生殖医学杂志

目的建立新疆地区成年男性不同年龄段血清FSH的正常参考区间。方法采集2018年1月至2019年6月在新疆佳音医院生殖中心体检正常的756名健康成年男性血清,按照年龄分为4组:20～29岁组(n=70)、30～39岁组(n=399)、40～49岁组(n=267)、50～56岁组(n=20),用美国贝克曼DXI 800全自动化学发光系统检测血清中FSH水平;按20～39岁、40～56岁分组进行分析检测结果,采用双侧限值P_2.5～P_97.5建立本地区成年男性FSH的参考区间。另外收集2019年1～6月就诊本中心的1 159例男性患者的血清FSH值和精液常规参数,分别用贝克曼DXI 800试剂说明书的FSH参考区间和本研究的FSH参考区间预测少精子症和无精子症,比较两组的敏感性、特异性和准确性。结果 FSH水平随年龄增长呈上升趋势,在20～39岁组及40～56岁组间差异有统计学意义(P<0.05),但20～29岁组与30～39岁组及40～49岁组与50～56岁组间差异无统计学意义。新疆地区20～39岁及40～56岁健康成年男性的FSH参考区间分别为(1.99～10.00)U/L和(2.67～14.33)U/L。参考区间的评估分析显示,使用本研究确立的FSH参考区间预测少精子症(46.90%vs. 23.89%)和无精子症(61.18%vs.36.17%)的敏感性比使用贝克曼FSH参考区间显著升高(P<0.05)。结论建立本实验室成年男性的血清FSH参考区间利于提高男科临床异常结果检出的敏感性,有助于以达到优化传统的参考区间、适应个性化医疗模式的目的。

Objective:To establish the normal reference interval of serum FSH in different age groups of adult men in Xinjiang.Methods:The sera of 756 healthy adult men were collected in the reproductive center of Xinjiang Jiayin hospital from January 2018 to June 2019. FSH level was detected with Beckman DXI 800 fully automated chemiluminescence system. The men were divided into 4 groups according to the age:20-29 years(n=70),30-39 years(n=399),40-49 years(n=267),and 50-56 years(n=20)groups. The FSH test levels were also analyzed between 20-39 years and 40-56 years groups. The FSH reference interval of adult men in Xinjiang was established by the two-sided limit P_2.5-P_97.5. In addition,the serum FSH values and semen routine parameters of 1 159 male patients who visited our center from January to June 2019 were collected. The reference interval of FSH in reagent specification of Beckman DXI 800 automatic immunoassay system and the reference interval established in this study were respectively used to predict oligozoospermia and azoospermia. The sensitivity,specificity and accuracy were compared between the two groups.Results:FSH level increased with the increase of age. There was a significant difference between the 20-39 and 40-56 year groups(P<0.05),but there was no significant difference between 20-29 year group and 30-39 year group,and between the 40-49 year group and the 50-56 year group. The FSH reference intervals of healthy adult men aged 20-39 and 40-56 in Xinjiang were established as(1.99-10.00)U/L and(2.67-14.33)U/L. The evaluation analysis of the reference interval showed that the sensitivity to predict oligozoospermia(46.90% vs. 23.89%)and azoospermia(61.18% vs. 36.17%)by using the reference interval established in this study was significantly higher than those of by using the reference interval of Beckman(P<0.05).Conclusions:The establishment of serum FSH reference interval of adult men in our laboratory is helpful to improve the sensitivity of detection of clinical abnormal results in andrology,to optimize the traditional reference interval and to adapt to the personalized medical model.