血清抑制素B、促卵泡生长激素联合检测对于预测无精症患者睾丸精子获取术检测的价值
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摘要
目的探讨联合检测血清促卵泡生长激素(FSH)、抑制素B(INHB)对于预测无精症患者实施睾丸精子获取术(TESE)检测结局的价值。方法选取2016年3月-2017年1月在本院生殖健康门诊接受TESE检测的90例无精子症患者作为疾病组、90例健康男性作为对照组,并根据TESE检测结果分为成功组49例(成功获取生精细胞)、失败组41例(未能获取生精细胞),对比各组研究对象的FSH、INHB等指标,并采用受试者工作曲线分析FSH、INHB单独或者联合应用预测TESE检测结局的价值。结果选取血清FSH临界值水平为7.7 IU/L时,对应的预测TESE取精成功的灵敏度为66.18%、特异度为74.89%、AUC值为0.712;选取血清INHB临界值水平为36.2 pg/ml时,对应的预测TESE取精成功的灵敏度为82.31%、特异度为88.64%、AUC值为0.839;FSH及INHB联合应用时,对应的预测TESE取精成功的灵敏度为93.56%、特异度为90.77%、AUC值为0.918。结论 FSH及INHB联合应用对于预测TESE检测无精症患者取精成功率具有一定的临床价值。
Objective To investigate the combine detection value of serum follicle stimulating hormone(FSH) and inhibin B(INHB) in predicting the outcome of testicular sperm retrieval(TESE) in azoospermia patients. Methods 90 patients with azoospermia who received TESE at the reproductive health clinic from March 2016 to January 2017 were selected as the case group and 90 healthy men as the control group. According to the TESE test results, the objects were divided into success group(49 patients who received spermatogenic cells) and failure group(41 cases who fail to obtain spermatogenic cells). Comparing the FSH, INHB and other indicators of each group, and the receiver working curve was used to analyze the alone or combined detections of FSH, INHB in predicting the outcome of TESE test. Results When the serum FSH threshold value was set as 7.7 IU/L, the sensitivity of TESE sperm retrieval was 66.18%, the specificity was 74.89%, and the AUC value was 0.712. When the serum INHB threshold value was 36.2 pg/ml, The sensitivity of TESE sperm extraction was 82.31%, the specificity was 88.64%, and the AUC value was 0.839. When FSH and INHB were combined, the sensitivity of TESE sperm extraction was 93.56%, the specificity was 90.77%, and the AUC value was 0.918. Conclusion The combined use of FSH and INHB has a certain clinical value in predicting the success rate of sperm extraction in azoospermia patients by TESE.
Objective To investigate the combine detection value of serum follicle stimulating hormone(FSH) and inhibin B(INHB) in predicting the outcome of testicular sperm retrieval(TESE) in azoospermia patients. Methods 90 patients with azoospermia who received TESE at the reproductive health clinic from March 2016 to January 2017 were selected as the case group and 90 healthy men as the control group. According to the TESE test results, the objects were divided into success group(49 patients who received spermatogenic cells) and failure group(41 cases who fail to obtain spermatogenic cells). Comparing the FSH, INHB and other indicators of each group, and the receiver working curve was used to analyze the alone or combined detections of FSH, INHB in predicting the outcome of TESE test. Results When the serum FSH threshold value was set as 7.7 IU/L, the sensitivity of TESE sperm retrieval was 66.18%, the specificity was 74.89%, and the AUC value was 0.712. When the serum INHB threshold value was 36.2 pg/ml, The sensitivity of TESE sperm extraction was 82.31%, the specificity was 88.64%, and the AUC value was 0.839. When FSH and INHB were combined, the sensitivity of TESE sperm extraction was 93.56%, the specificity was 90.77%, and the AUC value was 0.918. Conclusion The combined use of FSH and INHB has a certain clinical value in predicting the success rate of sperm extraction in azoospermia patients by TESE.
引文
[1] Bernie AM,Mata DA,Ramasamy R,et al.Comparison of microdissection testicular sperm extraction,conventional testicular sperm extraction,and testicular sperm aspiration for nonobstructive azoospermia:a systematic review and meta-analysis[J].Fertil Steril,2015,104(5):1099-1103.
[2] 石亮,李卫巍,周雪,等.血清抑制素B检测在无精子症患者经睾丸抽吸术结局预评估中的应用[J].中华男科学杂志,2016,22(12):1095-1098.
[3] 唐金鑫,宋乐彬,秦超.睾丸显微取精术在非梗阻性无精子症中的应用[J].中华男科学杂志,2016,22(8):730-734.
[4] 王俊龙,孙璨,李朋,等.隐睾后非梗阻性无精子症患者睾丸精子获得率临床分析[J].中华泌尿外科杂志,2015,36(2):139-143.
