中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2015年
15期
2794-2798
,共5页
杨琳%杨长海%宋学茹%穆晓环
楊琳%楊長海%宋學茹%穆曉環
양림%양장해%송학여%목효배
无精子症%唯支持细胞综合征%卵泡刺激素%抑制素B%生精功能阻滞%睾丸体积
無精子癥%唯支持細胞綜閤徵%卵泡刺激素%抑製素B%生精功能阻滯%睪汍體積
무정자증%유지지세포종합정%란포자격소%억제소B%생정공능조체%고환체적
Azoospermia%Sertoli cell-only syndrome%Folicle stimulating hormone%Inhibin B%Spermatogenic arrest%Testicular volume
目的：检测不同睾丸体积的非梗阻性无精子症[唯支持细胞综合征（SCOS）和生精功能阻滞（SA）]患者血清卵泡刺激素（FSH）和抑制素B（InhB）水平，探讨两者在不同睾丸体积中与严重睾丸生精功能损害的关系及意义。方法入组病例包括SCOS 121例、SA 27例，每组疾病按睾丸体积≤5 ml，5 ml＜睾丸体积＜10 ml和睾丸体积≥10 ml分成三组进行血FSH和InhB检测，比较不同睾丸分组间两种激素表达水平的差异，以相同体积的重度少精子症或隐匿性无精子症匹配作为对照（50例）；考察不同疾病间睾丸体积与FSH和InhB的相关性；结合ROC曲线法对SCOS进行分析评价。结果当睾丸体积≤5 ml时，FSH和InhB在试验组和对照组之间表达均无统计学差异，而当睾丸体积＞5 ml时，FSH在三种疾病中表达有统计学差异；FSH在SA和对照组中与睾丸体积呈正相关性，InhB与睾丸体积无相关性；SCOS组中的睾丸体积与FSH和InhB均没有相关性；FSH诊断睾丸体积＞5 ml SCOS的切点值为11.53 mIU/ml，敏感度为87.4%，特异度为88.3%。结论在评价FSH与严重生精功能损害的程度时应与其睾丸体积相结合，当睾丸体积≥5 ml时，血清FSH水平有助于评估睾丸生精功能状况。
目的：檢測不同睪汍體積的非梗阻性無精子癥[唯支持細胞綜閤徵（SCOS）和生精功能阻滯（SA）]患者血清卵泡刺激素（FSH）和抑製素B（InhB）水平，探討兩者在不同睪汍體積中與嚴重睪汍生精功能損害的關繫及意義。方法入組病例包括SCOS 121例、SA 27例，每組疾病按睪汍體積≤5 ml，5 ml＜睪汍體積＜10 ml和睪汍體積≥10 ml分成三組進行血FSH和InhB檢測，比較不同睪汍分組間兩種激素錶達水平的差異，以相同體積的重度少精子癥或隱匿性無精子癥匹配作為對照（50例）；攷察不同疾病間睪汍體積與FSH和InhB的相關性；結閤ROC麯線法對SCOS進行分析評價。結果噹睪汍體積≤5 ml時，FSH和InhB在試驗組和對照組之間錶達均無統計學差異，而噹睪汍體積＞5 ml時，FSH在三種疾病中錶達有統計學差異；FSH在SA和對照組中與睪汍體積呈正相關性，InhB與睪汍體積無相關性；SCOS組中的睪汍體積與FSH和InhB均沒有相關性；FSH診斷睪汍體積＞5 ml SCOS的切點值為11.53 mIU/ml，敏感度為87.4%，特異度為88.3%。結論在評價FSH與嚴重生精功能損害的程度時應與其睪汍體積相結閤，噹睪汍體積≥5 ml時，血清FSH水平有助于評估睪汍生精功能狀況。
목적：검측불동고환체적적비경조성무정자증[유지지세포종합정（SCOS）화생정공능조체（SA）]환자혈청란포자격소（FSH）화억제소B（InhB）수평，탐토량자재불동고환체적중여엄중고환생정공능손해적관계급의의。방법입조병례포괄SCOS 121례、SA 27례，매조질병안고환체적≤5 ml，5 ml＜고환체적＜10 ml화고환체적≥10 ml분성삼조진행혈FSH화InhB검측，비교불동고환분조간량충격소표체수평적차이，이상동체적적중도소정자증혹은닉성무정자증필배작위대조（50례）；고찰불동질병간고환체적여FSH화InhB적상관성；결합ROC곡선법대SCOS진행분석평개。결과당고환체적≤5 ml시，FSH화InhB재시험조화대조조지간표체균무통계학차이，이당고환체적＞5 ml시，FSH재삼충질병중표체유통계학차이；FSH재SA화대조조중여고환체적정정상관성，InhB여고환체적무상관성；SCOS조중적고환체적여FSH화InhB균몰유상관성；FSH진단고환체적＞5 ml SCOS적절점치위11.53 mIU/ml，민감도위87.4%，특이도위88.3%。결론재평개FSH여엄중생정공능손해적정도시응여기고환체적상결합，당고환체적≥5 ml시，혈청FSH수평유조우평고고환생정공능상황。
Objective To detect the levels of serum FSH and inhibin B in different testicular volume(TV) of patients with non-obstructive azoospermia (NOA), and to explore the relationship and significance of FSH and inhibin B for severe spermatogenesis damage.Methods 121 patients of Sertoli cel only sydrome, 27 of spermatogenic arrest were colected according to their classifications of testicular biopsy with histopathological examination, quantitative examination of serum FSH and inhibin B was performed in al patients to compare the association with different TV (TV≤5 ml, 5 ml<TV<10 ml and TV≥10 ml) , severe oligozoospermia and cryptozoospermia were matched with same TV as control group. Bivariate correlation analysis was performed to identify the relevance of different TV with the levels of FSH and inhibin B. ROC curves were drawn for analyzing SCOS.Results Serum FSH levels differed with statistical significance in all of the patients with TV≥5 ml; the levels of FSH were positive related to SA and the control group; neither serum FSH nor inhibin B had relationship with SCOS. When testicular volume≥5 ml, sensitivity and specificity for FSH as a predictive diagnostic tool for SCOS were 87.4% and 88.3%, respectively, at the cutoff value of 11.53 mIU/ml.Conclusion The assessment of FSH level on severe spermatogenesis damage should be combined with the testicular volume, when testicular volume≥5 ml, serum FSH level help the evaluation on testicular spermatogenesis function.
