生殖激素水平和睾丸体积对非梗阻性无精症患者精子存在的预测价值.docVIP

生殖激素水平和睾丸体积对非梗阻性无精症患者精子存在的预测价值 冯 科，张翠莲，李杭生，郭海彬 （450003 郑州，河南省人民医院生殖中心） [摘要] 目的 探讨非梗阻性无精症（nonobstructive azoospermia，NOA)患者生殖激素水平、睾丸体积等参数对睾丸内是否存在精子的预测价值，以及可用于预测TESA结果的切点值，为NOA患者避免手术创伤提供临床参考资料。 方法 将我中心男科门诊就诊的133例NOA患者按TESA的结果分为有精子组和无精子组，测定生殖激素水平、睾丸体积、精浆果糖，中性-ɑ糖苷酶、染色体、AZF等。 结果 有精子组和无精子组左侧睾丸体积（mL）：9.120±2.25和 6.254±2.63，右侧睾丸体积（mL）：9.230±2.02和 6.471±2.48，促卵泡生成素(FSH，mIU/mL):9.820±2.09和 22.62±15.0，总睾酮（TT，ng/mL）：5.190±0.68 和4.155±1.82，总睾酮/黄体生成素（T/LH）：0.606±0.19 和0.574±0.35，总睾酮/雌激素（T/E2）：162.4±16.66 和141.4±93.4。无精子组血清FSH显著高于有精子组，优选的FSH水平切点值为13.31mIU/mL时，其敏感度为74.1%，特异性为96.2%。FSH水平ROC曲线的AUC为0.850，表明其诊断准确性中等。 结论 就单一因素而言，FSH水平对于NOA患者预测睾丸内是否有精子发生具有相当重要的价值，并且价值明显优于睾丸体积，两者的联合应用对非梗阻性无精子症患者预测其睾丸内精子存在更有意义。 [关键词] 非梗阻性无精子症；促卵泡生成素；睾丸体积；预测价值 [中图法分类号] [文献标志码] A The predictive value of reproductive hormone levels and testicular volume of non-obstructive azoospermia patients exist sperm Feng Ke，Zhang Cuilian, Li Hangsheng, Guo Haibin (Reproductive Medical center,Henan Provincial People s Hospital , Zhengzhou,450003) Abstract: Objective：To investigate patients with non-obstructive azoospermia reproductive hormone levels, testicular volume and other parameters of the existence of sperm in the testis predictive value , as well as cut -point values can be used to predict the outcome of TESA , thus non- obstructive azoospermia patients avoid unnecessary surgical trauma to provide important clinical information. Methods The 133 cases of non-obstructive azoospermia my male outpatient center on the result divided by TESA sperm group and no sperm group , and measured levels of reproductive hormones and testicular volume and related tests.Results There are no sperm sperm group and testis volume (ml), follicle-stimulating hormone (FSH, mIU / ml), total testosterone (TT, ng / ml), T / LH, T/E2 levels were : L: 9.120 ± 2.25 and 6.254±2.63, R: 9.230 ± 2.02 and 6.471±2.48,9.820 ± 2.09 and 22.62 ± 15.0,5.190 ± 0.68 and 4.155 ± 1.82,0.606 ± 0.19 and 0.574 ± 0.35,162.4 ± 16.66 and 141.4