睾丸扭转诱发抗精子抗体产生及对睾丸功能的影响

目的:监测单侧睾丸扭转患者患侧睾丸切除术前后不同时间血清中抗精子抗体(AsAb)、生殖激素及抑制素B(INH B)动态变化,探讨睾丸扭转诱发抗精子抗体的产生,以及对健侧睾丸功能的影响。方法:本组10例患者,16~45岁,平均19.6岁;睾丸扭转病程3~6 d,平均4.7 d;左侧9例,右侧1例,全部行患侧睾丸切除术。ELISA法定量检测患者术前和术后3、6、12、26周血清中3种AsAb(IgG、IgM、IgA)和INH B的浓度;全自动化学发光法检测血清中FSH、LH、T值。结果:血清中3种AsAb均可检出,术后3~6周升高明显,然后逐步下降;以IgM型AsAb最多,IgA型AsAb最少。INH B术后3周水平最低,术后第12周后恢复正常,术前与术后3、6周比较差异有显著性(P<0.05)。术后26周血LH和INH B水平相对术后6周时显著升高。结论:睾丸损伤发生后,AsAb水平升高,并持续相当长时间。患侧睾丸切除后,健侧睾丸有一个损伤和修复的过程,并部分代偿。INH B变化能反映睾丸损伤和修复程度。所以,睾丸损伤后,测定AsAb、INH B对于监测患者睾丸功能和生育力有临床意义。

Antisperm-antibodies Induced by Testicular Torsion and Its Influence on Testicular Function

Objective:To investigate the changes of antisperm antibodies(AsAb),sexual hormones,and inhibin B(INH B) in patients before and after testicular torsion,as well as the effects of these factors on testicular function and reproduction.Methods: Ten patients with single acute testicular torsion(left side 9 and right side 1),aged 16~45 years((19.6) on average),disease course of 3~6 days(averaging(4.7) days),underwent surgical removal of the damaged testis.Before and after the operation, serum AsAb(IgG,IgM,IgA)and INH B were measured by ELISA,and serum follicle-stimulating hormone(FSH),luteotropic hormone(LH),and testosterone(T) determined by chemoluminescence autoanalyzer.Results: After the operation,the AsAb levels rose significantly and remained high for at least 26 weeks.The level of INH B was the lowest in the 3rd week and restored to normal in the 12th week,with significant difference between preoperation and the 3rd or the 6th week after the operation.The levels of LH and INH B in the 26th week were elevated significantly compared with the 6th.Conclusion: Testicular injury induced the elevation of AsAb,which would last a very long time.The change of INH B was closely related with the injury of the testis, which reflected the degree of testicular injury and functional restoration of the patients after the operation.Our study showed that AsAb and INH B can be used as useful tools for monitoring testicular function and reproduction.