精液生精细胞学检查与睾丸细针穿刺对无精症诊断的比较

Comparison of seminal spermatogenic cells examination and testicular fine needle aspiration to diagnosis on azoospermia

目的探讨精液生精细胞检查对无精症诊断的应用价值及临床意义。方法分析81例无精子症患者精液生精细胞学检查结果,与睾丸穿刺活检结果对照分析。结果精液生精细胞学检查对梗阻性和非梗阻性无精症分型诊断的符合率分别为85%、95.1%。41例非梗阻性无精症中,生精阻滞阶段在精子细胞、精母细胞、精原细胞分别为14例2、1例和6例。对同一患者精液细胞学检查与睾丸穿刺活检一致性分析中,生精细胞发育程度一致(P<0.01)。结论精液生精细胞学检查能对非梗阻性无精症诊断、分型有很高的预示性价值,但对梗阻性无精子症诊断还需与其它指标进一步确诊。

Objective To investigate the applied value and clinical value of classification diagnosis on azoospennia by seminal spermatogenic cells examination.Methods 81 cases with seminal spermatogenic cells examination results were analyzed and compared with the results of epididym puncture biopsy. Results The diagnostic correspondent rate of obstructive and nonobstructive azoospermia by seminal spermatogenic cells examination was 85 %, 95.1% respectively. The spermatogenic arrest at spennatid level, spermatocyte level and spermatogonium level or sertoli cells only were 14,21 and 6 cases respectively. The seminal spermatogenic cells examination was coincident with the result of testis puncture biopsy at the spermatogenie cells developmental level in the same patient （ P 〈 0. 01）. Conclusion The seminal spermatogenic cells examination can exactly and credibly classifies the types of azoospermia. Subject to spermatogenic cells and endocrine indicators can be further confirmed the diagnosis.