早产新生儿与足月儿睾丸及附睾形态变化分析

Analysis of testis development and epididymal morphology in preterm and term newborns

目的探讨不同胎龄新生儿睾丸与附睾形态变化,为临床早期诊断新生儿睾丸及附睾疾病提供参考。方法选取2016年10月至2018年3月郑州大学第一附属医院新生儿科住院的456例不同胎龄的出生7 d的男性早期新生儿,均为适于胎龄儿,其中早产儿224例,足月儿232例;胎龄27~41+6周[(36.18±3.13)周];出生体质量0.90~3.82 kg[(2.66±0.67) kg]。采用超声诊断仪测量并计算新生儿双侧睾丸容积及附睾头长,附睾头、体、尾厚度。结果早产儿组的睾丸容积为(0.24±0.07) mL,早产儿组附睾头长、头、体、尾厚分别为(4.17±0.59) mm、(2.58±0.39) mm、(1.78±0.26) mm、(1.91±0.24) mm;足月儿组的睾丸容积为(0.38±0.13) mL,足月儿组附睾头长、头、体、尾厚分别为(4.49±0.45) mm、(2.78±0.34) mm、(1.95±0.20) mm、(1.99±0.16) mm;早产儿睾丸容积及附睾头长、头、体、尾厚均小于足月儿,2组间比较差异均有统计学意义(t=12.810、8.261、6.819、8.058、3.591,均P<0.001)。新生儿睾丸容积与胎龄、出生体质量、身长呈正相关(r=0.538、0.591、0.533,均P<0.001)。早产儿纠正胎龄≥37周时睾丸容积及附睾头长,头、体、尾厚与足月儿比较差异无统计学意义(t=1.561、0.863、0.282、1.732、1.147,均P>0.05)。结论早期新生儿睾丸容积、附睾头长、头厚、体厚随着胎龄、出生体质量、身长增大而增长,早产儿至纠正胎龄37周时其生殖系统发育水平可追赶至足月儿水平,若未能追赶则应定期随诊,特别关注。

Objective To explore the testis development and epididymis in the preterm and term newborns so as to provide the scientific evidence for early clinical diagnosing early. Methods From October 2016 to March 2018, 456 hospitalized neonates at Department of Neonatology, the First Affiliated Hospital of Zhengzhou University were recruited within 7 days at birth in this study.In these patients, 224 cases were preterm newborns and 232 cases were term newborns.These gestational ages of newborns at birth were (36.18±3.13) weeks (27-41+ 6 weeks) and weighted (2.66±0.67) kg(0.90-3.82 kg). The size of the testis and epididymis were measured by ultrasonography. Results The mean testicular volume of the preterm was (0.24±0.07) mL.The mean length of epididymal head, thickness of epididymal head and body and tail of the preterm newborns were (4.17±0.59) mm,(2.58±0.39) mm,(1.78±0.26) mm,(1.91±0.24) mm, respectively.The mean testicular volume of the term newborns was (0.38±0.13) mL, the mean length of epididymal head, thickness of epididymal head and body and tail of the term newborns were (4.49±0.45) mm,(2.78±0.34) mm,(1.95±0.20) mm,(1.99±0.16) mm, respectively.The mean testi-cular volume, length of epididymal head, thickness of epididymal head and body and tail of the preterm newborns were significantly lower compared with the term newborns (t=12.810, 8.261, 6.819, 8.058, 3.591, all P<0.001). The mean testicular volume of the newborns were highly linear positively correlated with gestational age, birth weight and birth length (r=0.538, 0.591, 0.533, all P<0.001). In the preterm newborns at postmenstrual age (PMA) of 37 weeks, the mean testicular volume, length of epididymal head, thickness of epididymal head and body and tail of the preterm newborns had no significant difference between the 2 groups (t=1.561, 0.863, 0.282, 1.732, 1.147, all P>0.05). Conclusions The testicular volume, the length of epididymal head, thickness of epididymal head and body increase with gestational age, birth weight and birth length in early neonates.The growth of reproductive system in the preterm newborns at PMA 37 weeks catch-up with term newborns.If this catch-up growth was incomplete at PMA 37 weeks, special attention should be given to monitor underlying diseases.