抗苗勒管激素与性激素、精液质量关系研究

Correlation between anti-Müllerian hormone in serum and sex hormone/and sperm parameters

目的评估抗苗勒管激素(AMH)水平与性激素、精液质量的关系,探讨抗苗勒管激素在男性不育症的诊断价值。方法根据精液检查结果分为3组:非梗阻性无精子症(NOA)组40人,少弱精子症组65人,精子正常组191人,采用电化学发光法检测血清中AMH、性激素水平。结果血清中AMH值在NOA组中为(7.05±6.57)ng/m L,在少弱精子症组中为(7.82±5.10)ng/m L,两组均低于精子正常组(9.86±5.47)ng/m L,两组分别与正常组比较差异均有统计学意义(P<0.05)。AMH与精液量呈正相关(r=0.12,P<0.05),与精子浓度呈正相关(r=0.19,P<0.01),与精子前向运动率呈正相关(r=0.14,P<0.05),与精子总活力呈正相关(r=0.14,P<0.05)。AMH与促卵泡生成素(FSH)呈负相关(r=-0.35,P<0.01),与促黄体生成素(LH)呈负相关(r=-0.28,P<0.01),与睾酮(T)呈正相关(r=0.15,P<0.05)。结论男性不育患者血清AMH水平受FSH、LH、T影响,检测基础性激素和AMH对评估男性不育患者的生精能力有重要意义。

Objective To analyze the relationship between anti-Müllerian hormone and sex hormones/and semen quality, and explore the value of anti-mullerian hormone（AMH） in the diagnosis of male infertility. Methods According to the results of semen examination, the patients were divided into 3 groups including non-obstructive azoospermia（40 cases）, oligoasthenospermatism,（65 cases）, normal semen（191 case）. The levels of AMH, Follicle stimulating hormone（Follicle-stimulating hormone, luteinizing hormone, testosterone andprolactin, estradiol in serum were measured by electrochemical luminescence detection. Results The concentrations of AMH in serum were 7.05±6.57 ng/m L in the non-obstructive anspermia group,（7.82±5.10）ng/m L in oligoasthenozoospermia group; The levels of AMH in above two groups were all lower than that of normal semen group（9.86±5.47）ng/m L, The difference was statistically significant（P〈0.05）. The level of AMH was correlated with semen volume（r = 0.12, P〈0.05） and positively correlated with sperm concentration（r = 0.19, P〈0.01）, percentage of progressively moving the pre-sperm movement rate（r = 0.14, P 0.05）, total sperm activity rate（r = 0.14, P〈0.05） and T level（r = 0.15, P〈0.05）. Whereas, AMH were negatively correlated with FSH（r =-0.35, P〈0.01）, LH（r =-0.28, P〈0.01）. Conclusion The level of serum ANH in male sterile patients was affected by FSH, LH and T, and the detection of basic sex hormones and AMH were of great significance in evaluating the sperm production capacity of male sterile patients.