【摘要】 目的 研究无精子症及严重少精子症患者Y染色体微缺失的缺失类型与睾丸活检组织学类型的关系。方法 收集来我院就诊的病因诊断为Y染色体微缺失的无精子症及严重少精子症患者的完整睾丸活检病理报告。根据Y染色体微缺失区域类型,将研究对象分为A缺失组、B缺失组、B/C/D联合缺失组和C/D联合缺失组。分析Y染色体微缺失的缺失类型与睾丸活检组织学类型、睾丸体积、卵泡刺激素、黄体生成素之间的关系。结果 在254例Y染色体微缺失患者中,各缺失组之间睾丸活检组织学类型存在统计学差异(P<0.01)。A缺失组有66.7%(14/21)为唯支持细胞综合征和28.6%(6/21)为成熟停滞;B缺失组有9.7%(3/31)为唯支持细胞综合征和90.3%(28/31)为成熟停滞;B/C/D联合缺失组有44.4%(28/63)为唯支持细胞综合征和52.4%(33/63)为成熟停滞;C/D联合缺失33.1%(46/1 39)为唯支持细胞综合征和有51.8%(72/1 39)为成熟停滞。成熟精子总检出率9.4%(24/254)。各缺失组之间血清卯泡刺激素存在统计学差异(P<0.01)。各缺失组之间在睾丸体积、黄体生成素水平之间比较无统计学差异性(P>0.05)。结论 Y染色体微缺失患者中,不同缺失类型之间睾丸活检组织学类型存在差异。AZFa缺失类型主要表现为唯支持细胞综合征,AZFb缺失类型主要表现为成熟停滞,AZFb联合缺失和AZFc/d联合缺失则表观多样化,主要表现为成熟停滞和唯支持细胞综合征,成熟精子的检出率低。更多还原

【Abstract】 Objective To analyze the correlation of Y chromosome microdeletion and the pathological alterations of spermatogenic impairment in patients with azoospermia and severe oligozoospermia.Methods The pathological report of testicular biopsy of patients diagnosed as azoospermia and severe oligozoospermia with Y chromosome microdeletion were collected.Based on the locus of deletion,they were divided into Groupl(AZFa deletion),Group2(AZFb deletion),Group3(AZFb/c/d deletion),Group4(AZFc/d deletion).The correlation of Y chromosome microdeletion and testicular histology,testicular volume,follicle stimulating hormone,luteinizing hormone was analyzed respectively.Results There were significant difference for the pathological alteration among the four groups by the microdeletion of Y chromosome(P<0.01).The 14(66.7%) cases of Sertoli cell only syndrome and the 6(28.6%) cases of maturation arrest were found in the groupl.The 3(9.7%) cases of Sertoli cell only syndrome and the 28(90.3%) cases of maturation arrest were found in the group2.The 28(44.4%) cases of Sertoli cell only syndrome and the 33(52.4%) cases of maturation arrest were found in the group3.The 46(33.1%) cases of Sertoli cell only syndrome and the 72(51.8%) cases of maturation arrest were found in the group4.The spermatozoa present positive rate in testicular biopsy was 9.4%.Significant differences were found among the four groups in testicular histology,serum FSH level(P<0.01),but not in testicular volume,serum LH level(P>0.05).Conclusion Different types of microdeletions would bring about different pathological alteration.The microdeletion of AZFa were mainly found in the Sertoli cell only syndrome in testicular biopsy,and the microdeletion of AZFb in the maturation arrest in testicular biopsy.The presence of AZFb/c/d or AZFc/d deletion were diversified and grouped mainly on the Sertoli cell only syndrome or maturation arrest in testicular biopsy.Spermatozoa present of testicular biopsy was lower in the patients with Y chromosome microdeletion.更多还原