隐睾患儿手术前后血中性激素的变化

Blood sex hormone levels in children with cryptorchidis before and after cryptorchidopexy

目的 探讨丘脑 垂体 睾丸轴与隐睾症的关系。 方法 采用放射免疫法对 40例隐睾患儿术前、术后外周静脉血清睾酮 (T)、5α 双氢睾酮 (5α DHT)、雌二醇 (E2 )、黄体生成素 (LH)、卵泡刺激素 (FSH )和催乳素 (PRL)进行测定 ,并与 2 4例正常儿童进行比较。 结果 隐睾症患儿术前组血清T、5α DHT值明显低于正常儿童 (P <0 .0 5 ) ,而E2 、LH均显著升高 (P <0 .0 5 ) ,FSH升高则更明显 (P <0 .0 1) ,PRL在两组间比较差别无显著性意义 (P >0 0 5 )。睾丸固定术后 3～ 6个月内血清T、5α DHT较术前组明显上升 (P <0 .0 5 ,P <0 .0 1) ,而血清E2 、FSH则低于术前组 ,差别有非常显著性意义 (P均 <0 .0 1)。手术前后LH、PRL差别无显著性意义 (P均 >0 0 5 )。 结论 下丘脑 垂体 睾丸轴的激素分泌调节功能紊乱可能是影响睾丸正常下降和正常发育的重要因素。早期行睾丸固定术有利于睾丸功能恢复 ,睾丸固定术最好在 2周岁前进行。

Objective To study the relationship betwwen the hypothalamic-pituitary-testicular (HPT)axis and the cryptorchidism and the significance of surgical treatment for children with cryptorchidism. Methods The levels of serum T、5α-DHT、E 2、LH、FSH and PRL were measured in 40 children with cryptorchidism both before and after operation and in 24 normal children by radioimmunoassay (RIA). Results The serum levels of T and 5α-DHT in cryptorchids before operation were lower compared with the controls ( P < 0.05 ), but E 2,LH and FSH were higher in cryptorchids( P < 0.05 , P < 0.01 ).The serum levels of T、FSH and 5α-DHT increased significantly in 3～6 months after operation, whereas E 2 decreased significantly. Conclusions It is likely that severe dysfunction of the hypothalamic-pituitary-testicular axis,and sever damage of testicular structure are the main causes of cryptorchids. It is believed that cryptorchidopexy benifit the restoring of testicular struture and function. It should be undertaken at the age of 2 years.