无精子症分型诊断和睾丸生精功能的评价

目的:探讨睾丸体积、血清生殖激素与精液细胞学检查对无精子症分型诊断和睾丸生精功能的应用价值。方法:对68例无精子症患者回顾性分析其睾丸体积、血清生殖激素和精液细胞学检查的结果,并和附睾或睾丸穿刺活检结果对照、分析。结果:睾丸体积、血清生殖激素、精液细胞学检查均能在不同程度上对无精子症进行分型诊断和睾丸生精功能的评价,以此3项检查作为单独指标诊断梗阻性和非梗阻性无精子症的符合率分别为56.7%、71.1%,80.0%、84.2%,93.3%、94.7%。以3项检查联合诊断梗阻性和非梗阻性无精子症分型的符合率分别为96.0%、100.0%;同一患者精液细胞学检查与附睾或睾丸穿刺活检所反映的生精细胞发育水平一致(P<0.05)。结论:睾丸体积、血清生殖激素结合精液细胞学检查能对无精子症进行比较准确、可靠的分型诊断及其睾丸生精功能的评价。

Classification Diagnosis of Azoospermia and Evaluation on Testicular Spermatogenic Function

Objective: To investigate the value of testicular volume, serum reproductive hormones and seminal cytology examination on classification diagnosis of azoospermia and evaluation of testicular spermatogenic function. Methods: Results of testicular volume, serum reproductive hormones and seminal cytology examination in 68 man with azoospermia were retrospectively analysed and were compared with epididymis or testis puncture biopsy results. Results: The testicular volume, reproductive hormones in serum and seminal fluid cytology examination could classify azoospermia and evaluate testicular spermatogenic function on different degrees. The correspondence rates of the above single exams for obstructive and nonobstructive azoospermia were 56.7%, 71.1%; 80.0%,84.2%; 93.3%, 94.7%, respectively, whereas that of combining above three exams together were 96.0% and 100.0%. The result of spermatogetic cells devdoping by spermatic fluid cytology examination was coincident with that of epididym or testis puncture biopsy (P<0.05). Conclusion: Combining three types of examinations together can exactly and credibly classify azoospermia and evaluate testicular spermatogenic function.