diagnosis of normal spermatogenesis was lower than that of INHB alone.There was a significant difference in semen volume and INHB between the ICSI pregnant group and the ICSI non-pregnant group(P<0.05).In oligoasthenospermia patients,INHB was significantly positively correlated with testicular volume,and significantly negatively correlated with FSH and LH(P<0.05).The AUC of serum INHB to evaluate ICSI pregnancy outcome was 0.776,and the AUC of INHB combined with FSH to evaluate ICSI pregnancy outcome was 0.835,with a sensitivity and specificity of 95%and 70.6%.Conclusion Serum INHB can be used as an independent specific indicator in judging people with normal spermatogenesis in azoospermia.However,in people who are less and less proficient in I

关 键 词：无精症 少弱精 血清抑制素B 妊娠结局 

分 类 号：R698.2[医药卫生—泌尿科学]