Y染色体微缺失检测及生殖激素水平研究在非梗阻性无精子症患者睾丸穿刺中的意义

The analysis of Y chromosome microdeletions and gonadal hormone level in patients with non-obstructive azoospermia

目的探讨非梗阻性无精子症患者睾丸穿刺取精前进行Y染色体微缺失筛查和生殖激素检测的意义。方法按照WHO标准进行检查和精液分析,收集非梗阻性无精子症患者246例作为研究对象,用改良PCR进行Y染色体微缺失筛查,其中109例无精子症患者接受了睾丸穿刺精子抽吸术。梗阻型无精子症124例作为对照组。所有患者均采集年龄、不育史、附属性腺B超检测、睾丸体积以及生殖激素检测进行分析。结果非梗阻性无精子症患者的FSH均值升高,与对照组相比,差异有统计学意义(P<0.01)。其中穿刺有精子与穿刺无精子患者相比,FSH均值偏低,差异有统计学意义(P<0.05);与AZF缺失的非梗阻性无精子症患者的FSH均值相比,差异无统计学意义(P>0.05)。结论 FSH水平可以作为非梗阻性无精子症患者穿刺结果的预判因素之一,但对于Y染色体微缺失患者无预判价值。

Objective To evaluate clinical significance of Y chromosome microdeletion screening and gonadal hormone level testing before testicular sperm aspiration（TESA） in patients with non-obstructive azoospermia（NOA）. Methods According to the guideline recommended by WHO, 246 patients with NOA were analyzed using modified multiplex PCR-electrophoresis for AZF microdeletion and 109 of them received TESA and 124 patients with obstructive azoospermia （OA） were as controls.The clinical data of the patients including age, reproductive history, B ultrasound of genital system serum, testis volume and gonadal hormone level were collected for analyzed. Results Levels of serum follicle stimulating hormone （FSH） in NOA groups were significantly higher than that in OA groups （P〈0.01）. However, FSH levels of patients with sperm retrieved in the NOA groups after TESA were lower than that of the patients failed to retrieve sperm （P〈0.05） There was no significant differences in FSH level between NOA patients and patients with AZF mierodeletion （P〉0.05）. Conclusion FSH levels was a useful indicator for TESA to NOA patient, need to perform TESA, but no useful for the patient with AZF microdeletion.