大鼠单侧精索扭转后保留同侧坏死睾丸对对侧睾丸和附睾的组织学影响  

Histological effects of unilateral spermatic cord torsion without removal of the ipsilateral necrotic testis on the contralateral testis in rats

作　　者：文焰林[1] 邓显忠[2] 杨正伟[3] 王安果[1] 张宗平[1] 伍季[1] 姜滔[1] 唐硕[1] 蔡运林[1] 李云祥[1] 范俊[1] 

机构地区：[1]川北医学院第二临床学院泌尿外科,四川南充637000 [2]川北医学院附属医院泌尿外科,四川南充637000 [3]川北医学院形态定量研究室,四川南充637000

出　　处：《中华男科学杂志》2013年第7期604-611,共8页National Journal of Andrology

摘　　要：目的:将大鼠单侧精索持续扭转96 h,研究保留扭转侧坏死睾丸对对侧睾丸和附睾的影响,以说明延迟性的睾丸切除是否对对侧睾丸功能有保护作用。方法:将33只青春前期(21～42日龄)正常雄性SD大鼠,随机分为假手术对照组(n=11)、扭转保留组(n=12)和扭转切除组(n=10)。假手术对照组只对左侧睾丸行睾丸肉膜囊固定术,后两组扭转实验组用睾丸肉膜囊固定术固定维持扭转720°的睾丸、附睾,在扭转96 h后将扭转保留组扭转侧睾丸、附睾行复位及固定,而同时扭转切除组则将扭转侧睾丸、附睾切除。术后3个月抽取血液标本,ELISA测定大鼠血清睾酮、抗精子抗体浓度。同时取睾丸、附睾标本,石蜡包埋切片后作组织学观察,并利用体视学方法定量研究睾丸、附睾结构的体积以及生精小管直径。结果:3组大鼠血清睾酮值无统计学差异;仅扭转保留组造模后1例大鼠血清抗精子抗体阳性。光镜下定性观察发现精索扭转组睾丸间质细胞核较假手术对照组间质细胞核增大,假手术对照组、扭转保留组和扭转切除组睾丸结构有明显形态改变的数量分别为1、3、0只。扭转保留组对侧睾丸相对假手术对照组睾丸体积增加19%,相应附睾体积增加11%,扭转切除组对侧睾丸体积增加21%,附睾体积增加7%,且睾丸代偿性肥大具有统计学意义(P<0.05)。假手术对照组、扭转保留组和扭转切除组对侧睾丸生精小管体积分别为(1.15±0.07)、(1.30±0.04)、(1.35±0.05)cm3,3组间无显著性差异。3组大鼠对侧睾丸内间质体积分别为(0.25±0.02)、(0.36±0.02)、(0.34±0.03)cm3,精索扭转组和假手术对照组相比显著增加(P<0.05)。3组大鼠对侧睾丸内生精小管直径分别为(226.00±7.00)、(223.00±6.00)、(221.00±3.00)μm,无显著性差异(P>0.05)。结论:单侧精索长期扭转后对侧睾丸、附睾主要改变是单侧去势后的对侧代偿性肥大表现,是否切除对对侧Objective ： To investigate the protective effect of retarded removal of the unilateral necrotic testis after long-time （ 〉24 h） spermatic cord torsion on the contralateral testis in rats. Methods： Thirty-three male SD rats aged 21 -42 days were divided into a sham-operation group （n = 11 ）, a torsion-reservation group （n = 12 ） and a torsion-orchiectomy group （n = 10）. The rats of the sham-operation group received dartos pouch orchidopexy on the left testis, while those of the latter two groups underwent 720~ unilateral spermatic cord torsion on the left side. Ninety-six hours later, the rats of the torsion-reservation group received detorsion with the ipsi- lateral testis preserved, while those of the torsion-orchiectomy group underwent orchiectomy. Three months after operation, blood sam- ples were obtained from the rats for measurement of serum testosterone and antisperm antibodies by ELISA, and meanwhile testes and epididymides were harvested for determination of the volumes of various structures and the diameter of seminiferous tubules with stereo- logical methods. Results ： There were no significant differences in the level of serum testosterone among the three groups. Anti-sperm antibody positive was found in only 1 animal in the torsion-reservation group. The Leydig cell nuclei in the contralateral testis appeared larger in the torsion groups than in the sham-operation group. Marked morphological changes were observed in 1,3 and 0 of the animals in the sham-operation, torsion-reservation and torsion-orchiectomy group, respectively, mainly including atrophy of seminiferous tubules and reduced number of spermatogenic ceils. The volume of the contralateral testis was increased by 19% and 21% in the torsion-reser- vation and torsion-orchiectomy group, respectively, in comparison with that in the sham-operation group （ P 〈 0.05 ）. No significant differences were observed in the volume of seminiferous tubules of the contralateral testis among the sham-operation, torsion-reservation

关 键 词：精索扭转 睾丸切除 体视学 睾丸 附睾 组织学 大鼠 

分 类 号：R699[医药卫生—泌尿科学]