CAJ | 학술논문

目的：联合检测育龄男性无精子患者血清卵泡刺激素（FSH）和抑制素B（INHB）水平评估睾丸生精功能的临床诊断价值。方法95例无精子症患者均行血清FSH、INHB检测，根据睾丸活检病理组织学分类，唯支持细胞综合征20例、生精低下25例、成熟阻滞18例和生精功能正常32例。统计分析FSH和INHB的血清水平与病理分类的相关性。结果血清FSH、INHB和INHB/FSH在唯支持细胞综合征组与其他组比较具有显著性差异（P<0.05），生精功能低下组、成熟阻滞组和生精功能正常组比较没有显著性差异（P>0.05）；FSH、INHB和INHB/FSH与精细胞成熟阻滞无显著相关性（P>0.05），而在其他组别中均具有显著负相关性（P>0.05）；INHB和INHB/FSH在所有研究组别中均具有显著性正相关（P<0.05）；血清INHB小于28.55 pg/ml诊断唯支持细胞综合征的敏感度为97%，特异性为85%。结论血清FSH和INHB水平不能有效区分睾丸生精功能状态，但能有效确定唯支持细胞综合征，其他类型的生精功能异常仍需依赖活检病理组织学检查。
목적：연합검측육령남성무정자환자혈청란포자격소（FSH）화억제소B（INHB）수평평고고환생정공능적림상진단개치。방법95례무정자증환자균행혈청FSH、INHB검측，근거고환활검병리조직학분류，유지지세포종합정20례、생정저하25례、성숙조체18례화생정공능정상32례。통계분석FSH화INHB적혈청수평여병리분류적상관성。결과혈청FSH、INHB화INHB/FSH재유지지세포종합정조여기타조비교구유현저성차이（P<0.05），생정공능저하조、성숙조체조화생정공능정상조비교몰유현저성차이（P>0.05）；FSH、INHB화INHB/FSH여정세포성숙조체무현저상관성（P>0.05），이재기타조별중균구유현저부상관성（P>0.05）；INHB화INHB/FSH재소유연구조별중균구유현저성정상관（P<0.05）；혈청INHB소우28.55 pg/ml진단유지지세포종합정적민감도위97%，특이성위85%。결론혈청FSH화INHB수평불능유효구분고환생정공능상태，단능유효학정유지지세포종합정，기타류형적생정공능이상잉수의뢰활검병리조직학검사。
Objective This study is in an attempt to evaluate the diagnostic significance to predict the spermatogenesis of azoospermic men in examination of serum follicle-stimulating hormone (FSH) combinatiing with serum inhibin B (INHB). Methods Quantitative examination of serum FSH and INHB was performed in 95 case of azoospermic men. According to their classifications of testicular biopsy with histopathological examination, there were 20 patients of Sertoli cell only, 25 of hypospermatogenesis, 18 of spermatogenic maturation arrest (complete or incomplete), and 32 of normal spermatogenesis. The association of serum FSH and INHB levels with histopathological classifications were analyzed by using statistical software. Results Serum FSH, INHB and INHB/FSH levels of Sertoli cell only differed with statistical significance from hypospermatogenesis, spermatogenic maturation arrest and normal spermatogenesis (P<0.05). FSH, in which there were no statistical significance among the latter three classifications (P>0.05). Serum FSH, INHB and INHB/FSH levels were no relationship with maturation arrest (P>0.05), but were negatively related to the other classifications (P<0.05). INHB level less than 28.55 pg/ml predicted Sertoli cell only in a sensitivity of 97%and a specificity of 85%. Conclusion Serum FSH and INHB levels is ineffective to distinguish the spermatogenic classifications from azoospermic men, but they are available to confirm the disease of Sertoli cell only. The other abnormalities of azoospermic men is also dependent on bioptic histopathology to confirm the subtypes.