| 摘要: |
| ［摘要］ 目的 分析血清睾酮、雌二醇（E2）及睾酮/E2比值在生精功能障碍评估中的应用价值。方法 选择2020年6月至2021年12月于广西壮族自治区妇幼保健院生殖中心就诊的750例男性的临床资料。其中精液质量正常者300名（正常对照组），生精功能障碍者450例。根据精子总数，生精功能障碍者分为轻度少精组、重度少精组和非梗阻性无精子症组，每组150例。分析精液质量正常者性激素指标水平的百分位数分布情况。比较四组血清促卵泡刺激素（FSH）、总睾酮（TT）、E2、游离睾酮（FT）、TT/E2比值和FT/E2比值。结果 精液质量正常男性TT和FT的均值分别为504.50 ng/dl和10.28 ng/dl，第5百分位数值分别为273.28 ng/dl和6.70 ng/dl；TT/E2比值和FT/E2比值的均值分别为15.75和0.32，第20百分位数值分别为10.06和0.23。随着生精障碍严重程度加重，FSH水平呈上升趋势，E2、TT和FT水平呈下降趋势。非梗阻性无精子症组TT、FT、E2水平以及TT/E2比值、FT/E2比值与正常对照组比较差异均有统计学意义（P<0.05）。非梗阻性无精子症组FSH水平显著高于轻度少精组和重度少精组（P<0.05），FT水平、FT/E2比值显著低于轻度少精组和重度少精组（P<0.05）。与正常对照组和轻度少精组相比，重度少精组FSH水平升高，TT、FT水平以及TT/E2比值、FT/E2比值降低，差异有统计学意义（P<0.05）。轻度少精组FSH水平高于正常对照组，FT水平低于正常对照组，差异有统计学意义（P<0.05）。结论 生精功能障碍评估中血清FT是值得关注的重要指标，TT和FT参考值下限分别为273.28 ng/dl和6.70 ng/dl；TT/E2比值<10.06可作为治疗界限值。 |
| 关键词: 生精功能障碍 总睾酮 游离睾酮 雌二醇 |
| DOI：10.3969/j.issn.1674-3806.2023.10.18 |
| 分类号:R 698.2 |
| 基金项目: |
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| Analysis on the application value of serum testosterone, estradiol and testosterone/estradiol ratio in evaluation of spermatogenic dysfunction |
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GAN Xian-you, XU Kong-rong, LING Xiao-bin, et al.
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Reproductive Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530002, China
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| Abstract: |
| ［Abstract］ Objective To analyze the application value of serum testosterone, estradiol(E2) and testosterone/E2 ratio in evaluation of spermatogenic dysfunction. Methods The clinical data of 750 male patients who visited the Reproductive Center of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from June 2020 to December 2021 were selected. Among the 750 male patients, semen quality was normal in 300 cases(normal control group), and spermatogenic dysfunction in 450 cases. According to the total number of sperm, the spermatogenic dysfunction patients were divided into mild oligospermia group, severe oligospermia group and non-obstructive azoospermia group, with 150 cases in each group. The percentile distribution of sex hormone index levels in the normal semen patients was analyzed. Serum follicle stimulating hormone(FSH), total testosterone(TT), E2, free testosterone(FT), TT/E2 ratio and FT/E2 ratio were compared among the four groups. Results The mean values of TT and FT in the male patients with normal semen quality were 504.50 ng/dl and 10.28 ng/dl, respectively, and the 5th percentile values were 273.28 ng/dl and 6.70 ng/dl, respectively. The mean values of TT/E2 and FT/E2 ratios in the male patients with normal semen quality were 15.75 and 0.32, respectively, and the 20th percentile values were 10.06 and 0.23, respectively. As the severity of spermatogenic dysfunction worsens, the levels of FSH showed an upward trend while the levels of E2, TT and FT showed a downward trend. There were significant differences in the levels of TT, FT and E2, TT/E2 ratio and FT/E2 ratio between the non-obstructive azoospermia group and the normal control group(P<0.05). The level of FSH in the non-obstructive azoospermia group was significantly higher than that in the mild oligospermia group and the severe oligospermia group(P<0.05). The level of FT and FT/E2 ratio in the non-obstructive azoospermia group were significantly lower than those in the mild oligospermia group and the severe oligospermia group(P<0.05). Compared with the normal control group and the mild oligospermia group, the level of FSH in the severe oligospermia group was increased, while the levels of TT and FT, TT/E2 ratio and FT/E2 ratio in the severe oligospermia group were decreased, and the differences were statistically significant(P<0.05). The level of FSH in the mild oligospermia group was higher than that in the normal control group, and the level of FT in the mild oligospermia group was lower than that in the normal control group, and the differences were statistically significant(P<0.05). Conclusion In the evaluation of spermatogenic dysfunction, serum FT is an important indicator to be concerned about, and the lower limits of TT and FT reference values are 273.28 ng/dl and 6.70 ng/dl, respectively. The TT/E2 ratio <10.06 can be used as the therapeutic threshold value. |
| Key words: Spermatogenic dysfunction Total testosterone(TT) Free testosterone(FT) Estradiol(E2) |
