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目的:观察老年人睾丸间质细胞结构以及类固醇激素合成快速调节蛋白(steroidogenic acute regulatoryprotein,StAR)和胆固醇侧链裂解酶(cholesterol-side-chain cleavage enzyme,P450scc)蛋白表达的变化,以探讨迟发性性腺功能减退症的机制。方法:青年人(20～30岁)及老年人(70～90岁)睾丸标本各10例,对患者进行AMS(Aging Male’s Symptoms)评分。应用HE染色观察睾丸组织形态学变化,电子显微镜观察睾丸间质细胞的超微结构改变,Western blot法比较青年组和老年组睾丸组织中StAR和P450scc蛋白表达水平的差异,并用ELISA法检测其血清总睾酮水平的差异。结果:老年组AMS评分显著高于青年组(61.25±7.08 vs.20.75±3.73,P<0.001),且血清总睾酮水平显著低于青年组(3.12±0.58μg/L vs.6.29±1.17μg/L,P<0.05)。HE染色显示,老年人睾丸呈老年退行性改变,电子显微镜下观察到老年睾丸间质细胞线粒体肿胀,线粒体嵴消失。睾丸组织中StAR和P450scc蛋白表达水平显著低于青年组(P<0.05)。结论:老年人睾丸间质细胞结构、线粒体的损伤,以及StAR和P450scc蛋白表达水平的下降等病理变化均与老年人迟发性性腺功能减退症症状和血清总睾酮水平变化密切相关,其确切机制有待深入研究。
OBJECTIVE: To observe the changes of the structure of testicular stromal cells and the expression of steroidogenic acute regulatory protein (StAR) and cholesterol-side-chain cleavage enzyme (P450scc) Mechanisms of Hypogonadism. Methods: A total of 10 testis specimens were collected from young people (20-30 years) and seniors (70-90 years old), and AMS (Aging Male’s Symptoms) was scored. The morphological changes of testis were observed by HE staining. The ultrastructure changes of testicular stromal cells were observed by electron microscope. The differences of StAR and P450scc protein expression in testis between young group and old group were compared by Western blot. The serum levels of StAR and P450scc were detected by ELISA. Differences in total testosterone levels. Results: The AMS score in the elderly group was significantly higher than that in the youth group (61.25 ± 7.08 vs.20.75 ± 3.73, P <0.001), and the serum total testosterone level was significantly lower in the elderly group (3.12 ± 0.58μg / L vs.6.29 ± 1.17μg / L, P <0.05). Hematoxylin and eosin staining showed that the aged testicular showed degenerative changes in the elderly. The mitochondria swelling and mitochondrial cristae disappeared in the aged testicular stromal cells under the electron microscope. The levels of StAR and P450scc in testis were significantly lower than those in youth (P <0.05). CONCLUSION: Pathological changes of the testicular stromal cells in the elderly, mitochondrial damage, and the decrease of StAR and P450scc protein expression are closely related to the symptoms of delayed hypogonadism and serum total testosterone in the elderly. The exact mechanism To be further studied.