抑制素B在评估男性睾丸生精功能方面的研究进展

抑制素B主要由睾丸内Sertoli细胞分泌并对成年男性促卵泡激素(FSH)分泌起负反馈作用,抑制素B的分泌调节受年龄、体重指数的影响,血清抑制素-B水平与睾丸体积、精子总数显著相关,血清抑制素-B测定可用于评价男性不育病人的生精功能,能有效确定唯支持细胞综合征,可作为监测男性生殖系统疾病影响生精功能效应的指标。     

血清抑制素B与睾丸生精功能

目的　探讨血清抑制素B与睾丸生精功能的关系。方法　将男性不育症病人分为原发性无精子症、严重少精子症和梗阻性无精子症 3组 ,另设正常对照组 ,分别测定其抑制素B、FSH及精子密度。结果　上述 4组的抑制素B浓度分别为 4 7.36± 32 .85 ,2 0 0 .92± 86 .4 4 ,2 82 .4 0± 98.2 1,2 36 .79± 10 7.70。结论　血清抑制素B可直接反映睾丸的生精功能状态 ,因而是判断男性生育力更有效的指标     

无精子症患者睾丸组织病理分型与血清抑制素B关系的研究

目的:探讨无精子症患者睾丸组织病理分型与血清抑制素B(INH B)水平间的关系,了解血清INH B在评估无精子症患者睾丸生精功能状态的敏感性和特异性。方法:对83例无精子症患者进行睾丸活组织病理检查诊断,根据病理形态的不同分为:唯支持细胞综合征组(n=21)、生精功能低下组(n=20)、生精阻滞组(n=24)和生精功能基本正常组(n=18)。患者睾丸活检前分别测定其血清INH B、卵泡刺激素(FSH)、黄体生成素(LH)及睾酮(T)水平。结果:上述4组血清INH B水平分别为(20.85±18.78)、(67.25±40.98)、(73.63±25.54)和(149.48±27.92)ng/m l。INH B水平在生精阻滞组与生精功能低下组之间差异无显著性(P>0.05),其他各组间以及与上述两组血清INH B水平间差异均有极显著性(P<0.001);FSH水平在生精阻滞组与基本正常组间差异无显著性(P>0.05),其他各组间以及与上述两组血清FSH水平间差异均有显著性(P<0.05);4组血清LH及T水平之间无相关性。结论:血清INH B水平在生精小管生精功能受损时明显降低,唯支持细胞综合征者下降最为显著。血清INH B水平可直接反映睾丸生精功能的总体状态,是判断无精子症患者睾丸生精功能更有效的诊断指标。     

抑制素B与精索静脉曲张关系的研究进展

抑制素B主要由睾丸支持细胞合成的可特异性地抑制垂体FSH合成与分泌的一种糖蛋白激素,与生精功能密切相关。精索静脉曲张指精索内蔓状静脉丛的异常迂曲、扩张,可以引起睾丸生精功能障碍,是导致男性不育常见的病因。越来越多的证据表明,血清抑制素B水平与精索静脉曲张程度呈负相关,检测血清抑制素B水平能评估精索静脉曲张患者生精功能的损害程度,并可预测精索静脉曲张术后的疗效,在精索静脉曲张疾病的诊疗中有潜在的应用价值。     

