苗勒管抑制物质在尿道下裂发病中的作用

The role of mullerian inhibiting substance in the development of hypospadias

目的探讨苗勒管抑制物质（MIS）在尿道下裂发病中的作用。方法分别检测54例单纯型尿道下裂及36例无泌尿生殖系统疾病儿童血清苗勒管抑制物质、睾酮及雄烯二酮的水平。结果尿道下裂组和对照组儿童的血清MIS平均值分别为（122．0±21．7）ng／ml和（80．5±11．4）ng／ml，P〈0．01。对照组儿童血清睾酮为（1．55±0．42）pg／ml，尿道下裂组儿童为（0．64±0．31）pg／ml，P〈0．05。对照组儿童血清雄烯二酮的水平明显高于尿道下裂组儿童，分别为（1．41±0．28）ng／ml和（0．66±0．19）ng／ml，P〈0．01。尿道下裂儿童较高的MIS水平和较低的睾酮水平呈较弱的负相关。结论尿道下裂儿童血清苗勒管抑制物质的水平与睾酮水平呈负相关，苗勒管抑制物质可能通过抑制睾酮的合成进而在尿道下裂的发病中发挥作用。

Objective To explore the role of mullerian inhibiting substance in the development of male hypospadias. Methods Fifty-four isolated hypospadias patients and 36 patients which suffered from other diseases were chosen as our research objects. Of the hypospadias patients, there were 11 patients were less than 12 months,24 patients from 13 to 24 months,and 19 patients from 25 to 36 months. Serum mullerian inhibiting substance, testosterone, and androstenedione were assayed, respectively. And the differences of the testosterone and mullerian inhibiting substance between these two groups were compared. Results The concentration of mullerian inhibiting substance in hypospadias group （122.0 ±21.7 ng/ml） was significantly higher than that in control group （80.5±11.4 ng/ ml）. While the concentrations of testosterone and androstenedione in hypospadias group were significandy lower than those in control group. Furthermore, these two groups were divided into 3 subgroups according to their age. The concentrations of testosterone and androstenedione in hypospadias group whose age was less than 12 months and 13 to 24 months were significantly lower than those in control group. And the higher concentration of mullerian inhibiting substance was negatively related to the lower concentration of testosterone in hypospadias patients, and the relative coefficient was negative 0.31 and 0. 42, respectively. Conclusions Mullerian inhibiting substance may inhibit the synthesization of testosterone. Mullerian inhibiting substance plays a part in the development of hypospadias.