阴囊皮瓣修复后局部温度变化对生精细胞凋亡的影响  

Effect of local temperature change on apoptosis of spermatogenic cells after scrotal reconstruction with skin flap

作　　者：王达利[1] 孙广峰[1] 崔红旺[1] 魏在荣[1] 李丽[1] 

机构地区：[1]遵义医学院附属医院烧伤整形外科,贵州遵义563003

出　　处：《第四军医大学学报》2009年第7期628-631,共4页Journal of the Fourth Military Medical University

基　　金：贵州省优秀科技教育人才省长专项基金(2005-65)

摘　　要：目的:探讨采用皮瓣重建阴囊后局部温度变化及其对生精细胞凋亡和生育能力的影响.方法:24只健康雄性新西兰大白兔随机分成重建组(皮瓣重建阴囊组)和对照组,每组12只.雌性12只用于配对试验.重建组建立皮瓣重建阴囊模型前采集精液进行计数,埋藏法测量阴囊内睾丸表面的温度,然后建立皮瓣重建阴囊模型.于重建阴囊第8周,重建组再次采集精液及测量阴囊内睾丸表面的温度,并随机取重建组及对照组各6只动物进行睾丸活检.应用原位末端标记(TUNEL)法检测生精细胞凋亡.将两组未行睾丸活检的各6只雄兔分别与雌兔配对喂养观察生育情况.结果:皮瓣重建阴囊后第8周睾丸表面温度明显高于皮瓣重建阴囊前的温度,精子计数明显低于阴囊重建前的精子计数(P<0.05).与对照组相比,重建组睾丸生精细胞凋亡指数显著升高(P<0.05).配对喂养结果显示,重建组没有生育,而对照组平均生育幼兔(6.0±1.3)只(P<0.05).结论:皮瓣重建阴囊后兔睾丸局部温度升高,睾丸的生精细胞过度凋亡,导致雄兔不育.皮瓣不宜被临床继续选用于重建阴囊.AIM： To explore the temperature change of testicular surface after scrotal reconstruction with skin flap and its effect on apoptosis of spermatogenie cells. METHODS： Twenty-four male New Zealand albino rabbits were randomly divided into reconstruction group （the group of scrotum reconstruction with flaps） and control group, with 12 rabbits in each group. Twelve female rabbits were used for mating experiment. The sperms were examined and the testicular surface temperature was measured in reconstruction group and the flap reconstruction scrotum models were then established. The data of sperm and temperature were obtained again in reconstruction group in the 8th weeks after scrotal reconstruction. The testes biopsy was performedrandomly for 6 rabbits in experiment group and in control group respectively. The apoptosis of spermatogenic cells was detected by TUNEL assay. In the 8th week after the scrotal reconstruction, matched-pair feed was performed in the other 6 rabbits in reconstruction group and in control group, respectively. RESULTS： The results showed that the testicular surface temperature was higher and the sperm count was lower significantly in reconstruction group than those in control group（ P 〈 0.05 ）. The apoptotic index of spermatogenic cells in reconstruction group was significantly higher than that in control group （ P 〈 0.05 ）. In the 8th week after the scrotal reconstruction, male and female matched-pair feed showed infertility in reconstruction group, while （6.0 ±1.3 ） rabbit babies were born in control group averagely （P 〈 0.05）. CONCLUSION： The testicular surface temperature increases after scrotal reconstruction with skin flaps and it leads to spermatogenic cell apoptosis and infertility. Skin flaps are not recommended for reconstruction of the scrotum.

关 键 词：重建阴囊 皮瓣 温度 生精细胞 细胞凋亡 

分 类 号：R699.8[医药卫生—泌尿科学] R691.6[医药卫生—外科学]