不育男性外周血T、AR、HSP 90表达及其对睾丸生精功能的影响

The impact of spermatogenesis by T,AR and HSP 90 of venous blood of sterility man

目的探讨不育男性外周血睾酮(T)、雄激素受体(AR)、热休克蛋白90(HSP 90)的表达及其对睾丸生精功能的影响。方法选择105例患者,其中正常精子30例,严重少精子症30例,无精子症45例,抽取外周静脉血,采用化学发光法测量促卵泡激素(FSH)、促黄体生成素(LH)、T浓度;采用ELISA法测量AR、HSP 90浓度,采用输精管分离钳钝性分离技术行睾丸活检。根据精液结果和睾丸穿刺有无精子以及FSH值分为A(正常精子)、B(严重少精子症)、C(无精子症,睾丸穿刺有精子,FSH 8 IU·L-1)、D(无精子症,睾丸穿刺无精子,FSH 8IU·L-1)、E(无精子症,睾丸穿刺无精子,FSH>8I U·L-1)5组,比较5组间FSH、LH、T、AR、HSP 90的差异性,分析T、AR、HSP 90的变化趋势。结果 FSH的E组高于A、B、C、D 4组(P<0.05);T的A组较B、C 2组高(P<0.05),B组较E组低(P<0.05);AR的A组高于B、C、D、E 4组(P<0.05),B组高于C、D、E 3组(P<0.05),C、D2组较E组低(P<0.05);HSP90的A组较B、C 2组高(P<0.05),较D、E 2组低(P<0.05),B组较A、C、D、E 4组低(P<0.05),C组较D、E 2组低(P<0.05),D组较E组低(P<0.05)。T的A组最高,B组最低,B、C、D、E 4组渐次升高;AR的A、B、C 3组渐次降低,而C、D、E 3组渐次升高,A组最高,C组最低;HSP90的B、C、D、E 4组渐次升高,E组最高,B组最低。结论睾丸体积正常的无精子症患者,随着睾丸精子生成能力的下降,外周血T、AR、HSP90呈现先下降再升高的趋势,且三种指标的变化趋势基本一致。

Objective To explore the impact of spermatogenesis by testosterone（ T）,androgen receptor（ AR） and heat shock protein（ HSP 90） of venous blood of sterility man. Methods Total of 105 patients were recruited in the study,30 of them had normal sperm,30 of them had severity oligozoospermia,45 of them had no sperm. Their venous blood samples were collected and the concentrations of serum FSH,LH,T,AR,HSP 90 were measured. Meanwhile their testes were biopsied and testicular was observed by microscope weather had sperm or not.The samples were divided into 5 groups based on the semen quality and biopsied results and FSH level,such as group A（ had normal sperm）,B（ had severity oligozoospermia）,C（ azoospermia,but testicular had sperm,FSH 8 IU·L- 1）,D（ azoospermia,testicular also no sperm,FSH 8IU·L- 1） and E（ azoospermia,testicular also no sperm,FSH 8 IU·L- 1）,and their correlations were analyzed. Results The FSH of group E was significant highest among the 5 groups（ P〈0. 05）,and the T of group A was higher than groups B,C（ P〈0. 05）,group B was lower than those in groups E（ P〈0. 05）,and the AR of group A was the highest among the 5 groups（ P〈0. 05）,group B was higher than those in group C,D,E（ P〈0. 05）,group C,D were lower than those in group E（ P〈0. 05）,and the HSP 90 of group A was higher than those in group B,C（ P〈0. 05）,was lower than those in group D,E（ P〈0. 05）,the group B was the lowest among the 5 groups（ P〈0. 05）,the group E was the highest among the 5 groups（ P〈0. 05）. Conclusion The T,AR,HSP90 are declined firstly,after then they were risen accompanied the declining off of the spermatogenesis in the patients with normal volume testicular.