血清抑制素B水平对隐睾支持细胞功能评价的意义

The significance of serum inhibin B levels in evaluating the Sertoli cell function of cryptorchidism

目的探讨血清抑制素B水平评估隐睾支持细胞功能的价值。方法采用酶联免疫吸附试验（ELISA）检测2006年8月至2011年8月收治的672例隐睾患儿血清抑制素B水平。患儿年龄6～72个月，平均27.7个月。其中年龄6～24个月者385例，25～36个月者109例，37～72个月者178例。对照组为335例相应年龄段的体检儿童或包茎儿童，其中6～24个月者98例，25～36个月者101例，37～72个月者136例。单侧隐睾者505例（单侧隐睾组），双侧隐睾者106例（双侧隐睾组），单侧无睾丸者61例（单侧无睾丸组）。所有患儿术前采集血清标本，部分病例分别在睾丸下降术后6、12、18个月采集标本。分析比较各组间患儿血清抑制素B水平的差异及手术前后血清抑制素B水平的差异。结果各年龄段单侧隐睾组和双侧隐睾组的术前血清抑制素B水平明显低于对照组（均P〈0.05）；单侧无睾丸组血清抑制素B水平除6～24个月者[38.54 pg/ml（25.98，50.24）pg/ml]显著低于对照组[68.04 pg/ml （44.95，115.64） pg/ml，P〈0.05]外，其余年龄段与对照组比较差异均无统计学意义（均P〉0.05）；双侧隐睾组中6～24个月患儿的血清抑制素B水平[30.68 pg/ml（17.37，42.43）pg/ml]显著低于单侧隐睾组[45.91 pg/ml（30.98，69.70）pg/ml，P〈0.05]，其余年龄段与单侧隐睾组比较差异均无统计学意义（均P〉0.05）。136例睾丸下降固定术后6个月隐睾患儿的血清抑制素B水平[37.34 pg/ml（22.79，64.25）pg/ml]显著高于术前[30.48 pg/ml（16.56，50.08）pg/ml，P〈0.05]。单侧隐睾组和双侧隐睾组6～24个月患儿的血清抑制素B水平和睾丸容积间存在相关性（P〈0.05）。结论血清抑制素B水平可作为评估隐睾支持细胞功能的可靠指标，睾丸下降固定术有利于隐睾血清抑制素B水平的提高。

Objective To investigate the value of serum inhibin B in evaluating the Sertoli cell function in cryptorchidism children by the study of the correlation between the serum inhibin B levels and cryptorchidism.Methods From August 2006 to August 2011, 672 cryptorchidism aged from 6 to 72 months （mean age 27.7 months） were measured of serum inhibin B level by ELISA. Of those 672 boys, 505 were unilateral, 106 were bilateral and 61 were unilateral vanished testis. Three hundred and eighty-five cases aged 6 to 24 months, 109 cases aged 25 to 36 months and 178 cases aged 37 to 72 months. The control group consisted of 335 boys selected from physical examination or circumcision with corresponded age, 98 cases aged 6 to 24 months, 101 cases aged 25 to 36 months and 136 cases aged 37 to 72 months. The blood samples for serum inhibin B were taken from everyone and, in part of cases, 6 months, 12 months, 18 months postoperatively respectively. The comparision of serum inhibin B levels among the groups was done, and the correlation between serum inhibin B level and testicular volume was analyzed.Results Compared with the control group, the serum inhibin B levels of all groups with unilateral and bilateral cryptorchidism are lower significantly（P〈0.05）. No difference was found between the unilateral vanished testis and the control group（P〉0.05）, except those aged 6 to 24 months[38.54 pg/ml（25.98, 50.24）pg/ml vs.68.04 pg/ml （44.95, 115.64） pg/ml, P〈0.05]. For bilateral cases aged 6 to 24 months, the serum inhibin B level are significantly lower than that of unilateral cases[30.68 pg/ml（17.37, 42.43）pg/ml vs.45.91 pg/ml（30.98, 69.70）pg/ml, P〈0.05]. The serum inhibin B levels were significantly increased 6 months later in those who had undergone orchidopexy [37.34 pg/ml（22.79, 64.25）pg/ml vs. 30.48 pg/ml（16.56, 50.08）pg/ml, P〈0.05]. For boys with unilateral and bilateral cryptorchidism aged 6 to 24 months, inhibin B levels correlated positively with testicular volume（P〈0.05）.Conclusions The serum inhibin B level can be used as a reliable marker in evaluating the Sertoli cell function of cryptorchidism, and the orchidopexy had a positive impact on the serum levels of inhibin B.