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目的探讨非梗阻性无精子症患者睾丸穿刺取精前进行Y染色体微缺失筛查和生殖激素检测的意义。方法按照WHO标准进行检查和精液分析,收集非梗阻性无精子症患者246例作为研究对象,用改良PCR进行Y染色体微缺失筛查,其中109例无精子症患者接受了睾丸穿刺精子抽吸术。梗阻型无精子症124例作为对照组。所有患者均采集年龄、不育史、附属性腺B超检测、睾丸体积以及生殖激素检测进行分析。结果非梗阻性无精子症患者的FSH均值升高,与对照组相比,差异有统计学意义(P<0.01)。其中穿刺有精子与穿刺无精子患者相比,FSH均值偏低,差异有统计学意义(P<0.05);与AZF缺失的非梗阻性无精子症患者的FSH均值相比,差异无统计学意义(P>0.05)。结论 FSH水平可以作为非梗阻性无精子症患者穿刺结果的预判因素之一,但对于Y染色体微缺失患者无预判价值。
Objective To investigate the significance of detecting Y chromosome microdeletions and detecting reproductive hormones before testicular biopsy in patients with non-obstructive azoospermia. Methods According to the WHO standard examination and semen analysis, 246 patients with non-obstructive azoospermia were collected as the research object. Y chromosome microdeletion screening was performed by modified PCR. Among them, 109 patients with azoospermia received testicular aspiration sperm aspiration . Obstructive azoospermia 124 cases as a control group. All patients were collected for age, history of infertility, accessory gland B-test, testicular volume, and reproductive hormone test. Results The mean value of FSH in non-obstructive azoospermia patients was significantly higher than that in control group (P <0.01). The mean value of FSH was lower in sperm with punctured spermatozoa than in punctured azoospermia (P <0.05). There was no significant difference in FSH mean value between non-obstructive azoospermia and non-obstructive azoospermia (P> 0.05). Conclusion The level of FSH can be used as one of the predictors of the puncture outcome in patients with non-obstructive azoospermia. However, there is no predictive value for the patients with Y chromosome microdeletion.