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目的研究睾丸扭转患者术前和术后不同时间性激素、抑制素B及精液参数的动态变化,探讨健侧睾丸的损伤与修复代偿功能。方法10例睾丸扭转患者(16～45岁),睾丸扭转病程3～6d,平均4.7d;左侧9例,右侧1例,术中探查示患侧睾丸坏死,全部行患侧睾丸切除。全自动化学发光法检测血清中FSH、LH、T的值;ELISA法定量检测患者血清中抑制素INHB的浓度;WLJY-9000分析精液参数。结果INHB水平在术后3周水平最低,12周时恢复正常,术前与术后3周、6周之间有显著差异;术后26周血LH和INHB水平相对术后6周时显著升高;精液常规检测示,术后3周时精液中精子数、精子活率、精子活力较正常标准明显降低,12周时有好转,26周时基本恢复正常;FSH与INHB呈显著负相关P<0.05,R=-0.900,INHB与精子数量及精子存活率呈显著正相关P<0.01,R=1.000。结论睾丸扭转者患侧睾丸切除后,健侧睾丸有一个损伤和修复的过程;血清INHB和T变化是睾丸功能的敏感指标,能较准确地反映睾丸损伤和修复程度。
Objective To study the dynamic changes of sex hormones, inhibin B and semen parameters before and after operation in patients with testicular torsion, and to explore the damage and repair compensatory function of contralateral testis. Methods Twenty patients with testicular torsion (16-45 years old) were enrolled in this study. The course of testicular torsion was 3-6 days (mean 4.7 days). Nine cases were left and one was right. One case of testicular necrosis was found during operation. The levels of FSH, LH and T in serum were detected by automatic chemiluminescence method. The concentrations of inhibin INHB in serum were detected by ELISA. The parameters of semen were analyzed by WLJY-9000. Results The level of INHB was the lowest at 3 weeks after operation and returned to normal at 12 weeks. There was a significant difference between preoperative and postoperative 3 weeks and 6 weeks. The levels of serum LH and INHB at 26 weeks after operation were significantly higher than those at 6 weeks after operation Sperm motility and sperm motility were significantly lower than those of the normal standard at 3 weeks after operation and improved after 12 weeks and returned to normal at 26 weeks. There was a significant negative correlation between FSH and INHB (P <0.05) <0.05, R = -0.900. There was a significant positive correlation between INHB and sperm count and sperm viability (P <0.01, R = 1.000). Conclusion The contralateral testis in testis torsion has an injury and repair process. The changes of serum INHB and T are sensitive indicators of testicular function, which can accurately reflect the degree of testicular injury and repair.