无精子症患者FSH、LH与外周血和睾丸组织T、E2、T/E2相关性的研究

Correlation analysis bewteen levels of serum FSH, LH and the levels of T, E2 and T/E2 in testicle tissues of azoospermia patients

目的：探讨无精子症患者促卵泡激素（FSH）、促黄体生成素（LH）与外周血和睾丸组织睾酮（T）、雌二醇（E2）、T/ E2的关系。方法选择45例无精子症患者，要求睾丸体积12-25ml，抽取静脉血，测量FSH、LH、T、E2；行睾丸穿刺，取得生精小管显微镜检观察有无精子，之后用滤纸吸去生精小管的培养液、电子天平秤量后投入液氮，取出后粉碎，加入1000倍量PBS，充分混匀，200×g离心，测量上清液T、E2的含量。按睾丸穿刺结果和FSH值分为A（睾丸穿刺有精子，FSH＜8 IU/L）、B（睾丸穿刺无精子，FSH＜8 IU/L）、C（睾丸穿刺无精子，FSH＞8 IU/L）三组，比较三组间外周血和睾丸组织T、E2和T/E2的差异性，分析FSH、LH与外周血和睾丸组织T、E2、T/ E2的直线相关关系。结果三组间比较，外周血E2和 T/ E2差异均有统计学意义（P＜0.05），T差异无统计学意义（P＞0.05）。睾丸组织T和E2差异均有统计学意义（P＜0.05）、T/ E2差异无统计学意义（P＞0.05）；直线相关性分析：FSH与外周血E2（r=-0.522，P=0.026）呈负相关关系、与外周血T/ E2（r=0.534，P=0.028）呈正相关关系；与睾丸组织T（r=0.691，P=0.004）和E2（r=0.597，P=0.019）呈正相关关系，有统计学意义。LH与外周血T（r =0.629，P =0.012）和T/ E2（r =0.630，P =0.012）呈正相关关系，与睾丸组织T （r=0.722，P=0.002）和E2（r=0.610，P=0.016）呈正相关关系，有统计学意义。结论睾丸体积正常的无精子症患者，外周血T 和E2对LH和FSH有显著的正/负反馈调节作用，且伴随着FSH和LH的增高，睾丸组织T、E2的浓度明显升高，而外周血T变化不明显，E2却明显降低。

Objective To investigate the relationship between the levels of serum FSH and LH, and levels of T, E2 and T/E2 in testicle tissues of azoospermia patients. Methods Total of 45 patients with azoospermia were recruited in the study,whose testis volume ranged from 12-25 ml. Their venous blood sample were collected and the concentrations of serum FSH, LH, T and E2 were measured. Meanwhile, their testes were biopsied and testical weather was observed by microscope. The culture media of collected samples were filtered by filter paper and threw into liquid nitrogen, then were crushed into powders. Subsequently, the powder samples were resolved and mixed in PBS, the supernatants were collected by 200g/s centrifugation and their T and E2 levels were detected. The samples were divided into 3 groups based on biopsied results and FSH level, such as group A （had sperm, FSH〈8 IU/L ） B （no sperm, FSH〈8 IU/L ） and C （no sperm, FSH〉8IU/L）,and their correlations were analyzed. Results There were significant differences in E2 and T/ E2 of venous blood among three groups, and there were also obvious variability in T or E2 of testis tissue. FSH level was significant positively correlated with T/ E2 （r=0.534, P=0.028） of venous blood, T （r =0.691, P=0.004） or E2 （r =0.597, P=0.019） of testis tissue, and negatively correlated with E2 （r =-0.522, P=0.026） of venous blood. LH level was positively correlated with T （r =0.629, P=0.012） or T/ E2 （r =0.630, P=0.012） of venous blood, and T （r =0.722, P=0.002） or E2 （r =0.610, P=0.016） of testis tissue. Conclusion There are positive / negative feedbacks to LH and FSH from T and E2 of venous blood in azoospermia patients with normal testis volume. With increase of serum FSH and LH, levels of T and E2 of testis tissue increase accordingly, but T level in venous blood has no chang, and level of E2 dcreases evidently.