摘要
目的探究血清抑制素B表达与精索静脉曲张(VC)患者精子质量的相关性。方法选取2015年1月—2019年6月于武城县妇幼保健计划生育服务中心就诊并经超声诊断的左侧VC不育患者82例为研究组和已生育健康男性50名作对照组,比较两组研究对象血清抑制素B、性激素水平。根据病理诊断结果将82例VC患者分为亚临床型VC(SVC)18例,VCⅠ级21例,VCⅡ级24例,VCⅢ级19例,比较各组患者血清抑制素B、性激素水平及精子质量。利用酶联免疫吸附法测定血清抑制素B以及性激素睾酮、卵泡刺激素(FSH)、黄体生成素(LH)水平。Pearson法分析血清抑制素B与精子质量的相关性;利用受试者操作特征(ROC)曲线分析血清抑制素B、睾酮、FSH、LH预测VC发生的价值。结果研究组VC患者术前血清抑制素B、睾酮水平明显低于对照组(P<0.05),FSH、LH水平明显高于对照组(P<0.05);随着VC患者病情严重程度加重,血清抑制素B、睾酮及精子密度、精子活力均呈下降趋势,FSH、LH水平呈上升趋势(P<0.05);与VC患者术前相比,术后患者血清抑制素B、精子密度、精子活力、睾酮水平均明显上升(P<0.05),FSH、LH水平均明显下降(P<0.05);血清抑制素B水平与精子密度、精子活力、睾酮水平呈正相关(P<0.05),与FSH、LH水平呈负相关(P<0.05);ROC结果显示,血清抑制素B、睾酮、FSH、LH预测VC发生的曲线下面积(AUC)分别为0.895、0.687、0.701、0.766;术前高抑制素B水平VC患者术后1年内配偶受孕情况明显高于低抑制素B水平患者(P=0.022)。结论血清抑制素B随VC患者病情严重程度加重而下降,与精子质量呈正相关,在一定程度上可反映VC患者预后情况,可作为指示VC患者预后的潜在指标。
Objective To explore the correlation between serum inhibin B expression and sperm quality in patients with varicocele(VC).Methods A total of 82 patients with left VC infertility diagnosed by ultrasound in our hospital from January 2015 to June 2019 were selected as the study group and 50 fertile healthy men as the control group,the serum inhibin B and sex hormone levels were compared between the two groups.According to the results of pathological diagnosis,82 patients with VC were divided into subclinical VC(SVC) of 18 cases,grade Ⅰ VC of 21 cases,grade Ⅱ VC of 24 cases,grade Ⅲ VC of 19 cases,the levels of serum inhibin B,sex hormone,and sperm quality were compared.The levels of serum inhibin B,sex hormones testosterone,follicle stimulating hormone(FSH) and luteinizing hormone(LH) were measured by enzyme-linked immunosorbent assay(ELISA).Pearson method was used to analyze the correlation between serum inhibin B and sperm quality;and the value of serum inhibin B,testosterone,FSH and LH in predicting the occurrence of VC was analyzed by the receiver operating characteristic curve.Results The levels of inhibin B and testosterone in the study group were significantly lower than those in the control group(P<0.05),and the levels of FSH and LH were significantly higher than those in the control group(P<0.05);with the aggravation of VC patients’ condition,serum inhibin B,testosterone,sperm density and sperm motility showed a downward trend,while FSH and LH levels showed an upward trend(P<0.05);compared with those before operation,serum inhibin B,sperm density,sperm motility and testosterone level were significantly increased(P<0.05),while FSH and LH levels were significantly decreased(P<0.05);serum inhibin B level was positively correlated with sperm density,sperm motility and testosterone level(P<0.05),and negatively correlated with FSH and LH levels(P<0.05);ROC results showed that the area under the curve(AUC) of serum inhibin B,testosterone,FSH and LH were 0.895,0.687,0.701 and 0.766,respectively;the pregnancy rate of spouses within 1 year after operation in VC patients with high preoperative inhibin B level was significantly higher than that in patients with low inhibin B level(P=0.022).Conclusion Serum inhibin B decreases with the severity of VC,and is positively correlated with sperm quality.It can reflect the prognosis of VC patients to a certain extent,and may be used as a potential indicator to indicate the prognosis of VC patients.
作者
潘庆亮
王世礼
任洪胜
PAN Qingliang;WANG Shili;REN Hongsheng(Wucheng Maternal and Child Health Care and Family Planning Service Center,Wucheng,Shandong 253300,China;Rizhao Maternal and Child Health Care Hospital,Rizhao,Shandong 276800,China)
出处
《中国优生与遗传杂志》
2021年第5期703-706,共4页
Chinese Journal of Birth Health & Heredity