不育男性血清和精浆抑制素B水平与生精功能的关系

目的探讨血清和精浆抑制素B(INH-B)与睾丸生精功能的关系。方法回顾性分析2015年1~6月来深圳中山泌尿外科医院生殖医学中心就诊的141例男性不育症患者资料。根据精液参数分为5组:精子浓度正常组(A组,43例)、轻中度少精子症组(B组,40例)、重度少精子症组(C组,27例)、梗阻性无精子症组(OA组,9例)和非梗阻性无精子症组(NOA组,22例);NOA组中有17例患者接受睾丸细针精子抽吸术(TESA)取精,根据TESA结果分为成功组(13例)和失败组(4例)。比较各组的精液参数(精子总数、浓度及活动力),测定其血清和精浆INH-B水平及血清FSH、LH、T、E_2、泌乳素(PRL)、孕酮(P)的水平,分析血清性激素、INH-B与精液质量之间的关系。结果 A、B组的睾丸总体积显著高于OA和NOA组(P0.05)。C组和NOA组的血清INH-B显著低于A组和OA组,A组的精浆INH-B浓度显著高于C组、OA组和NOA组(P均0.05)。不同生精功能男性的血清INH-B与血清FSH、LH及PRL呈负相关,与血清T和精浆INH-B呈正相关(P均0.05);精浆INH-B与血清FSH和LH呈负相关(P0.05)。A、B、C组中血清和精浆INH-B与总精子数呈低度正相关(P0.01)。NOA组中血清INH-B与睾丸总体积呈高度正相关,与血清FSH和LH呈负相关(P均0.01);精浆INH-B与血清FSH呈极弱负相关(P0.05)。TESA取精成功组的睾丸总体积和血清INH-B显著高于TESA失败组,血清FSH和LH则显著低于TESA失败组(P均0.01)。结论血清和精浆INH-B与血清性激素、总精子数具有一定相关性,可作为评估男性生精功能的参考。无精子症中尤其是NOA患者,血清INH-B可以评估睾丸生精状态、鉴别诊断无精子症、预测取精结局。     

抑制素B与男性生殖的研究进展

抑制素B是直接由睾丸分泌的二聚体糖蛋白激素,对多种外源性激素起反应。血清抑制素B水平受年龄、睾丸体积、青春期发生时间、标本采集时间、不同人群等多种因素影响。抑制素B能直接反映睾丸的精子发生,可作为临床评价男性生育力的重要指标。抑制素B的检测在男性不育病因诊断和监测放、化疗对男性生精功能的损伤及儿童隐睾症、精索静脉曲张治疗疗效评估方面有其应用价值。在辅助生殖技术中,抑制素B的检测对睾丸精子抽吸的结果有预测作用。     

Ⅲ度精索静脉曲张患者显微结扎术后生精功能的变化

目的：研究Ⅲ度精索静脉曲张显微结扎术后生精功能的变化,以探讨手术的价值.方法：选择Ⅲ度精索静脉曲张并男性不育患者118例,观察其显微结扎术前后睾丸体积、精子密度、活率、形态、血清卵泡刺激素（FSH）、睾酮（T）及抑制素B浓度的变化.结果：患者手术6个月后的左侧睾丸体积（P〈0.05）、精子密度（P〈0.01）及活率（P〈0.05）均明显提高,血清FSH水平明显降低（P〈0.05）,T（P〈0.01）及抑制素B（P〈0.05）水平明显提高.而睾丸体积及精子形态无显著变化.结论：显微结扎术能改善Ⅲ度精索静脉曲张患者的生精功能.     

抑制素B对非梗阻性无精子症病人睾丸精子获取成功的预测

目的探讨抑制素B对非梗阻性无精子症病人睾丸精子获取成功的预测价值。方法选择非梗阻性无精子症病人28例,梗阻性无精子症病人16例和精液指标正常者19例,测定其抑制素B、FSH水平及睾丸体积,并对非梗阻性无精子症病人行睾丸精子获取术(TESE)。结果非梗阻性无精子症病人中TESE成功者9例,其抑制素B水平显著高于19例17ESE未成功者(P<0．05),两者的。FSH水平和睾丸体积差异无显著性(P>0．05);抑制素B受试者作业特征曲线下面积显著大于FSH和睾丸体积的受试者作业特征曲线下面积(P< 0．01)。结论抑制素B是预测非梗阻性无精子症病人睾丸精子获取成功的有效指标。     

体外X-射线照射对小鼠生精功能影响的研究

目的探讨体外X-射线对小鼠生精功能的影响及抑制素B在睾丸生精功能损伤筛查中的地位和作用。方法将10～12周的ICR雄性小鼠50只,随机分为5组照射后2d组、7d组、21d组、42d组和对照组,每组10只。实验组小鼠予以X-射线3．5Gy单剂量快速照射睾丸,分别于照射后2、7、21和42d测定血清抑制素B值及性激素值,同时电镜观察生精细胞及支持细胞线粒体形态与功能情况。结果2d组,电镜下可发现各生精细胞及支持细胞的结构与功能受到了损害；7d组血清抑制素B值开始下降；21d和42d组血清抑制素B值都进一步下降,而血清FSH水平于X-射线照射后21d才开始上升,42d组电镜下线粒体形态有所恢复。结论X-射线照射睾丸可引起生精细胞及支持细胞的损伤,线粒体是细胞内最易受损伤的一个敏感细胞器,对X-射线损伤有一定的恢复能力。抑制素B是一个能早期反映生精功能受损的血清指标。     

