无精子症患者外周血和睾丸组织睾酮、雄激素受体、热休克蛋白90水平的变化

Contents of testosterone,testosterone receptor,and heat shock protein 90 in the peripheral blood and testicular tissue of azoospermia patients

目的探讨无精子症患者外周血及睾丸组织睾酮(T)、雄激素受体(AR)、热休克蛋白90(HSP90)水平的相关性。方法选择45例无精子症患者,测量其静脉血促卵泡激素(FSH)、促黄体生成素(LH)、T、AR、HSP90水平;行睾丸穿刺,获取生精小管观察有无精子,之后磨碎、离心后获取上清液,测量上清液T、AR、HSP90的含量。按睾丸穿刺结果和血FSH值分为A(睾丸穿刺有精子,FSH<8IU/L)、B(睾丸穿刺无精子,FSH<8IU/L)、C(睾丸穿刺无精子,FSH>8IU/L)3组,比较3组间外周血和睾丸组织T、AR、HSP90水平,分析FSH、LH、T、AR、HSP90间的相关性。结果 3组间比较,外周血AR(P=0.026)、HSP90(P=0.019),睾丸组织T(P=0.006)、AR(P=0.047)差异有统计学意义,而外周血T和睾丸组织HSP90水平差异无统计学意义。相关性分析表明:FSH与外周血HSP90(r=0.729,P=0.001)、睾丸组织T(r=0.722,P=0.002)正相关;LH与外周血(r=0.629,P=0.012)和睾丸组织(r=0.610,P=0.016)T均正相关;外周血T与外周血AR(r=-0.665,P=0.005)负相关,而睾丸组织T与睾丸组织AR(r=0.544,P=0.029)正相关;外周血(r=0.559,P=0.042)和睾丸组织(r=0.803,P=0.000)AR与其相应的HSP90正相关。结论睾丸体积正常的无精子症患者外周血HSP90、AR浓度升高,反馈作用于FSH和LH,睾丸内T和AR逐渐升高,HSP90变化不明显。

Objective To explore the association of testosterone（T）,testosterone receptor（AR）,and heat shock protein90（HSP90）levels in the peripheral blood with those in the testicular tissue of azoospermia patients.Methods A total of 45 azoospermia patients were selected in this study.Their blood levels of luteotropic hormone（LH）,follicle-stimulating hormone（FSH）,T,AR,and HSP90 were measured.The testicular tissues were biopsied to observe the presence of sperm under microscope.Then the biopsied tissues were ground,centrifuged to obtain the supernatant,which was then subjected to detection of T,AR,and HSP90 levels.According to the biopsied results and FSH value,the patients were divided into three groups：group A（had sperm,FSH〈8 IU/L）,B（no sperm,FSH〈8 IU/L）,and C（no sperm,FSH〉8 IU/L）.The blood and testicular levels of T,AR,and HSP90 were compared between the three groups,and the relationship between FSH,LH,T,AR,and HSP90 levels was analyzed.Results There were significant differences between the three groups regarding the levels of AR（F=5.478,P=0.026）and HSP90（F=5.972,P=0.019）in the blood samples,and levels of T（F=6.757,P=0.006）and AR（F=4.988,P=0.047）in the testis tissue samples.We also found that FSH level was positively correlated with blood HSP90level（r=0.729,P=0.001）and testicular T level（r=0.722,P=0.002）;LH level was positively correlated with blood（r=0.629,P=0.012）level and testicular T levels（r=0.610,P=0.016）;blood T level was negatively correlated with blood AR level（r=-0.665,P=0.005）while testicular T level was positively correlated with testicular AR level（r=0.544,P=0.029）;and blood（r=0.559,P=0.042）and testicular（r=0.803,P=0.000）AR levels were positively correlated with their corresponding HSP90 levels.Conclusion Azoospermia patients with normal testicular volume have increased blood HSP90 andAR levels,and it has a feedback effect upon FSH and LH levels,with gradually increased testicular T and AR levels and unchanged HSP90 level.