血清抑制素B对非阻塞性无精子症睾丸精子存在的预测价值

Predictive Value of Serum Inhibin B Levels as an Indicator of the Presence of Testicular Spermatozoa in Nonobstructive Azoospermia

目的:探讨血清抑制素B(INHB)对非阻塞性无精子症(NOA)患者睾丸精子存在与否的预测价值。方法:分别对40例NOA、20例阻塞性无精子症(OA)及10例正常生育男性以双抗体夹心ELISA法测定其血清INHB水平。并用化学发光法检测了上述研究对象的卵泡刺激素(FSH)水平。结果:NOA患者的血清FSH[(21.34±12.15)IU/L]明显高于OA组和正常生育男性组[(3.94±1.52)IU/L和(4.27±2.84 IU/L],而血清INHB水平[(53.15±58.74)ng/L]明显低于后两者[(162.49±78.38)ng/L和(228.49±110.68)ng/L]。正常生育男性与OA组患者的血清INHB水平差异无显著性(P>0.05)。NOA患者血清INHB水平与其睾丸精子抽吸(TESE)的结果有相关性(r=0.528,P<0.01)。TESE获得精子者血清INHB水平[(90.31±72.18)ng/L]显著高于TESE无精子者[(19.54±20.38)ng/L,P<0.01];而两者的血清FSH差异无显著性(P>0.05)。结论:血清INHB可作为预测TESE的参考指标。血清INHB的测定有望替代睾丸活检确定睾丸精子的存在与否。

Objective： To evaluate the predictive value of serum inhibin B （ INH B ） levels as an indicator of the presence of testieular spermatozoa in nonobstruetive azoospermia. Methods： Forty patients with nonobstruetive azoospermia （NOA）, 20 patients with obstructive azooapermia（ OA）, and 10 fertile volunteers were involved in this study. A ehemolumineseenee method was used to measure the levels of FSH ; Inhibin B was analysed by using sandwich enzyme-linked immuno-sorbent assay. Results： Patients with nonobstruetive azooapermia has significantly higher levels of serum FSH [ （21.34 ± 12.15 ） IU/L] and signieantly lower levels of inhibin B [ （53.15 ± 58.74） ng/L] than patients with obstructive azoospermia[ FSH： （3.94 ± 1.52 ） IU/L, INH B： （ 162.49 ±78.38 ） ng/L, P 〈0.01] and fertile volunteers[ FSH： （4.27 ±2.84） IU/L, INH B： （228.49 ± 110.68） ng/L,P〈0.01]. Mean serum inhibin B were significantly higher in patients with nonobstruetive azoospermia who had spermatozoa on TESE than in those in whom no spermato- zoa was found on TESE [ INHB： （90.31 ±72.18 ） ng/L vs （ 19.54 ± 20.38 ） ng,/L, r = 0. 528, P 〈 0.01 ], but mean FSH levels did not have similar predictive power（ P 〉 0.05 ）. Conclusion ： Serum INH B level seems to be more accurate than serum FSH in the prediction of presence of testicular spermatozoa in patients with nonobstructive azoospermia. Serum inhibin B determination may be asubstitute of TESE as a diagnostic index.