无精子症、少精子症患者精浆和血清中抑制素B水平测定

抑制素是由睾丸的Leydig和Sertoli细胞产生的调节生殖内分泌与评估男性生殖功能的一个重要的激素[1].我们采用ELISA法对无精子、少精子症患者的精浆和血清中的抑制素B进行检测,以进一步了解抑制素B水平与男性生殖功能的关系.     

Serum levels of inhibin B in men with different causes of spermatogenic failure

Inhibin B appears to be the physiological feedback signal for FSH. Herein the determination of serum levels of inhibin B, FSH, LH and testosterone in 148 infertile patients and their association with clinical findings and seminal parameters are reported. A significant negative correlation of FSH and inhibin B (r = -0.60) was found. LH levels showed a significant inverse correlation (r = 0.37), but a weak regression (c0 = 0.01). No correlation with testosterone levels occurred. A significantly positive correlation was observed between testis volume and inhibin levels (r = 0.39) as well as between sperm count and inhibin levels (r = 0.39). To evaluate whether the secretion of inhibin B depends on the nature of damage to the Sertoli cells, inhibin levels in 23 patients with varicocele; eight after cryptorchidism, and 16 after hemiorchiectomy were compared to those of other patients without these diseases, but identical sperm count. No significant differences were found. In 20 men undergoing testicular biopsy, inhibin levels were compared to histology. Although the men with Sertoli-cell-only syndrome had significantly lower levels ((15.83 +/- 12.2) pg ml-1) than those with normal spermatogenesis ((183.8 +/- 112.3) pg ml-1), a distinction between patients with hypospermatogenesis from those with normal spermatogenesis was not possible on the basis of inhibin levels. Between these groups, the distinction was better achieved by the FSH levels (sensitivity of 85%). We conclude that inhibin B levels are a serum marker of Sertoli cell function, but the prediction of the quality of spermatogenesis is not superior to that of FSH levels.     

Serum inhibin pro alphaC in infertile men.

Specific assays have been developed for bioactive inhibin dimers, inhibin A and B, and inhibin alpha-subunit precursor pro alphaC. To better understand the role of serum inhibin pro alphaC in infertile men, the authors measured these forms of inhibin in sera from 39 infertile men and analyzed inhibin relationships with serum gonadotropins, testosterone, and estradiol. All subjects had oligozoospermia. Inhibin A levels were undetectable in all subjects. Inhibin B concentrations were 117 +/- 59 pg/mL. Inhibit B concentrations correlated negatively with serum FSH (r = .584, p < .0001) and positively with sperm count (p < .01) and bilateral testicular volume (r = .607, p < .0001). The concentration of pro alphaC was 556 +/- 236 pg/mL (normal range, 446 +/- 28). Inhibin pro alphaC showed no correlation with serum FSH, LH, testosterone, sperm concentration, and bilateral testicular volume. In addition, inhibin pro alphaC was not correlated with inhibin B. Pro alphaC is unlikely to be a useful marker for spermatogenesis in infertile men compared with inhibin B.     

