973例无精子者睾丸体积、生殖激素与精液细胞学分析

摘要

目的：探讨无精子症患者睾丸体积、生殖激素水平与精液生精细胞检出结果的相关性。方法将973例无精子症患者按W HO男性不育病因诊断分类标准分为梗阻性无精子症（OA ）和非梗阻性无精子症（NOA ），NOA按精液生精细胞检出结果分为生精细胞存在型和生精细胞缺乏型两组，并分别对各组患者的睾丸体积、生殖激素水平进行统计比较。结果973例无精子症患者，明确为OA者235例（24．15％），NOA者738例（75．85％）。NOA精液生精细胞存在型410例（55．56％），生精细胞缺乏型328例（44．44％）。NOA生精细胞存在型与缺乏型两组睾丸体积明显缩小、T、T／LH值较低，LH、FSH水平明显升高，与OA组比较差异均具有统计学意义（P＜0．001）；与PRL比较差异无统计学意义（P＞0．05）。NOA精液生精细胞存在型与缺乏型组比较，生精细胞缺乏型睾丸体积明显缩小（P＜0．001），LH、FSH水平均高于生精细胞存在型（P＜0．01，P＜0．05），T、T／LH及PRL水平比较差异无统计学意义（P＞0．05）。结论睾丸体积、生殖激素水平与精液细胞检出的多寡密切相关，T／LH测定对了解睾丸间质细胞功能与基膜变化有关联。%Objective To investigate the correlation between the testicular volume and reproductive hormones level with sperm cytological detection results in azoospermic patients .Methods Based on the WHO male infertility etiology diagnosis classification criteria ,973 azoospermic patients were divided into the obstructive azoospermia (OA ) and non‐obstructive azoospermia (NOA ) . Then NOA was divided into the existing spermatogenic cells type group and non‐existing spermatogenic cells type group according to the sperm spermatogenic cell detection results .The testicular volume and reproductive hormones levels were statistically analyzed and compared among various groups .Results In 973 azoospermia patients ,235 cases were OA (24 .15% ) and 738 cases were NOA (75 .85% ) .There were 410 cases (55 .56% ) of existing spermatogenic cells type and 328 cases(44 .44% ) of non‐existing spermato‐genic cells type .The testicular volume in the existing spermatogenic cells type group and non‐existing spermatogenic cells of NOA was clearly reduced ,the T and T/LH were lower ,while the LH and FSH levels were significantly increased ,the difference between the OA group and the NOA group had statistical difference (P<0 .001) ,but PRL had no statistical difference between them (P<0 .05) .The testicular volume of existing spermatogenic cells type was smaller than non‐existing spermatogenic cells type ( P<0 .001) .The LH and FSH levels were higher than those of existing spermatogenic cells type (P<0 .01 ,P<0 .05);T ,T/LH and PRL levels had no statistical difference (P>0 .05) .Conclusion The testicular volume and reproductive hormones level are closely related with the detection quantity of sperm cells and the detection of T /LH is helpful for understanding the relation between the function of leydig cells and basement membrane change .