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一种用于定性检测输精管切除术后低浓度精子的灵敏免疫诊断家用检测产品的临床和消费者试用性能。

Clinical and consumer trial performance of a sensitive immunodiagnostic home test that qualitatively detects low concentrations of sperm following vasectomy.

作者信息

Klotz Kenneth L, Coppola Michael A, Labrecque Michel, Brugh Victor M, Ramsey Kim, Kim Kyung-ah, Conaway Mark R, Howards Stuart S, Flickinger Charles J, Herr John C

机构信息

Department of Cell BiologyCenter for Research in Contraceptive and Reproductive Health, University of Virginia, Charlottesville, Virginia 22908-0732, USA.

出版信息

J Urol. 2008 Dec;180(6):2569-76. doi: 10.1016/j.juro.2008.08.045. Epub 2008 Oct 19.

Abstract

PURPOSE

Compliance with post-vasectomy semen analysis could be improved with the availability of a simple, rapid and accurate home test. SpermCheck Vasectomy, a highly sensitive lateral flow immunochromatographic diagnostic device, was designed to detect extreme oligospermia or azoospermia in men after vasectomy. We report the results of clinical and consumer testing of SpermCheck.

MATERIALS AND METHODS

A prospective, noncomparative observational study assessed the ability of SpermCheck Vasectomy to predict post-vasectomy sperm counts obtained using a hemacytometer procedure based on standard World Health Organization methodology. Consumer studies evaluated ease of use.

RESULTS

A cohort of 144 post-vasectomy semen samples was tested in the clinical trial. SpermCheck was 96% accurate in predicting whether sperm counts were greater or less than a threshold of 250,000 sperm per ml, a level associated with little or no risk of pregnancy. Sensitivity was 93% (95% CI 79% to 98%) and specificity was 97% (91% to 99%). The positive predictive value of the test was 93% (79% to 98%), and most importantly the negative predictive value was 97% (91% to 99%). The test gave a positive result 100% of the time at sperm concentrations of 385,000/ml or greater. Consumer studies with 109 lay volunteers showed that SpermCheck was easy to use. Volunteers obtained the correct or expected test result in every case and the correct response rate on a 20 question survey about the test was 97%.

CONCLUSIONS

SpermCheck Vasectomy, a simple and reliable immunodiagnostic test that can provide evidence of vasectomy success or failure, offers a useful alternative to improve compliance with post-vasectomy sperm monitoring. It is currently the only Food and Drug Administration approved test for this purpose.

摘要

目的

一种简单、快速且准确的家庭检测方法若能问世,或许可提高输精管结扎术后精液分析的依从性。SpermCheck输精管结扎术检测试剂盒是一种高灵敏度的侧向流动免疫层析诊断设备,旨在检测输精管结扎术后男性的极度少精子症或无精子症。我们报告了SpermCheck的临床和消费者测试结果。

材料与方法

一项前瞻性、非对比性观察性研究评估了SpermCheck输精管结扎术检测试剂盒预测基于世界卫生组织标准方法使用血细胞计数器程序获得的输精管结扎术后精子计数的能力。消费者研究评估了其易用性。

结果

在临床试验中对144份输精管结扎术后精液样本进行了检测。SpermCheck在预测精子计数是否高于或低于每毫升250,000个精子的阈值方面准确率达96%,该水平与怀孕风险极小或无风险相关。灵敏度为93%(95%置信区间为79%至98%),特异性为97%(91%至99%)。该检测的阳性预测值为93%(79%至98%),最重要的是阴性预测值为97%(91%至99%)。当精子浓度为385,000/毫升或更高时,该检测在所有情况下均给出阳性结果。对109名非专业志愿者进行的消费者研究表明,SpermCheck易于使用。志愿者在每种情况下都获得了正确或预期的检测结果,在一项关于该检测的20个问题的调查中,正确回答率为97%。

结论

SpermCheck输精管结扎术检测试剂盒是一种简单可靠的免疫诊断检测方法,可提供输精管结扎术成功或失败的证据,为提高输精管结扎术后精子监测的依从性提供了一种有用的替代方法。它是目前美国食品药品监督管理局批准用于此目的的唯一检测方法。

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