Serum inhibin B as a marker for spermatogenesis

Inhibin B generated by Sertoli cells provides negative feedback on FSH secretion. In men, inhibin B seems to be the physiologically important form of inhibin. Serum inhibin B was measured by two-site immunoenzymatic assay in 40 normal men (27 years of age) with sperm concentrations 100 +/- 9.2 x 10(6)/mL, 51 subfertile men (31 years of age) with sperm concentrations 6.8 +/- 0.8 x 10(6)/mL, 16 men with varicocele with sperm concentrations 54.3 +/- 0.8 x 10(6)/mL (31 years of age), men with hypogonadotrophic hypogonadism, men with Klinefelter syndrome, and men with obstructive and non-obstructive azoospermia. In men with normal sperm concentrations (>20 x 10(6) mL) serum inhibin B was 201 +/- 17 pg/mL and FSH 4 +/- 0.5 IU/L. Varicocele patients showed normal sperm concentrations > 20 x 10(6)/mL, normal serum inhibin B (173 +/- 21 pg/mL), and normal FSH levels (4.6 +/- 0.6 IU/L). In patients with sperm concentrations < 20 x 10(6)/mL the inhibin B level was 118 +/- 14 pg/mL and the FSH level was 10 +/- 1.1 IU/L. In all patients, except those with hypogonadotrophic hypogonadism and Klinefelter syndrome. inhibin B and FSH were inversely correlated (r = -.41, p > 0.01). There was a positive correlation between inhibin B and sperm concentrations (r = .34, p < .01). In varicocele men there was a correlation of r = .574, p < .05. Inhibin B may be a marker of exocrine testicular function and may offer an improved diagnosis of testicular dysfunction.     

Can serum Inhibin B and FSH levels, testicular histology and volume predict the outcome of testicular sperm extraction in patients with non-obstructive azoospermia?

Introduction In our study, we evaluated the diagnostic accuracy of serum follicle stimulating hormone (FSH), Inhibin B, testicular volumes and distribution of testicular sperm extraction (TESE) outcome according to the histological diagnosis in men with non-obstructive azoospermia. Materials and methods Between February 2001 and April 2002, 66 men presenting with infertility of at least 1 year were found to have non-obstructive azoospermia. Serum FSH and Inhibin B levels, testicular volumes and pathological analysis were reviewed retrospectively using medical records of these patients. Results Of 66 patients, 52 were enrolled into the study and sperm extraction was successful in 31 of 52 patients (59.6%). There was no statistically significant difference between the patients who had successful and unsuccessful TESE in terms of mean serum Inhibin B, FSH levels and testicular volumes (P > 0.05). The area under ROC analysis for serum Inhibin, serum FSH and testicular volume was 0.557, 0.523 and 0.479, respectively. For Inhibin B, the best cut-off value for discriminating between successful and failed TESE at 90% sensitivity was 6.25 with a very low level of specificity (14%) and diagnostic accuracy that was 53.8. Conclusion Besides the controversies about the direct marker role of serum Inhibin B in determination of spermatogenesis, it does not seem to give a clue about the prediction of sperm presence before TESE. Because of the conflicting results in the literature, the potential role of serum Inhibin B as a marker for prediction of sperm presence in testis is yet to be determined.     

Possible relationship between seminal plasma inhibin B and spermatogenesis in patients with azoospermia

Inhibin B is bidirectionally secreted by Sertoli cells, basal secretion into the circulation exerts negative feedback on follicle-stimulating hormone secretion, and serum inhibin B is considered a marker of spermatogenesis. The precise role of apical secretion is unknown. The objective of our work was to study the relationship between seminal inhibin B and spermatogenesis. Dimeric inhibin B was measured by immunoassay in seminal plasma of volunteers with normozoospermia (n = 10, group 1), in men after vasectomy (n = 10, group 2), and in men with azoospermia (n = 50, group 3). Testicular biopsy and testicular sperm extraction were performed in men with azoospermia. Seminal inhibin B levels were higher in men in group 1 than in men in groups 2 and 3 (P <.0001). In seminal plasma, inhibin B presents a positive correlation with alpha glucosidase activity (r =.37, P =.002). Seminal inhibin B is inversely related with serum FSH (r = -.58, P <.001), and presents a weak positive correlation with serum testosterone concentration (r =.29, P =.03). No difference was found between inhibin B levels in seminal plasma of patients with nonobstructive or obstructive azoospermia, and between positive or negative outcome of TESE. We conclude that inhibin B secretion by Sertoli cells is differentially regulated. The contribution of accessory sex glands limits the use of seminal plasma inhibin B as a marker of spermatogenesis.     

