血清抑制素B在新疆维、汉族男性不育症中的研究

The Study of Serum Inhibin B for Male Infertility in Uygur and Han Nationalities

目的旨在研究维、汉族男性不育症的血清抑制素B(INHB)水平。方法收集2016年3月至2017年7月来我院生殖助孕中心及男科就诊的不育男性患者516例,其中非梗阻性无精症116例,严重少弱精症67例,梗阻性不育症312例,低促性腺激素性腺功能减退症4例,生殖器异常17例;汉族375例,维吾尔族141例,进行血清INHB检测并加以统计分析。结果 (1)20岁以上成年男性血清INHB水平分布无年龄差异(P=0.726);(2)血清INHB水平在维、汉族间无明显差异(P=0.766);(3)非梗阻性无精症组与梗阻性不育症组(P=0.004)、生殖器异常组(P=0.044)差异有统计学意义;(4)严重少弱精组与梗阻性不育症组(P <0.001)、生殖器异常组(P=0.007)差异有统计学意义;(5)其余组之间差异无统计学意义(P>0. 05);(6)非梗阻性无精症/严重少弱精症血清INHB结果(阴阳)与其他类型不育症差异有统计学意义(P <0.001);(7)利用ROC曲线分析比较血清INHB水平鉴别非梗阻性无精症/严重少弱精症和其他类型不育症,ROC曲线下最大面积(AUC)为0. 932,灵敏度及特异性分别为91.8%、94.6%。结论 (1)血清INHB在年龄间不存在差异性;(2)血清INHB在维、汉间不存在差异性;(3)作为诊断非梗阻性无精症及严重少弱精症是一个较好的临床检测指标,可以有效区别其余不育症,具有很好的灵敏度及特异性。

Objective To study the level of serum inhibin B （INHB） for male infertility in uygur and han nationalities. Methods The serum INHB of infertile male that coming to the reproductive center and the male outpatients of our hospital treated from March 2016 to July 2017 were measured and analyzed. Among them, there were 116 patients with non-obstructive anspermia, 67 people with severe oligospermia, 312 patients with obstructive infertility, 4 patients with hypogonadotropic hypogonadism, and 17 genital abnormalities. The han nationality is 375, and the uyghur people are 141. Results （ 1 ） There was no significant difference in serum INHB levels in adult males （ age i〉 20 years） in different age groups （P = 0. 726 ） ; （2） There was no significant difference in serum INHB level between uygur and han nationalities （ P= 0. 766 ） ; （ 3 ） The differences between the nonobstructive anspermia group and the obstructive infertility group （ P = 0. 004 ）/the genital abnormality group （ P = 0. 044 ） were statistically significant; （4） The differences between the severe oligospermia group and the obstructive infertility group （ P 〈 0. 001 ）/the genital abnormality group （ P= 0. 007 ）were statistically significant; （5）There was no statistically significant difference among other groups （P 〉 0.05）. （6）The serum inhibin B differences between the non-obstructive anspermia group/the severeoligospermia group and other types of infertility were statistically significant; （7）The ROC curve was used to compare the serum INHB levels of the non-obstructive anspermia group/the severe oligospermia group and other types of infertility, and when the cut off was 47pg/mL, the maximum area under the ROC curve （AUC） was 0. 932, and the sensitivity was 91.8%, the specificity 94.6%. Conclusion （1）There is no significant difference in serum INHB levels across ages; （2）There is no significant difference in serum INHB level between uygur and ban nationalities; （ 3 ） As a better clinical test indicator, the diagnosis of non- obstructive anspermia and severe oligospermia can effectively distinguish the remaining infertilities, which has a good sensitivity and specificity.