非梗阻性无精子症患者睾丸显微取精病理学检查与睾丸活检组织剥离检查精子检出情况比较  

Comparison of sperm detection bysperm microsurgical testicular sperm extraction pathological examination and testicular biopsy dissection examination in patients with non-obstructive azoospermia

作　　者：王丹丹 房格[1,2,3,4,5,6,7] 于瑞梅 赵雪 刘雯[1,2,3,4,5,6,7] WANG Dandan;FANG Ge;YU Ruimei;ZHAO Xue;LIUWen(State Key Laboratory of Reproductive Medicine and Offspring Health,Center for Reproductive Medicine,Institute of Women,Children and Reproductive Health,Shandong University,Jinan 250012,Shandong,China;National Research Center for Assisted Reproductive Technology and Reproductive Genetics,Shandong University,Jinan 250012,Shandong,China;Key Laboratory of Reproductive Endocrinology(Shandong University),Ministry of Education,Jinan 250012,Shandong,China;Shandong Technology Innovation Center forReproductive Health,Jinan 250012,Shandong,China;Shandong Provincial Clinical Research Center forReproductive Health,Jinan 250012,Shandong,China;Shandong Key Laboratory of Reproductive Medicine,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250012,Shandong,China;Research Unit of Gametogenesis and Health of ART-off spring,Chinese Academy of Medical Sciences(No.2021RU001),Jinan 250012,Shandong,China)

机构地区：[1]山东大学妇儿与生殖健康研究院/山东大学附属生殖医院山东大学生殖医学与子代健康全国重点实验室,济南250012 [2]山东大学国家辅助生殖与优生工程技术研究中心,济南250012 [3]山东大学生殖内分泌教育部重点实验室,济南250012 [4]山东省生殖健康技术创新中心,济南250012 [5]山东省生殖健康临床医学研究中心,济南250012 [6]山东省生殖医学重点实验室,济南250012 [7]中国医学科学院配子发生与辅助生殖子代健康研究创新单元(2021RU001),济南250012

出　　处：《中国性科学》2024年第6期5-9,共5页Chinese Journal of Human Sexuality

基　　金：山东省医药卫生科技发展计划项目(202205030189);济南市卫生健康委员会科技计划项目(2022-2-193)。

摘　　要：目的探讨非梗阻性无精子症(NOA)患者组织病理学检查与睾丸活检组织剥离检查检出精子的一致性。方法回顾性分析2020年1月至2022年12月就诊于山东大学附属生殖医院的197例男性NOA患者,均于睾丸显微取精活检手术后对睾丸组织同时进行病理学检查和睾丸活检组织剥离检查,对其精子获取率进行分析。结果将患者根据病理学检查结果分为未见精子组[生精功能阻滞(MA)+唯支持细胞综合征(SCOS)]170例(86.3%)与查见精子组[生精功能低下(HS)]27例(13.7%)。睾丸活检组织剥离精子检出29例(14.7%),7例SCOS患者通过睾丸组织剥离查见精子并实施卵胞质内单精子注射(ICSI)。两种方法的精子检出率比较,差异无统计学意义(P>0.05)。卵泡刺激素(FSH)水平在两组间差异具有统计学意义(P<0.05)。结论两种方法查找精子一致率高,睾丸活检病理学检查作为病因学分析,对NOA患者再次体外取精能否成功提供预测依据,FSH水平也有助于预测能否成功取精,而睾丸组织剥离找到精子后可直接应用于人工辅助生殖技术,因此更具有决定性意义。Objective To investigate the consistency of sperm detection between microextraction of testis histopathology and testicular biopsy dissection examination in patients with non-obstructive azoospermia(NOA).Methods Retrospective analysis was performed on 197 NOA male patients who were admitted to the Affiliated Reproduction Hospital of Shandong University from January 2020 to December 2022.After sperm microsurgical testicular sperm extraction biopsy,testicular tissue pathology examination and testicular biopsy tissue dissection examination were performed,and the sperm retrieval rate was analyzed.Results According to the examination of testicular histopathology,patients were divided into non-spermatozoa group[spermatogenic arrest(MA)+Sertoli cell only syndrome(SCOS)]with 170 patients(86.3%)and spermatozoa group[hypospermatogenesis(HS)]with 27 patients(13.7%).Sperm were detected by testicular tissue dissection in 29 patients(14.7%),and spermatozoa were detected by testicular tissue dissection and intracytoplasmic sperm injection(ICSI)was performed in 7 SCOS patients.There was no significant difference in the sperm detection rate between the two methods(P>0.05).Follicle-stimulating hormone(FSH)levels were significantly different between the two groups(P<0.05).Conclusions The two methods has high consistency in finding sperm.The testicular biopsy pathological examination,as the etiology analysis,provides the basis for male physicians to predict the success of in vitro sperm extraction for NOA,FSH levels also help predict successful extraction.The spermatozoa found by testicular tissue dissection can be directly used in artificial assisted reproductive technology,so it is therefore more decisive.

关 键 词：男性不育症 非梗阻性无精子症 睾丸组织病理学检查 睾丸活检组织剥离检查 

分 类 号：R697[医药卫生—泌尿科学]