精浆AMH水平对非梗阻性无精症的临床预测价值(1)
[摘要] 目的 探討抗缪勒管激素(AMH)水平对非梗阻性无精子症(NOA)的临床预测价值。 方法 釆用酶联免疫法和电化学发光免疫分析法检测NOA患者精浆AMH、血清促卵泡激素(FSH)以及睾酮(T)的浓度;B超检测其睾丸体积;通过睾丸显微取精术(M-TESE)检获精子;同时设置对照组，并进行统计学分析。 结果 NOA组的AMH浓度分别低于OA组[(19.53±9.13)pmol/L，(52.34±15.13)pmol/L，P<0.05]及NF组[(158.53±37.45)pmol/L，P<0.05];NOA组的FSH浓度分别高于OA组[(18.36±8.95)U/L，(5.51±3.32)U/L，P<0.05]及NF组[(6.12±3.02)U/L，P<0.05];NOA患者的睾酮浓度[(15.32±5.43)nmol/L]分别与OA组[(15.63±6.23)nmol/L]、NF组[(15.81±5.73)nmol/L]比较无显著性差异(P>0.05，P>0.05);NOA组左右睾丸体积TV[(9.58±3.83)mL，(7.46±3.57)mL]分别与OA组[(16.97±2.56)mL，(15.32±3.63)mL]、NF组[(16.23±3.53)mL，(16.84±2.83)mL]存在显著性差异(P<0.05，P<0.05)。NOA组有10人检获精子，OA组19人检获精子(P<0.05)。Logistic回归分析检验发现AMH预测NOA 患者睾丸内是否存在精子的拟合优度最佳(Wald χ2=26.198，P<0.01);ROC曲线图显示精浆AMH的AUC值最大;精浆AMH的阳性似然比为7.36[81.82%/(1-88.89%)]，阴性似然比为0.20[(1-81.82%)/88.89%]。 结论 精浆AMH 浓度对于预测NOA 患者M-TESE成功与否具有重要的意义。
[关键词] 非梗阻性无精症;抗缪勒管激素;睾丸显微取精术;精子检获
[中图分类号] R446.6 [文献标识码] A [文章编号] 1673-9701(2019)31-0001-04
Clinical predictive value of seminal plasma AMH level for non-obstructive azoospermia
DUAN Li1， 2 CHEN Yi2 YANG Fan2 DU Dan2 WANG Kegeng1 LU Siyu3 SHEN Wentao4 LIU Yan1
1.Institute of Pathogenic Biology， Hengyang Medical College， Nanhua University， Hengyang 421001， China; 2.Chenzhou First People's Hospital， Chenzhou 423000， China; 3.School of Nursing， Nanhua University， Hengyang 421001， China; 4.Huilongshan Town Health Center of Tuanfeng County in Huibei Province， Tuanfeng 438800， China
[Abstract] Objective To evaluate the clinical predictive value of anti-Mullerian hormone(AMH) level for non-obstructive azoospermia(NOA). Methods Enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay were used to detect the concentration of seminal plasma AMH， serum follicle stimulating hormone (FSH) and testosterone (T) in NOA patients. B-ultrasound was used to test testicular volume. And Sperm was acquired by M-TESE. The control group was set up at the same time and statistical analysis was performed. Results The AMH concentration (19.53±9.13) pmol/L in the NOA group was lower than that in the OA group (52.34±15.13) pmol/L and that in the NF group (158.53±37.45) pmol/L， P<0.05. The FSH concentration (18.36±8.95) U/L in the NOA group was higher than that in the OA group (5.51±3.32) U/L and that in the NF group (6.12±3.02) U/L， P<0.05. The testosterone concentration in NOA patients (15.32±5.43) nmol/L was not significantly different from that of OA group (15.63±6.23)nmol/L and NF group (15.81±5.73)nmol/L， P>0.05. The left and right testicular volume TV in the NOA group was(9.58±3.83)mL and(7.46±3.57)mL， which was significantly different from that in the OA group (16.97±2.56)mL and (15.32±3.63) mL， and that in the NF group(16.23±3.53)mL and(16.84±2.83)mL， P<0.05. Sperm was detected in 10 patients in the NOA group and 19 in the OA group (P<0.05). Logistic regression analysis showed that AMH predicted the best fit of sperm in the testis of NOA patients (Wald χ2=26.198， P<0.01).ROC curve showed the AUC value of seminal plasma AMH was the highest. The positive likelihood ratio of the seminal plasma AMH was 7.36(81.82%/(1-88.89%))，and the negative likelihood ratio was 0.20 (1-81.82%)/88.89%). Conclusion The concentration of seminal plasma AMH is important for predicting whether the success of M-TESE in patients with NOA or not., 百拇医药(段丽 陈艺 杨帆)
[关键词] 非梗阻性无精症;抗缪勒管激素;睾丸显微取精术;精子检获
[中图分类号] R446.6 [文献标识码] A [文章编号] 1673-9701(2019)31-0001-04
Clinical predictive value of seminal plasma AMH level for non-obstructive azoospermia
DUAN Li1， 2 CHEN Yi2 YANG Fan2 DU Dan2 WANG Kegeng1 LU Siyu3 SHEN Wentao4 LIU Yan1
1.Institute of Pathogenic Biology， Hengyang Medical College， Nanhua University， Hengyang 421001， China; 2.Chenzhou First People's Hospital， Chenzhou 423000， China; 3.School of Nursing， Nanhua University， Hengyang 421001， China; 4.Huilongshan Town Health Center of Tuanfeng County in Huibei Province， Tuanfeng 438800， China
[Abstract] Objective To evaluate the clinical predictive value of anti-Mullerian hormone(AMH) level for non-obstructive azoospermia(NOA). Methods Enzyme-linked immunosorbent assay and electrochemiluminescence immunoassay were used to detect the concentration of seminal plasma AMH， serum follicle stimulating hormone (FSH) and testosterone (T) in NOA patients. B-ultrasound was used to test testicular volume. And Sperm was acquired by M-TESE. The control group was set up at the same time and statistical analysis was performed. Results The AMH concentration (19.53±9.13) pmol/L in the NOA group was lower than that in the OA group (52.34±15.13) pmol/L and that in the NF group (158.53±37.45) pmol/L， P<0.05. The FSH concentration (18.36±8.95) U/L in the NOA group was higher than that in the OA group (5.51±3.32) U/L and that in the NF group (6.12±3.02) U/L， P<0.05. The testosterone concentration in NOA patients (15.32±5.43) nmol/L was not significantly different from that of OA group (15.63±6.23)nmol/L and NF group (15.81±5.73)nmol/L， P>0.05. The left and right testicular volume TV in the NOA group was(9.58±3.83)mL and(7.46±3.57)mL， which was significantly different from that in the OA group (16.97±2.56)mL and (15.32±3.63) mL， and that in the NF group(16.23±3.53)mL and(16.84±2.83)mL， P<0.05. Sperm was detected in 10 patients in the NOA group and 19 in the OA group (P<0.05). Logistic regression analysis showed that AMH predicted the best fit of sperm in the testis of NOA patients (Wald χ2=26.198， P<0.01).ROC curve showed the AUC value of seminal plasma AMH was the highest. The positive likelihood ratio of the seminal plasma AMH was 7.36(81.82%/(1-88.89%))，and the negative likelihood ratio was 0.20 (1-81.82%)/88.89%). Conclusion The concentration of seminal plasma AMH is important for predicting whether the success of M-TESE in patients with NOA or not., 百拇医药(段丽 陈艺 杨帆)