[5] 杨欢利,邵秀娟,诸溢扬,等.非阻塞性无精子症精子获取预测因素的研究进展[J].中华男科学杂志,2016,22(5):462-466.
[6] Plotton I,Giscard DS,Cuzin B,et al.Preliminary results of a prospective study of testicular sperm extraction in young versus adult patients with nonmosaic 47,XXY Klinefelter syndrome[J].J Clin Endocrinol Metabolism,2015,100(3):961-967.
[7] 何泳志,李大文,黄悦悦,等.睾丸与附睾精子DNA完整率及行ICSI结局的对比研究[J].重庆医学,2015,17(25):3531-3533.
[8] 邓伟,杨杰,陕文生,等.血清抑制素B与卵泡刺激素对非阻塞性无精子症睾丸精子抽吸成功的预测价值的Meta分析[J].中国优生与遗传杂志,2015,11(8):115-117.
[9] 刘小惠,吴小华.抑制素B在两性生殖生理和病理中的研究进展[J].生殖与避孕,2016,36(9):737-744.
[10] 廖森成,谢纯平,王君龙,等.精索静脉曲张患者睾丸微循环变化与血清抑制素B及精液质量的关系[J].实用医学杂志,2016,32(11):1844-1846.
[11] 孙礼刚,蔡玉娇,杨桦.急性微波辐射对雄性大鼠睾丸形态和血浆FSH及抑制素B浓度的影响[J].重庆医学,2015,44(13):1747-1748.
[12] 刘小惠,吴小华.血清及卵泡液中抑制素B动态变化及其与促排卵结局的相关性研究[J].生殖与避孕,2016,36(11):897-903.
[13] 董莲花,冉茂良,李智,等.TGF-β超家族信号通路及其调控睾丸发育和精子生成的研究进展[J].中国畜牧杂志,2016,52(3):86-92.
[14] 冯科,张翠莲,李杭生,等.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[J].第三军医大学学报,2015,37(1):69-73.
[15] 胡杨杨,王丽媛,宋博天,等.不同睾丸活检术对睾丸功能及抗精子抗体的影响[J].中华男科学杂志,2017,23(7):620-625.
[2] 石亮,李卫巍,周雪,等.血清抑制素B检测在无精子症患者经睾丸抽吸术结局预评估中的应用[J].中华男科学杂志,2016,22(12):1095-1098.
[3] 唐金鑫,宋乐彬,秦超.睾丸显微取精术在非梗阻性无精子症中的应用[J].中华男科学杂志,2016,22(8):730-734.
[4] 王俊龙,孙璨,李朋,等.隐睾后非梗阻性无精子症患者睾丸精子获得率临床分析[J].中华泌尿外科杂志,2015,36(2):139-143.
[5] 杨欢利,邵秀娟,诸溢扬,等.非阻塞性无精子症精子获取预测因素的研究进展[J].中华男科学杂志,2016,22(5):462-466.
[6] Plotton I,Giscard DS,Cuzin B,et al.Preliminary results of a prospective study of testicular sperm extraction in young versus adult patients with nonmosaic 47,XXY Klinefelter syndrome[J].J Clin Endocrinol Metabolism,2015,100(3):961-967.
[7] 何泳志,李大文,黄悦悦,等.睾丸与附睾精子DNA完整率及行ICSI结局的对比研究[J].重庆医学,2015,17(25):3531-3533.
[8] 邓伟,杨杰,陕文生,等.血清抑制素B与卵泡刺激素对非阻塞性无精子症睾丸精子抽吸成功的预测价值的Meta分析[J].中国优生与遗传杂志,2015,11(8):115-117.
[9] 刘小惠,吴小华.抑制素B在两性生殖生理和病理中的研究进展[J].生殖与避孕,2016,36(9):737-744.
[10] 廖森成,谢纯平,王君龙,等.精索静脉曲张患者睾丸微循环变化与血清抑制素B及精液质量的关系[J].实用医学杂志,2016,32(11):1844-1846.
[11] 孙礼刚,蔡玉娇,杨桦.急性微波辐射对雄性大鼠睾丸形态和血浆FSH及抑制素B浓度的影响[J].重庆医学,2015,44(13):1747-1748.
[12] 刘小惠,吴小华.血清及卵泡液中抑制素B动态变化及其与促排卵结局的相关性研究[J].生殖与避孕,2016,36(11):897-903.
[13] 董莲花,冉茂良,李智,等.TGF-β超家族信号通路及其调控睾丸发育和精子生成的研究进展[J].中国畜牧杂志,2016,52(3):86-92.
[14] 冯科,张翠莲,李杭生,等.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[J].第三军医大学学报,2015,37(1):69-73.
[15] 胡杨杨,王丽媛,宋博天,等.不同睾丸活检术对睾丸功能及抗精子抗体的影响[J].中华男科学杂志,2017,23(7):620-625.