生殖激素检测在非梗阻性无精子症患者诊治中的价值

Value of reproduction hormone level detecting in treatment of non-obstructive azoospermia patients

目的探讨非梗阻性无精子症患者血清生殖激素水平与睾丸精子发生的关系。方法筛选135例非梗阻性无精子症患者,根据WHO推荐标准。测量所有患者血清促卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)、T/LH比值、抑制素B(INHB)、INHB/FSH比值和催乳素(PRL)水平。NOA患者根据睾丸穿刺精子抽吸(TESA)结果分为睾丸有精子组与无精子组,分析INHB/FSH比值在获精结果的诊断效能。结果 NOA患者中睾丸无精子组与有精子组比较,有精子组血清INHB/FSH比值明显高于无精子组,差异有统计学意义(t=9.790,P<0.001),INHB/FSH比值鉴别NOA患者有精子与无精子结果的ROC曲细切点值2.57,敏感性与特异度分别为83.3%,96.8%,曲线下面积(AUC)为0.962,表明其诊断准确性较高。结论 FSH、T/LH比值水平测定对无精子症诊断分型有参考作用,INHB/FSH比值对预测NOA患者睾丸取精结果有重要价值。

Objective To investigate the relationship between serum reproduction hormone level and testicular spermato- genesis in non - obstructive azoospermia patients. Methods We enlisted 135 non - obstructive azoospermia patients in this study, according to WHO recommended standard. Serum reproductive hormone including FSH, LH, T, T/LH, IN- HB, INHB/FSH ratio and PRL were determined in all of patients, and then NOA patients were divided into sperm group and non- sperm group based on the results of testicular sperm aspiration （TESA）. The diagnostic efficiency was ana- lysed for the sperm obtained result Using INHB/FSH ratio. Results The mean value of serum INHB/FSH ratio of sperm group were significantly higher than non - sperm group in NOA patients （t = 9. 790,P 〈 0. 001 ）. The cut - off point of INHB/FSH ratio to distinguish patients having sperm and non - sperm was 2. 57, sensitivity and specificity of it were 83.3 % and 96. 8 % respectively, The area under curve （ AUC ） of receiver operator characteristic （ROC） curvet was 0. 962, indicating a high diagnostic accuracy. Conclusions It has important value to predict the TESA result of NOA patients using INHB/FSH ratio.