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1、血清抑制素B在精索静脉曲张患者中的表达及手术前后的变化【中文摘要】目的:研究血清抑制素B在精索静脉曲张患者中的表达及精索静脉曲张手术前后的变化。方法:选取进湘雅医院就诊的左侧精索静脉曲张患者29例,其中度VC患者为A组18例,度V C患者为B组11例,并选择健康男性为C组(对照组)10例,对所有V C患者行腹腔镜下精索静脉高位结扎术,分别测定各组术前及术后3个月血清InhB、FSH、LH及*常规,分析它们的变化和相关性。血清抑制素B测定采用双抗体夹心ABC-ELISA法,FSH、LH、T采用电化学发光免疫测定法。不同组之间比较采用两样本t检验,两指标相互关系的分析采用相关性分析,同一组手术前后
2、比较采用配对t检验,以P0.05表示差异具有统计学意义。结果:1.术前A组(度VC)血清抑制素B为153.6920.19pg/ml,B组(度VC)血清抑制素B为142.6829.68pg/ml,均明显低于C组(正常对照组)262.0821.10pg/ml(分别为P0.01和NP0.01),而A组与B组之间血清抑制素B无明显差异(P=0.242)。2.所有精索静脉曲张患者血清抑制素B术前为149.5124.22pg/ml,术后三个月为175.6527.13pg/ml,差异有非常明显性(P0.01)。3.精索静脉曲张不育患者血清FSH术前为8.271.33mlU/ml,术后为8.141.33mIU
3、/ml,差异无明显性(P=0.109);血清LH术前为5.811.00mIU/ml,术后为5.701.01mIU/ml,差异无明显性(P=0.152);血清T术前为445.6695.94mIU/ml,术后为464.6897.54mIU/ml,差异有明显性(P0.05)。4.精索静脉曲张不育患者精子密度术前为15.002.73106/ml,术后为18.892.96106/ml,差异有非常明显性(P0.01)。5.精索静脉曲张不育患者血清抑制素B与FSH水平在术前及术后三个月均呈负相关关系(分别为r=-0.896,P0.01和r=-0.758,P0.01)。6.精索静脉曲张不育患者血清抑制素B与L
4、H水平在术前及术后三个月均无明显相关性(分别为r=-0.295,P=0.121和r=-0.311,P=0.101)。血清抑制素B与T水平在术前及术后三个月均无明显相关性(分别为r=0.347,P=0.065和r=0.231,P=0.227)。7.精索静脉曲张不育患者血清抑制素B与精子密度在术前及术后三个月呈正相关关系(分别为r=0.937,P0.01和r=0.899,P0.01)。结论:1.InhB可以作为一个较为敏感的指标来评价精索静脉曲张患者的生精功能,包括术前病情评估及术后判定预后。2.InhB可以协助体格检查,彩色多普勒超声检查等进步对精索静脉曲张进行临床分级的水平。3.InhB因其操
5、纵简便、创伤小、敏感性及特异性较高,值得推广应用。);【Abstract】 Objective:The Objective of this study was to examine the effect of varicocele treatment on the quality of spermatogenesis,as reflected by serum inhibinB levels,and to investigate the involvement of Sertoli cell-germ cell interaction in the pahtophysiological mec
6、hanism.Methods:Twenty nine consecutive patients present at XiangYa Hospital with varicocele who were complaining of infertility were included in the study. Varicocele was graded according to physical examination color-Doppler ultrasound.Eighteen gradeand eleven gradepatients were included in this st
7、udy.All patients were treated surgically by high spermatic vein ligation.Serum inhibinB,FSH,LH,T and sperm concentration were measured before and after operation.Ten unaffected adult male of age-matched were used as controls.Likewise Serum inhibinB,FSH,LH,T and sperm concentration were measured.And
8、thencalculated their changes and correlation.Use enzyme linked innunosorbent assay(ABC-ELISA) testing serum inhibinB level.Use radioimmunoassay to test serum FSH,LH,T level.To compare the endocrine and sperm concentration,Paired-Samples T test was used. Bivariate Correlation was used to calculate co
9、rrelations.And Independent-Samples T test was used when comparing the same indicator in two groups.Results:1.Before the varicocele operation,the serum inhibinB levels indegree patients is 153.6920.19pg/ml,indegree patients is 142.6829.68pg/ml,which are all higher than the serum inhibinB levels in th
10、e control group(P0.01 and P0.01).We can not observe significant difference of the serum inhibinB levels betweendegree patients anddegree patients(P=0.242)2.In all of the varicocele patients receiving varicocele operation,a significant increase in serum inhibinB levels was observed from 149.5124.22pg
11、/ml pretreatment to 175.6527.13pg/ml after treatment(P0.01).3.No significant changes were observed in serum levels of FSH and LH.A significant increase in serum T levels was observed from 445.6695.94mIU/ml pretreatment to 464.6897.54mIU/ml after treatment(P0.01).4.Semen analysis showed a significant
12、 improvement in sperm concentration,from 15.002.73106 /ml pretreatment to 18.892.96106/ml after treatment(P0.01).5.The serum inhibinB levels were inversely correlated with serum FSH levels both before and after treatment(r=-0.896,P0.01 and r=-0.758,P0.01). 6.The serum inhibinB levels were not signif
13、icant correlated with serum FSH,LH and T levels.7.The serum inhibinB levels were positive correlated with sperm concentration both before and after treatment(r=0.937,P0.01 and r=0.899,P0.01).Conclusions:Serum inhibinB can be as a sensitive marker,which can evaluate the fertility of patients with varicocele,including information pre- and after operation.Serum inhibinB is a sensitive and accurate marker and is easy to operate,so it could be used widely in chinic.
