抑制素B在青春期前精索静脉曲张患者睾丸功能评价中的作用  

Inhibin B level helps evaluate the testicular function of prepubertal patients with varicocele

作　　者：牛晓兵[1] 唐静[1] 王恒兵[1] 阎莉[1] 张春艳[1] 王功成[1] 梁健 窦晓予 傅广波[1] NIU Xiao-bing;TANG Jing;WANG Heng-bing;YAN Li;ZHANG Chun-yan;WANG Gong-cheng;LIANG Jian;DOU Xiao-yu;FU Guang-bo(Department of Urology, Huai＇an First People＇s Hospital of Nanjing Medical University, Huai＇an, Jiangsu 223300, Chin)

机构地区：[1]南京医科大学附属淮安第一医院泌尿外科,江苏淮安223300

出　　处：《中华男科学杂志》2018年第7期618-621,共4页National Journal of Andrology

基　　金：江苏省"333工程"科研项目(BRA2017241);淮安市临床专项资助项目(HAS2015014);南京医科大学科技发展基金项目(2014NJMU030)~~

摘　　要：目的:研究青春期前精索静脉曲张患者手术前后血清中抑制素B(INHB)的变化在睾丸功能评价中的作用。方法:31例青春期前患者,年龄9~14岁,平均12.6岁。所有患者确诊为左侧精索静脉曲张,其中合并右侧精索静脉曲张9例。所有患者行患侧精索内静脉高位结扎术。分别采用酶联免疫法检测术前、术后4周、12周和26周外周血及术中精索内静脉血中卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T),抗精子抗体(As Ab)及INHB。结果:外周血中INHB术前[(255.18±69.97)pg/ml]与术后12周[(141.78±59.83)pg/ml]及26周[(128.69±46.32)pg/ml]相比有显著性差异(P<0.05),术中精索内静脉血清INHB水平[(412.41±259.42)pg/ml]与术前外周血相比差异有显著性(P<0.01)。FSH术前、术后12周、26周分别为[(4.07±1.08)IU/L]、[(4.86±0.88)IU/L]、[(4.89±1.59)IU/L],呈上升趋势(P<0.05),相关性分析显示INHB与FSH呈负相关(r=-0.224,P<0.01)。结论:青春期前精索静脉曲张患者精索静脉高位结扎术后6个月内外周血中INHB水平呈下降趋势,与FSH呈负相关,联合检测INHB和FSH能较好的反映青春期前精索静脉曲张患者睾丸功能状态。Objective： To investigate the role of the serum inhibin B（ INHB） level in evaluating the testicular function of the prepubertal patient with varicocele（ VC） after high ligation of the spermatic vein（ HLSV）. Methods： This study included 31 prepubertal male patients with left VC,averaging 12. 55 years of age and 9 complicated by right VC. We collected peripheral blood samples before and at 4,12 and 26 weeks after HLSV as well as spermatic venous blood samples intraoperatively for determination of the levels of follicle-stimulating hormone（ FSH）,luteinizing hormone（ LH）,testosterone（ T）,anti-sperm antibody（ As Ab） and serum INHB by ELISA. Results： Compared with the baseline,statistically significant differences were observed in the INHB level in the peripheral blood at 12 and 26 weeks after operation（ [255. 18 ± 69. 97] vs [141. 78 ± 59. 82] pg/ml,P〈0. 05） and that in the spermatic venous blood intraoperatively（ [255. 18 ± 69. 97] vs [412. 44 ± 259. 42] pg/ml,P〈0. 01）. Spearman ＇s analysis showed a negative correlation between the level of INHB and that of FSH（ r =-0. 224,P〈0. 01）. Conclusion： The level of serum INHB in the peripheral blood of the prepubertal VC patient is decreased within 6 months after HLSV and negatively correlated with that of FSH. The levels of INHB and FSH may well reflect the testicular function of the prepubertal VC patient.

关 键 词：精索静脉曲张 抑制素B 青春期前 

分 类 号：R697.24[医药卫生—泌尿科学]