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目的通过检测无精子症患者血清FSH水平,分析鉴别梗阻性无精子症和非梗阻性无精子症两种类型;通过比较血清FSH水平与睾丸体积,分析血清FSH水平与睾丸体积的关系,探讨其判断无精子症分型的意义。方法对2007年10月-2008年4月间76例来自大连市妇产医院白山路生殖中心的无精子症患者的血液样本,采用ROCHE2010全自动免疫分析仪及其配套试剂盒检测血清FSH水平,采用Prader睾丸模型比拟法测定睾丸体积。结果与对照组相比,非梗阻性无精子症组血清FSH水平显著升高(P<0.05),而对照组与梗阻性无精子症组血清FSH水平差异无显著性(P>0.05)。非梗阻性无精子症组与梗阻性无精子症组血清FSH水平差异显著(P<0.05)。与睾丸体积≥12ml组相比,睾丸体积<12ml组血清FSH水平显著升高(P<0.05)。以睾丸体积12ml为分界标准,≥12ml为梗阻性无精子症,<12ml为非梗阻性无精子症。该标准对梗阻性和非梗阻性无精子症诊断的符合率分别为89.3%(25/28)、75%(36/48)。以生殖激素中FSH12.4mIU/ml为分界标准,小于该值为梗阻性无精子症,大于该值为非梗阻性无精子症,该标准对梗阻性无精子症诊断的符合率为92.9%(26/28),对非梗阻性无精子症诊断的符合率为89.6%(43/48)。结论血清FSH水平为分析睾丸功能衰竭原因提供依据,对判定精道梗阻具有重要意义,是鉴别非梗阻性与梗阻性无精子症的首要临床指标;睾丸体积在判定无精子症分型中有一定意义;血清FSH水平与睾丸体积联合检测更有助于鉴别梗阻性无精子症和非梗阻性无精子症。
Objective To detect the levels of serum FSH in patients with azoospermia and to identify the two types of obstructive azoospermia and non-obstructive azoospermia. By comparing serum FSH levels with testicular volume, the relationship between serum FSH levels and testicular volume was analyzed, To determine the significance of azoospermatic classification. Methods From October 2007 to April 2008, 76 patients with azoospermia from the Baishan Road Reproductive Center of Maternity Hospital of Dalian were enrolled in this study. Serum FSH level was detected by ROCHE2010 automatic immunoassay analyzer and its kit. Testicular volume was determined using the Prader testes model comparison. Results Compared with the control group, serum FSH level in non-obstructive azoospermia group was significantly increased (P <0.05), while there was no significant difference in serum FSH level between control group and obstructive azoospermia group (P> 0.05). Serum FSH levels were significantly different between non-obstructive azoospermia group and obstructive azoospermia group (P <0.05). Serum FSH levels in testis volume <12 ml group were significantly higher than those in testicular volume ≥ 12 ml group (P <0.05). To testicular volume 12ml for the demarcation criteria, ≥ 12ml obstructive azoospermia, <12ml non-obstructive azoospermia. The standard coincidence rate of obstructive and non-obstructive azoospermia diagnosis were 89.3% (25/28), 75% (36/48). To reproductive hormones in FSH12.4mIU / ml as the cut-off criteria, less than the value of obstructive azoospermia, greater than the value of non-obstructive azoospermia, the standard diagnosis of obstructive azoospermia was 92.9% ( 26/28), the non-obstructive azoospermia diagnosis was 89.6% (43/48). Conclusions Serum FSH levels provide the basis for the analysis of the causes of testicular failure and are of great significance for the determination of obstructive tract obstruction. It is the most important clinical criterion for differentiating non-obstructive and obstructive azoospermia. The testicular volume has a certain value in determining the type of azoospermia Significance; combined detection of serum FSH levels and testicular volume is more helpful in the identification of obstructive azoospermia and non-obstructive azoospermia.