单侧睾丸扭转术后健侧睾丸功能的研究

Study on the compensative function of healthy testis following the testicular excision due to torsion

目的研究睾丸扭转患者术前和术后不同时间性激素、抑制素B及精液参数的动态变化,探讨健侧睾丸的损伤与修复代偿功能。方法10例睾丸扭转患者(16～45岁),睾丸扭转病程3～6d,平均4.7d;左侧9例,右侧1例,术中探查示患侧睾丸坏死,全部行患侧睾丸切除。全自动化学发光法检测血清中FSH、LH、T的值;ELISA法定量检测患者血清中抑制素INHB的浓度;WLJY-9000分析精液参数。结果INHB水平在术后3周水平最低,12周时恢复正常,术前与术后3周、6周之间有显著差异;术后26周血LH和INHB水平相对术后6周时显著升高;精液常规检测示,术后3周时精液中精子数、精子活率、精子活力较正常标准明显降低,12周时有好转,26周时基本恢复正常;FSH与INHB呈显著负相关P<0.05,R=-0.900,INHB与精子数量及精子存活率呈显著正相关P<0.01,R=1.000。结论睾丸扭转者患侧睾丸切除后,健侧睾丸有一个损伤和修复的过程;血清INHB和T变化是睾丸功能的敏感指标,能较准确地反映睾丸损伤和修复程度。

Objective To investigate the compensative function of healthy testis following the testicular excision due to torsion. Methods Ten patients with single acute testicular torsion, were investigated with the written consent forms. The course of disease was 3-6 （mean 4.7）days.All patients received the operations to remove the damaged testis.Before and after operation, the serum inhibin B（INHB） were measured with ELISA, and FSH, LH, T were measured with Chemoluminescence autoanalyzer. Seminal fluid was analyzed by WLJY-9000. Results After testicular torsion and operation, the level of INHB was lowest at the 3rd week,then recoverd to normal at the 12th week. There was a significant deviation between preoperative and the 3rd week or the 6th week after operation. The level of LH and INHB in the 26th week has elevated significantly comparing to the 6th week. The spermatozoa and the motility rate was obviously lower at the 3th week, improved at 12th week, then recoverd to normal at the 26th week. FSH and INHB were significant negative correlated （P〈0.05, R=-0.900）. The spermatozoa and their motility were positive correlated with INHB （P〈0.01 R=1.000）. Conclusion The healthy testicle suffered from the process of injures. The change of INHB had a intimate relationship with the injury of the testis, which reflected the functional degree of testicular injury in the patients after operation. INHB is a useful tool for monitoring testicular function and reproduction.