单侧睾丸扭转/复位致对侧睾丸损伤机制的超声造影研究  

Contrast-enhanced ultrasound study of mechanism of unilateral testicular torsion and detorsion on injury of contralateral testes

作　　者：陈林[1,2] 刘振华[1] 詹维伟[1] 芮文斌[3] 陈曼[1] 周建桥[1] 姚洁洁[1] 朱樱[1] 汪欣[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声医学科,上海200025 [2]复旦大学附属华东医院超声医学科,上海200040 [3]上海交通大学医学院附属瑞金医院泌尿外科,上海200025

出　　处：《上海交通大学学报（医学版）》2010年第9期1028-1034,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科委自然科学基金(09411963400)~~

摘　　要：目的探讨单侧睾丸扭转/复位致对侧睾丸损伤的机制。方法 15只雄性家兔随机分为对照组、扭转组和扭转/复位组,每组5只。每组均进行3次实时超声造影后获取对侧睾丸标本,分析对侧睾丸超声造影时间—强度曲线参数、病理学改变(形态学观察和细胞凋亡指数计算)和生化指标变化。结果①单侧睾丸扭转后即刻,对侧睾丸灌注强度增加,表现为强度增量(EI)升高(P<0.05);②复位后对侧睾丸灌注时间明显延长,主要表现为廓清时间(WT)延长(P<0.05);③扭转及复位后均导致生殖细胞凋亡指数增加(P<0.05),并且复位后比单纯扭转凋亡指数增加更为明显(P<0.01);④扭转及复位均导致睾丸组织一氧化氮(NO)含量、一氧化氮合酶(NOS)活力和超氧化物歧化酶(SOD)活力降低,丙二醛(MDA)含量升高,并且复位后的影响更为明显(P<0.01)。结论扭转侧睾丸扭转/复位时缺血-再灌注损伤因子与对侧睾丸的灌注增加共同导致了对侧睾丸的损伤,并且对侧睾丸的灌注增加可能使损伤进一步加重。Objective To explore the mechanism of unilateral testicular torsion and detorsion on injury of contralateral testes injury with contrast-enhanced ultrasound.Methods Fifteen male New Zealand white rabbits were randomly divided into control group,torsion group,and torsion and detorsion group,with 5 rabbits in each group.Contralateral testis samples were obtained after three times of real-time ultrasound visualization in each group,and parameters of time-intensity curves,pathological changes and biochemical parameters of contralateral testes were analysed.Results ①The perfusion intensity of contralateral testes increased immediately after unilateral testicular torsion,and were characterised by the increase of enhancing intensity （EI）（P0.05）.②The perfusion time of contralateral testes significantly increased after detorsion,and mainly presented as increased washout time （WT）（P0.05）.③Apoptotic indexes （AI） of reproductive cells significantly increased after torsion or detorsion （P0.05）,and AI after detorsion were significantly higher than those after torsion （P0.01）.④Both torsion and detorsion decreased content of nitrogen monoxidum （NO）,activity of nitricoxide synthase （NOS） and superoxide dismutase （SOD）,and increased content of malondialdehyde （MDA）,and were more significant after detorsion （P0.01）.Conclusion The injury of contralateral testes with unilateral testicular torsion may results from ischemia-reperfusion injury factors of ipsilateral testes and blood perfusion enhancement of contralateral testes together.

关 键 词：超声检查 睾丸扭转 缺血-再灌注 兔 

分 类 号：R697.22[医药卫生—泌尿科学] R-332[医药卫生—外科学]