胰岛素样因子3用于青少年精索静脉曲张评估

Feasibility Study of Insulin Like Factor 3 in Evaluation of Adolescent Juvenile Varicocele

目的:探讨胰岛素样因子3(INSL-3)应用于青少年精索静脉曲张评估的可行性。方法:将80例青少年精索静脉曲张患者作为阳性组,另外纳入80例健康青少年志愿者作为正常对照组,对比分析两组左侧睾丸体积,睾丸萎缩指数(AI)、血清促卵泡激素(FSH)、黄体生成素(LH)、睾酮(T)、精液量、精子密度、精子活力(a+b)、正常形态精子率及INSL-3等参数,统计分析阳性组和对照组在INSL-3表达是否存在差异,分析INSL-3与其他检测指标的相关性。结果:和对照组比较,阳性组左侧睾丸体积、睾丸萎缩指数显著偏小(P<0.05)。阳性组血清促卵泡激素(6.21±2.41)IU/L、黄体生成素(6.02±1.47)IU/L、睾酮(7.87±1.66)μg/L显著升高;而精液量(2.86±1.19)mL、精子密度(60.77±35.97)M/mL、精子活力(a+b)(29.14±16.77)%和正常形态精子率(60.31±18.66)%明显降低(P<0.05);INSL-3水平(259.6±30.7)pg/mL明显下降(P<0.01);INSL-3的浓度与精子活力(a+b)和正常形态精子率显著相关(P<0.05)。结论:血清INSL-3水平与青少年精索静脉曲张紧密相关,相比于常规指标与疾病的相关性更强,有望用于青少年精索静脉曲张的诊断和干预。

Objective To study the feasibility of insulin like factor 3 （INSL-3） in evaluation of adolescent juvenile varicocele. Methods Eighty cases of ado- lescent varicocele patients were admitted to positive group, while 80 healthy young volunteers were admit-ted to normal control group. The left testicular volume, testicular atrophy index （AI）, serum follicle stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone （T）, semen volume, sperm density, sperm motility （a＋b）, normal sperm morphology and INSL-3 were compared between two groups. The difference of INSL-3 expression between two groups was statistically analyzed. The correlation between INSL-3 and other indexes was analyzed. Results Compared with the control group, patients in positive group had smaller left testicular volume and tes- ticular atrophy index. For positive group, serum follicle stimulating hormone （6.21±2.41） IU/L, luteinizing hor- mone （6.02±1.47） IU/L and testosterone （7.87±1.66） μg/L increased significantly, but semen volume （2.86±1.19） mL, sperm density （60.77±35.97） M/mL, sperm motility （a＋b） （29.14±16.77） % and the normal form of sperm （60.31±18.66） % were significantly decreased （P 〈 0.05）. INSL-3 levels （259.6±30.7） pg/mL were significantly decreased （P 〈 0.01）. The concentration of INSL-3 correlated with sperm motility （a＋b） and normal morphologi- cal sperm rate. Conclusion Serum INSL-3 levels are closely related to juvenile varicocele, and can be used for the diagnosis and intervention of juvenile varicocele.