生育及不育男性血清及精浆抑制素-B水平分析

目的 :探讨生育及不育男性血清及精浆抑制素 B(inhibinB ,INHB)水平是否存在差异 ,了解血清及精浆INHB水平与精子发生的关系。　方法 :生育组 (n =2 0 )、少精子症组 (n =2 0 )、弱精子症组 (n =2 2 )和非阻塞性无精子症 (NOA)组 (n =2 0 )男性于上午 8∶0 0～ 10∶0 0留取精液和血液标本 ,进行精液常规分析 ,血清INHB、FSH、LH、T含量 ,精浆INHB、酸性磷酸酶、果糖、α 葡糖苷酶含量和活性测定。　结果 :血清、精浆INHB水平与血FSH均呈显著负相关 (r =- 0 .5 36 ,P <0 .0 0 1vsr =- 0 .2 88,P =0 .0 1) ,血清、精浆INHB水平与精子密度均呈显著正相关 (r=0 .49,P <0 .0 0 1vsr =0 .48,P <0 .0 0 1) ,血清INHB水平在生育组男性与少精子症组、NOA组男性间(分别为P <0 .0 5和P <0 .0 1)、弱精子症组与NOA组男性间 (P <0 .0 1)及少精子症组与NOA组男性间 (P <0 .0 5 )差异均有显著性 ,而精浆INHB变动范围较大 ,其水平仅在生育组男性与NOA组男性间及弱精子症组与NOA组男性间差异有显著性 (分别为P <0 .0 1和P <0 .0 5 )。精浆INHB水平与精浆α 葡糖苷酶活性呈正相关 (r=0 .377,P =0 .0 0 1)。血清INHB水平与精浆INHB水平间无相关性。　结论 :血清、精浆INHB水平均可反映睾丸的精子发生情况 ,精浆INHB水平还与     

Differential regulation of inhibin subunits by germ cells in human testes

Inhibin B is comprised of two dissimilar disulfide-linked subunits, termed alpha and betaB, and is physiologically more important than inhibin A in the male. The aim of this study was to investigate testicular expression of inhibin subtypes in infertile men to uncover any interaction between Sertoli cells and germ cells. Ten azoospermic patients with Sertoli cell only syndrome (SCO) and 39 oligozoospermic men were included in this study. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone concentrations were determined by chemiluminescence assays. The serum concentrations of inhibin B were measured by enzyme-linked immunosorbent assay. Immunohistochemical staining for the alpha-subunit, betaA-subunit, and betaB-subunit of inhibin were performed on testicular biopsy specimens. The results were that serum inhibin B was undetectable in azoospermic men with SCO, while it was 133.8 +/- 82.0 pg/ml in oligozoospermic men. There was little expression of betaA in the testes of any patient. Expression of inhibin alpha and betaB was observed in Sertoli cells. The percentage of Sertoli cells expressing inhibin alpha was similar in azoospermic patients with SCO (55.3% +/- 20.6%) and in oligozoospermic patients (42.8% +/- 30.4%). In contrast, expression of betaB in Sertoli cells of azoospermic patients (24.9% +/- 16.8%) was lower than in oligozoospermic men (43.4% +/- 25.5%: P = 0.0308). There are no significant correlations between testicular expression of inhibin betaB and the serum inhibin B concentrations. The expression of inhibin betaB by Sertoli cells is dependent on the coexistence of spermatogenic activity within these seminiferous tubules, explaining why the level of inhibin B is low in patients with SCO.     

腹腔镜经腹腹膜前修补术对睾丸血供及生精功能影响的临床研究

目的 观察腹经腹腹膜前修补术对睾丸血供及生精功能影响。方法 2017年6月~2019年1月,收集在医院行腹腔镜经腹腹膜前修补术患者,共41例,比较其术前、术后7天、术后6月精子浓度、精子活力、血清卵泡刺激素（FSH）、血清抑制素B（IHN-B）、睾丸体积、睾丸动脉收缩期峰值血液流速（PSV）的差异。结果 与术前相比,术后7天及术后6月精子浓度、精子活力、血清卵泡刺激素、血清抑制素B、睾丸体积均无明显差异,而PSV在术后6天较术前有明显降低,差异有统计学意义,而术后6个月差异无统计学意义。术后血肿、手术时间延长是术后睾丸血供异常的风险因素。结论 经腹腹膜前修补术对睾丸生精功能无显著影响。