血清生殖激素及抑制素B在无精子症诊治中的临床价值

Clinical value of serum reproductive hormones and inhibin B levels in azoospermia

目的探讨血清促卵泡成熟激素(FSH)、黄体生成素(LH)及睾酮(T)等生殖激素水平对无精子症分型以及血清抑制素B(INHB)水平对非梗阻性无精子症患者睾丸精子存在与否的预测价值。方法采用化学发光免疫分析法测定45例非梗阻性无精子症、40例梗阻性无精子症及40名正常生育男性血清FSH、LH及T的浓度,以双抗体夹心酶联免疫吸附试验(ELISA)测定血清INHB水平。结果非梗阻性无精子症患者血清的FSH、T、T/LH比值、INHB与对照组相比,差异有统计学意义(P<0.05);而梗阻性无精子症患者和对照组相比,各项指标差异均无统计学意义(P>0.05)。非梗阻性无精子症患者中,睾丸精子抽吸(TESE)获得精子者血清INHB水平显著高于TESE无精子者(P<0.05)。结论FSH水平是预测睾丸生精功能的可靠标志,T/LH比值可以作为早期判断间质细胞功能状态的敏感指标,血清INHB对预测TESE结局有重要的指导意义。

Objective To evaluate the influence of serum follicle stimulating hormone（FSH）,luteinizing hormone（LH） and testosterone（T） levels to the type of azoospermia and the predictive value of inhibin B（INHB） level as an indicator of the presence of testicular spermatozoa in patients with nonobstructive azoospermia.Methods 45 patients with nonobstructive azoospermia,40 patients with obstructive azoospermia and 40 healthy subjects were involved in this study.Serum FSH,LH and T levels were measured by chemiluminescence immunoassay,and serum INHB was measured by sandwich enzyme-linked immunosorbent assay（ELISA）.Results In 45 patients with nonobstructive azoospermia,the levels of FSH and LH were higher than those in control group（P0.05）,but the levels of INHB,T and T/LH were lower than those in control group（P 0.05）.There were no statistical significance between the levels of FSH,LH,T and INHB in patients with obstructive azoospermia and those in control group（P0.05）.Serum INHB level was significantly higher in patients with nonobstructive azoospermia who had spermatozoa on testicular sperm extraction（TESE） than in those who had no spermatozoa on TESE（P0.05）.Conclusions FSH level is a reliable marker for testicular spermatogenic function,and T/LH is an important sensitive index for the function of Leydig cells.Serum INHB level seems to be a prediction of the end-result of TESE.