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[血清抗苗勒管激素水平用于梗阻性和非梗阻性无精子症的鉴别诊断]

[Serum anti-Müllerian hormone level for differential diagnosis of obstructive and non-obstructive azoospermia].

作者信息

Xiong Zhe, Ye Zhen, Tu Jian, Meng Tian-Qing, Ren Ning

机构信息

Department of Physiology, Jianghan University School of Medicine, Wuhan, Hubei 430056, China.

Department of Urology, Tongji Hospital of Reproductive Medicine, Wuhan, Hubei 430013, China.

出版信息

Zhonghua Nan Ke Xue. 2019 Sep;25(9):823-827.

Abstract

OBJECTIVE

To determine whether the serum anti-Müllerian hormone (AMH) level can be used as a serum marker for the differential diagnosis of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA).

METHODS

Using chemiluminescence immunoassay, we detected the levels of serum AMH, inhibin B (IhB) and follicle stimulating hormone (FSH) and measured by scrotal ultrasound the testis volume of 43 normal fertile men and 14 OA and 45 NOA male patients, followed by a comparative analysis of the data obtained among the three groups subjects.

RESULTS

Compared with the NOA patients, the men in the normal control and OA groups showed significantly higher levels of AMH ([5.65 ± 3.13] vs [8.13 ± 3.95] and [8.51 ± 4.77] ng/ml, P < 0.05) and InH ([25.98±16.29] vs [127.38 ± 40.5] and [131.25 ± 52.3] pg/ml, P < 0.01), but a lower level of FSH ([19.87 ± 13.09] vs [4.22 ± 3.23] and [4.54 ± 2.09] IU/L, P < 0.01), none with statistically significant difference between the latter two groups (P > 0.05). Pearson correlation analysis exhibited that the level of IhB was correlated positively with that of AMH (r = 0.326, P = 0.01) but negatively with that of FSH (r =-0.662, P < 0.01), the FSH level negatively with the AMH level (r = -0.468, P < 0.01), the testis volume positively with the levels of AMH (r = 0.339, P < 0.01) and IhB (r = 0.733, P < 0.01) but negatively with that of FSH (r = 0.597, P < 0.01), the sperm concentration positively with that of IhB (r = 0.522, P < 0.01) but negatively with that of FSH (r = -0.421, P < 0.01), and the testis volume positively with the sperm concentration (r = 0.605, P < 0.01).

CONCLUSIONS

AMH can be used as one of the serum markers for testicular spermatogenesis and employed alone or in combination with IhB and FSH for the differential diagnosis of OA and NOA.

摘要

目的

确定血清抗苗勒管激素(AMH)水平是否可作为鉴别梗阻性无精子症(OA)和非梗阻性无精子症(NOA)的血清标志物。

方法

采用化学发光免疫分析法,检测43例正常生育男性、14例OA男性患者和45例NOA男性患者的血清AMH、抑制素B(IhB)和卵泡刺激素(FSH)水平,并通过阴囊超声测量睾丸体积,随后对三组受试者的数据进行比较分析。

结果

与NOA患者相比,正常对照组和OA组男性的AMH水平显著更高([5.65±3.13] vs [8.13±3.95]和[8.51±4.77] ng/ml,P<0.05),InH水平也显著更高([25.98±16.29] vs [127.38±40.5]和[131.25±52.3] pg/ml,P<0.01),但FSH水平更低([19.87±13.09] vs [4.22±3.23]和[4.54±2.09] IU/L,P<0.01)后两组之间无统计学显著差异(P>0.05)。Pearson相关性分析显示,IhB水平与AMH水平呈正相关(r = 0.326,P = 0.01),但与FSH水平呈负相关(r = -0.662,P<0.01),FSH水平与AMH水平呈负相关(r = -0.468,P<0.01),睾丸体积与AMH水平呈正相关(r = 0.339,P<0.01)和IhB水平呈正相关(r = 0.733,P<0.01),但与FSH水平呈负相关(r = 0.597,P<0.01),精子浓度与IhB水平呈正相关(r = 0.522,P<0.01),但与FSH水平呈负相关(r = -0.421,P<0.01),睾丸体积与精子浓度呈正相关(r = 0.605,P<0.01)。

结论

AMH可作为睾丸生精功能的血清标志物之一,单独或与IhB和FSH联合用于OA和NOA的鉴别诊断。

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