高位隐睾睾丸病理及血清性激素水平的改变及意义

Pathological change and serum sex hormone levels in boys with high positioned impalpable testes

目的探讨高位隐睾睾丸病理及血清性激素水平的改变及意义。方法选取高位隐睾患者28例，分为1～2岁组（12例，14侧）和2～10岁组（16例，18侧）；另择同期收治的14例男性腹股沟斜疝及16例包茎患儿作为对照组。年龄1～10岁。观察高位隐睾患者的睾丸大体及组织病理改变。同时测定术前1周及术后3～6个月的血清睾酮（T）、雌二醇（E2）、卵泡激素（FSH）水平，与对照组进行比较分析。结果2～10岁组隐睾发育较1～2岁组差，附睾畸形多，病理改变重。血清性激素水平：隐睾组患儿术前血清T水平明显低于对照组，血清E2、FSH水平明显高于对照组，差异均有统计学意义（均P〈0．05）；术后血清T及巳水平与对照组比无明显差异（P〉0.05），仅FSH水平明显高于对照组（P〈0．05）。与术前比较，隐睾组患儿术后血清T、E2、FSH水平均明显改变，差异均有统计学意义（均P〈0．05）。结论高位隐睾患儿2岁后睾丸组织结构出现变化，随年龄增长病理改变趋于严重。手术治疗后患儿血清性激素水平有改善，提示2岁以内手术为佳。

Objective To investigate the pathology changes and serum sexual hormones levels in high position cryp- torchidism. Methods Twenty-eight children with high cryptorchidism were enrolled, including 12 boys （14 sides） were aged 1-2y and 16 boys （18 sides） aged 2-10y. Pathological changes were examined in cryptorchidism patients and serum sexual hormone levels were assayed in 28 cryptorchidism patients, 14 boys with indirect inguinal hernia and 16 boys with phimosis, the latter two groups were used as controls. Results Macroscopic and microscopic examination revealed that the development of cryptorchidism was poorer in 2-10y group than that in 1-2y group, and more abnormality of epididymis was observed in 2-10y group. Serum T level in the cryptorchidism group was significantly lower than that in the control group, while serum E2 and FSH levels were significantly higher than those in the control group （P〈0.05）. Serum E2, FSH and T levels of cryptorchidism patients were changed significantly （P〈0.05） after operation. The postoperative FSH level was still higher than that of control group （P〈 0.05）; while there were no differences in postoperative serum E2 and T levels between cryptorchidism and control groups （P 〉 0.05）. Conclusion Pathological changes of high cryptorchidism become increasingly severe after the age of 2. Blood sexual hormone levels change significantly after surgery. These results indicated that surgical operation should be performed before the age of 2 for children with cryptorchidism.