西地那非对大鼠单侧睾丸扭转后对侧睾丸的影响及作用研究

目的 探讨大鼠单侧睾丸扭转后对侧睾丸的损伤以及西地那非（万艾可）的保护机理.方法 将72只健康雄性SD大鼠,随机分为假手术组、安慰剂组、西地那非组.3组分别在假手术/左侧睾丸扭转复位术后4 h、24 h、2周时,各组各处死8只大鼠.分别观察右侧睾丸组织病理学变化、测定右侧睾丸组织中MDA、NO/NOS含量.结果 术后4 h,各组间组织病理学变化、MDA、NOS含量无明显差异,睾丸组织未见损伤,但NO在两地那非组较假手术组、安慰剂组明显增加（P〈0.05）.术后24 h,假手术组右侧睾丸组织损伤最小,西地那非组较严重,安慰剂组最为严重;与假手术组比,其余两组MDA、NO/NOS含量明显升高（P〈0.05）;西地那非组NO/NOS含量与安慰剂组相比明显下降（P〈0.05）;术后2周时,睾丸组织损伤有不同程度恢复,但仍以安慰剂组最为严重;与假手术组比,其余两组MDA、NO/NOS含量仍然升高（P〈0.05）;西地那非组NO/NOS含量与安慰剂组相比明显下降（P〈0.05）.结论 大鼠单侧睾丸扭转复位后,对侧睾丸组织术后4 h时.睾丸组织未见损伤.12 h后睾丸组织明显损伤,并且持续至2周后.早期应用适量西地那非（万艾可）可促局部NO增加,扩血管作用加强,拮抗交感神经缩血管作用,进而保护对侧睾丸.

Effects of Sildenafil on rat's testicular function of the contralateral testicular after the unilateral Testicular Torsion/Detorsion

Objective To study the injury of the contralateral testicular after after unilateral testicular torsion in prepubertal rats, and the protective effects of Sildenafil against the injury of contralateral testicular spermatogenic function after unilateral testicular torsion. Methods 72 prepubertal Sprague-Dawley rats were divided randomly into three groups（ n = 24） ：sham-operation group, saline group and Sidenafil group. All the rats except sham-operation group underwent torsion/detorsion operation that rotated left testicle 720° clockwise and kept in torsion for 4 hours. All the rats except sham-operation group received corresponding drug orally before anesthesia. In all groups, The right （contralateral） testicle were removed from each groups （ n = 8 ） 4 hours,24 hours and 2 weeks respectively after the operation for histopathological analysis as well as the test of malondialdehyde （MDA） and NO/NOS levels. Results 4 hours after the operation： the histopathological change of testes, MDA and NOS levels were not statistically different among three groups. However, the NO level has a obviously increase in Sildenafil group than other two groups （ P 〈 0.05 ）. 24 hours after the opera- tion： in the saline （placebo）group, histopathological change of testes were much worse than sham-operation group and Sidenafil group . However, compared with the sham-operation group, the test levels of MDA and NO/NOS were statistically higher in saline group and Sidenafil group （ P 〈 0.05 ）. in those two groups, saline group has the higher levels than Sidenafll group （P 〈 0.05 ）. 24 hours after the operation： the histopathological analysis show there are most serious injury of contralateral testes of the saline group. Compared with the shamoperation group, the test levels of MDA and NO/NOS were statistically higher in saline group and Sidenafil group（P 〈0.05）. in those two groups, saline group has the higher levels than Sidenafil group （P 〈 0.05）.Conclusions The contralateral testicular has no significant injury after unilateral testicular torsion/detorsion in prepuberta] rats for 4hous later. It turns injury at 24 hours after the torsion/detorsion operation, and sustained until 2weeks later. Sidenafi] has a protective effect on contralateral testicle after unilateral testicular torsion- detorsion injury, though the protective effect of Sidenafil seems to increase the NO level in in focal organizations, dilate the blood vessel and antagonize the blood vessel constriction of sympathetic nerves.