实验性大鼠单侧睾丸扭转术后双侧睾丸生精功能的评估

Spermatogenesis function evaluation of bilateral testes in experimental rats after unilateral testicular torsion operation

目的评估大鼠单侧睾丸扭转术后双侧睾丸生精功能。方法雄性SD大鼠32只,随机分成4组,第1组为假手术组;第2组为2 h扭转/复位组;第3组为12 h扭转/复位组;第4组为12 h扭转/切除组,建立不同时间段720°单侧睾丸扭转动物模型。术后30 d留取双侧睾丸称重。应用流式细胞术(FCM)检测各组生精细胞凋亡和各群生精细胞百分比。结果随着扭转时间延长,术后第2、3组患侧睾丸重量明显下降,睾丸组织正常细胞群百分比降低,早/晚期凋亡细胞群和坏死细胞群百分比增高,与第1组相比,其差异均有显著性(P<0.05);第2组对侧睾丸重量、正常细胞群百分比与第1组相比无显著差异(P>0.05),但早/晚期凋亡细胞群、坏死细胞群百分比与第1组相比有明显差异(P<0.05),呈现损伤后修复过程表现;第3组对侧睾丸重量下降,与第1组相比,差异有显著性(P<0.05);第3、4组对侧睾丸组织中正常细胞群、早/晚期凋亡细胞群、坏死细胞群百分比与第1组相比有明显差异(P<0.05);第4组切除患侧睾丸后,对侧睾丸组织中正常细胞群、早/晚期凋亡细胞群、坏死细胞群百分比与第3组相比有明显差异(P<0.05)。结论短时间(2 h)单侧睾丸扭转/手术复位后对两侧睾丸生精功能均有损伤,该损伤可能持续较长时间,但两侧睾丸生精功能特别是对侧可逐渐恢复,手术复位能够带来更大益处;长时间(12 h)单侧睾丸扭转/手术复位后对两侧睾丸生精功能可能产生难以恢复的损伤;如果长时间扭转导致患侧睾丸血供不能恢复,应及时切除患侧睾丸以保护对侧睾丸生精功能。

Objective To evaluate the spermatogenesis functions of bilateral testes in rats after unilateral testicular torsion operation.Methods Total of 32 male Sprague⁃Dawley rats were randomly divided into four groups,and 8 rats in each group.For the rats in Group 1:a sham operation to the left testis was performed.For the rats in Group 2 and Group 3:I/R injury was created by rotating the left testis 720°in a clockwise direction for 2 h or 12 h then detorsion.For the rats in Group 4:the left testis rotated 720°for 12 h was performed through incision respectively.On 30 days after operation,the bilateral testes were collected and weighted,and their normal and apoptotic cells proportion were analyzed by the flow cytometry(FCM).Results Torsion/detorsion can significantly decreased the weight of ipsilateral testis and the percentage of normal cells,but increased the percentage of apoptotic cells and necrotic cells in Group 2 and Group 3.There were significant differences in the above indicators between Group 1 and Group 2/3(P<0.05).There were no 62 Chinese Journal of Andrology Vol.38 No.22024 significant differences in the weight or the percentage of normal cells of contralateral testis between Group 2 and Group 1(P>0.05),but significant differences in the percentage of apoptotic cells and necrotic cells(P<0.05).The weight of contralateral testis was lower in Group 3 than that in Group 1(P<0.05).There were also significant changes in the percentage of normal cells,apoptotic cells and necrotic cells between Group 3/4 and Group 1(P<0.05).Compared with Group 3,the orchiectomy treatment in Group 4 increased the percentage of normal cells and decreased the percentage of apoptotic cells and necrotic cells(P<0.05).Conclusion The short⁃time(2 h)testicular torsion/detorsion induce a continuous spermatogenesis damage for bilateral testis,but the spermatogenesis functions of bilateral testis,especially contralateral testis,can be gradually recovered.Therefore,surgical detorsion can provide even greater benefits.The long⁃time(12 h)testicular torsion/detorsion perhaps cause an unrecoverable injury to the bilateral testis.Whenever the torsional testis necrosis occurs definitely,the orchiectomy has beneficial effects against contralateral testis injury probably.