【摘要】：目的:探索尿促性腺素(HMG)聯(lián)合絨促性腺素(hCG)的扳機作用對于不明原因的非梗阻性無精子癥患者的治療是否有效。方法:回顧性分析2010年1月至2017年5月間在貴州省婦幼保健院就診的282例不明原因的非梗阻性無精子癥患者資料,扳機治療方法為每例患者第1周和第2周進行HMG每次75 IU肌肉注射,每周3次。第3周和第4周hCG每次2 000 IU肌肉注射,每周2次,并結合維生素E、左卡尼汀、他莫昔芬口服輔助治療,治療3個月至1年。結果:接受治療的282例非梗阻性無精子癥患者,27例未完成治療而失訪,完成治療的255例患者治療后精液中發(fā)現(xiàn)有精子的58例,均為嚴重少弱精子癥,其中47例接受輔助生殖技術助孕,2例失訪,女方獲得臨床妊娠18例;其余197例治療后精液檢查中未發(fā)現(xiàn)有精子,其中25例行附睪或睪丸穿刺活檢,有6例發(fā)現(xiàn)精子,均接受輔助生殖助孕,女方獲得臨床妊娠3例。共64例精液中或附睪、睪丸穿刺發(fā)現(xiàn)精子,有效率25.1%。結論:HMG聯(lián)合hCG藥物扳機治療結合口服藥物輔助治療對不明原因的非梗阻性無精子癥有一定效果。
[Abstract]:Aim: to investigate the efficacy of (HMG) combined with chorionic gonadotropin (hCG) in the treatment of unexplained non-obstructive azoospermia. Methods: the data of 282 patients with non-obstructive azoospermia from January 2010 to May 2017 in Guizhou Provincial Maternal and Child Health Hospital were retrospectively analyzed. Trigger therapy was performed by 75 IU intramuscular injection of HMG at week 1 and week 2 in each patient, three times a week. At week 3 and week 4, hCG was injected intramuscularly with 2 000 IU twice a week, combined with vitamin E, levacarnitine and tamoxifen oral adjuvant therapy for 3 months to 1 year. Results: 282 patients with non-obstructive azoospermia received treatment and 27 patients lost their spermatozoa without complete treatment. After treatment, 58 patients with spermatozoa were found to have spermatozoa, all of them were severe oligozoospermia. Among them, 47 cases received assisted reproductive technique and 2 cases lost pregnancy, 18 cases were clinically pregnant, the remaining 197 cases did not find sperm in semen examination after treatment, 25 cases received epididymal or testicular puncture biopsy, and 6 cases found spermatozoa. All of them received assisted reproductive aid, and 3 cases of clinical pregnancy were obtained. In 64 cases of semen or epididymis, spermatozoa were found by testicular puncture, the effective rate was 25.1g. Conclusion the combination of hCG and hCG combined with oral drug adjuvant therapy has certain effect on non-obstructive azoospermia with unknown cause.
【作者單位】： 貴州省婦幼保健院(貴陽市婦幼保健院)輔助生殖科;中信湘雅生殖與遺傳�？漆t(yī)院精子庫;
【基金】：貴州省科技計劃項目(黔科合LH字[2014]7312號)~~
【分類號】：R698.2

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