无精子症患者精液常规、精浆生化与生精细胞检测及其临床价值

    The detection of semen routine,biochemical criterion and spermatogenic cells in azoospermia patients and its clinical value

    • 摘要: 目的:探讨无精子症患者精液常规、精浆生化与生精细胞检测在无精子症鉴别诊断中的价值。方法:通过改良巴氏染色法分析70例无精子症患者精液中的生精细胞,根据精液中生精细胞的有无将患者分为A组(有生精细胞,32例)和B组(无生精细胞,38例),另选取30名健康成年男性作为对照组。测定3组患者的精液量、精液pH值、精浆生化(精浆果糖含量、中性α-糖苷酶活性),并对A、B组进行睾丸穿刺活检。结果:A组精液量、pH值和精浆中性α-糖苷酶活性与对照组差异均无统计学意义(P>0.05),精浆果糖含量均明显高于B组和对照组(P<0.01);而B组精液量、pH值和精浆中性α-糖苷酶活性均显著低于对照组和A组(P<0.01)。精液生精细胞、精液常规和精浆生化联合检查对非梗阻性和梗阻性无精子症的诊断与睾丸穿刺活检符合率分别为97.3%(36/37)和97.1%(33/34)。结论:精液生精细胞检查结合精液常规及精浆生化检测可作为鉴别非梗阻性与梗阻性无精子症的重要指标,对指导临床治疗有重要意义。

       

      Abstract: Objective:To investigate the value of semen routine,biochemical criterion and spermatogenic cells in the diagnosis of azoospermia.Methods:The seminal spermatogenic cells was detected using the modified papanicolaou staining.The patients were divided into the group A(32 cases with spermatogenic cells) and group B(38 cases without spermatogenic cells) according to the presence or absence of seminal spermatogenic cells,30 normal men were set as the control group.The semen volume and pH,seminal plasma fructose content,neutral α-glycosidase activity and testicular biopsy in three group were detected.Results:The differences of the semen volume and pH and neutral α-glycosidase activity between group A and control group were not statistically significant(P>0.05),the seminal plasma fructose content in group A was significantly higher than that in group B and control group(P<0.01),and the semen volume and pH,and neutral α- glucosidase activity in group B were significantly lower than those in group A(P<0.01).The coincidence rates of the combined detection of seminal spermatogenic cells,semen routine and biochemical criterion,and testicular biopsy in the dagnoisis of obstructive and non-obstructive azzospermia were 97.3%(36/37) and 97.1%(33/34),respectively.Conclusions:The joint detection of seminal spermatogenic cells,semen routine and biochemical criterion can be used as an important indicator in differentiating the obstructive and non-obstructive azzospermia,which has important significance in guiding clinical treatment.

       

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