血清抑制素B在非梗阻性无精子症中的应用

Application of serum inhibin B in non-obstructive azoospermia

目的:探讨血清抑制素B(INHB)在非梗阻性无精子症中的应用及对睾丸精子抽吸结局的预测作用。方法:用回顾性分析方法对52例非梗阻性无精子症(NOA)、12例梗阻性无精子症(OA)及20例正常生育男性,采用双抗夹心ELISA法测定各组血清中INHB水平;采用化学发光法测定各组血清中卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)水平。结果:NOA组血清INHB水平明显低于正常生育男性组和OA组,其差异均有统计学意义(P<0.01);血清FSH和LH水平明显高于OA组和正常生育男性组(P<0.01)。NOA组行睾丸抽吸(TESE)获得精子的患者,其血清INHB水平明显高于未获得精子者,其差异有统计学意义(P<0.01);而NOA组行TESE未获得精子的患者,其血清FSH水平明显高于获得精子者,其差异有统计学意义(P<0.01)。比较两组血清中LH和T水平,其差异均无统计学意义(P>0.05)。结论:血清INHB水平可反映睾丸精子发生的情况,能准确预测TESE获取精子的结局。

Objective:To explore the predictive value of serum inhibin B (INH B) as an indicator of the presence of testicular spermatozoa in non-obstructive azoospermia.Methods:52 patients with non-obstructive azoospermia (NOA),12 patients with obstructive azoospermia (OA) and 20 fertile male volunteers were involved in the study. The serum INH B levels were detected by sandwich enzyme-linked immunosorbent assay; the serum levels of follicle stimulating hormone (FSH),luteinizing hormone (LH) and testosterone (T) were detected by chemoluminescence method.Results:The level of INH B in NOA group was lower than those in OA group and control group (P<0.01),while the levels of serum FSH and LH reversed (P<0.01). Mean serum INH B level in patients with NOA who had spermatozoa on testicular sperm extraction (TESE) was significantly higher than those in whom no spermatozoa was found on TESE (P<0.01). However,mean FSH level in patients with NOA who had no spermatozoa on TESE was significantly higher than those in whom spermatozoa was found on TESE (P<0.01).There was no difference in serum levels of LH and T between NOA group and OA group.Conclusion:Serum INH B level reflects testis spermatogenic status,and also predicts the presence of testicular spermatozoa on TESE.