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目的 :分析无精子症患者临床和病理资料 ,研究病理学量化评价睾丸精曲小管精子发生功能的方法的临床意义。 方法 :无精子症患者 112例 ,年龄 2 2～ 4 6 (2 9.0± 4 .4 )岁 ,婚龄 2～ 12 (4 .0± 2 .8)年、病程 2～ 6 (2 .70±1.0 2 )年 ,其中原发性无精子症 96例 ,继发性无精子症 16例 ;梗阻性无精子症 7例。不育症患者精液常规检查 3次确认无精子症 ,检测性激素水平 ,常规消毒下睾丸活检病理检查 ,在高倍镜下计数每个精曲小管中各类生精细胞数 ,测定小管直径、生精上皮高度和固有层厚度 ,按制定的精曲小管精子发生功能 10分 5级分度法加以评分 ,进行统计学分析。 结果 :精曲小管生精上皮 10分分度法评分结果 ,1分 5例 (4 .5 % ) ,2分 38例 (33.9% ) ,3分 2例(1.8% ) ,4分 6例 (5 .4 % ) ,5分 2例 (1.8% ) ,6分 17例 (15 .2 % ) ,7分 6例 (5 .4 % ) ,8分 19例 (17% ) ,9分 10例(8.9% ) ,10分 7例 (6 .3% )。精曲小管精子发生功能 5级分度法结果 ,1级 5例 (4 .5 % ) ,2级 38例 (33.9% ) ,3级 33例 (2 9.5 % ) ,4级 2 9例 (2 5 .9% ) ,5级 7例 (6 .3% )。多元回归分析结果 ,精曲小管精子发生功能分级与生精上皮高度、固有层厚度、精曲小管直径和血清卵泡刺激素 (FSH)具有极显著相关性 (P <0 .0 1)。组合
OBJECTIVE: To analyze the clinical and pathological data of patients with azoospermia and to study the clinical significance of pathological quantification of the spermatogenic function of testicular seminiferous tubules. Methods: A total of 112 cases of azoospermia were enrolled in this study. The age ranged from 2 to 46 (range, 2 9.0 ± 4. 4 years), the age at marriage ranged from 2 to 12 (4.0 ± 2.8) years and the course ranged from 2 to 6 (2.70 ± 1.0 2) years, of which 96 cases of primary azoospermia, secondary azoospermia in 16 cases; obstructive azoospermia in 7 cases. Infertility patients semen routine examination 3 times to confirm azoospermia, testosterone levels, routine disinfection of testicular biopsy pathology, in high magnification count each sperm tubule in various types of spermatogenic cell number, determination of tubule diameter, spermatogenesis Epithelial height and lamina propria thickness, according to the development of fine tubule spermatogenesis 10 points grading 5 points to be scored for statistical analysis. Results: The score of fine tubule germinal epithelium was 10 points in 5 cases (4.5%), 2 points in 38 cases (33.9%), 3 points in 2 cases (1.8%), 4 points in 6 cases ( 5 cases were in 2 cases (1.8%), 6 cases were in 17 cases (15.2%), 7 cases were in 6 cases (5.4%), 8 cases were in 19 cases (17%), 9 cases were in 10 cases (8.9%), 10 points and 7 cases (6.3%). The results of grade 5 of the fine tubule spermatogenesis showed that grade 1 was 5 cases (4.5%), grade 2 38 cases (33.9%), grade 3 33 cases (29.5%), grade 4 29 cases (2) 5 .9%), grade 5 in 7 cases (6.3%). Multiple regression analysis showed that spermatic function classification of spermatic tubule had a significant correlation with spermatogenic epithelium height, lamina propria, tubule diameter and serum FSH (P <0.01). combination