精索靜脈曲張所致不育的免疫組化變化和臨床研究附編者按.pdf
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精索靜脈曲張所致不育的免疫組化
變化和臨床研究(附編者按)
鄭駿年 謝叔良 連保羅 陳家存 顧 驤 溫儒民 陳仁富 王軍啟
摘要 為了進(jìn)一步探討精索靜脈曲張(VC)與不育癥的關(guān)系 ,對(duì) 22 例正常人 ,35 例左側(cè) VC患者行
遠(yuǎn)紅外陰囊測(cè)溫及血清抗精子抗體(AsAb)測(cè)定 ,及睪丸組織免疫組化染色檢測(cè)三種 AsAb ( IgM、 IgG、IgA)含量。結(jié)果發(fā)現(xiàn):精液異常 VC患者睪丸溫度顯著升高( P < 01001) ,睪丸溫度與靜脈曲張程度無(wú)
關(guān) ,而與精子總數(shù)、活動(dòng)率呈顯著負(fù)相關(guān)( P < 0101) ;VC患者血清 AsAb陽(yáng)性率 57 % ,顯著高于正常人
( P < 01025) ;睪丸 IgM陽(yáng)性率 53 % , IgG 73 % ,均顯著高于正常人。IgM、 IgG含量與睪丸溫度呈顯著正
相關(guān)( ( P < 0101 , P < 0104) 。其中 IgM含量與睪丸生精功能呈顯著負(fù)相關(guān)( P < 0101) 。病理檢查發(fā)現(xiàn)
Sertoli細(xì)胞變性。認(rèn)為 VC患者同時(shí)存在睪丸溫度升高及抗精子免疫反應(yīng) ,共同損害生精功能 ,睪丸溫
度升高使 Sertoli細(xì)胞變性 ,破壞血睪屏障導(dǎo)致自身免疫反應(yīng)發(fā)生。
關(guān)鍵詞 精索靜脈曲張 不育癥 ,男性
The mechanism of varicocele 2induced infertil ity Zheng J unnian , Xie S hul iang , L ian Baoluo , et al . Depart2
ment of Urology , The A f f il iated Hospt ial of Xuz hou Medical Col lege , Xuz hou 221002
Abstract Scrotal temperature and antis permatozoal antibody (AsAb) were measured in 22 normal men
and 35 left varicocele patients. The immunolocalization of AsAb( IgM , IgG, IgA) was studied in the testicular
tissue of 15 normal men and 15 varicocele patients with immunohistochemist ry. The testicular temperature of
varicocele patients with poor semen was significantly higher than those of normal men ( P < 01001) . There was
no correlation between the testicular temperature and the degree of varicocele. There was negative correlation
between testicular temperature and sperm count or sperm motility ( P < 0101) . The positive rate of serum
AsAb in varicocele patients was 57 % ,significantly higher than that in normal men ( P < 01025) . The positive
rates of IgM and IgG in testicular tissue of varicocele patients were 53 % and 73 % res pectively ,being signifi2
cantly higher than those of normal men ( P < 0105 , P < 0101) . There was positive correlation between testicu2
lar temperature and the content of IgM or IgG ( P < 0101 , P < 0104) ,and the content of IgM was related to
impaired spermatogenesis. Degeneration of sertoli cells was observed on testicular bio psy. The result suggests
that testicular hyperthermia leads to the disru ption of the blood testis barrier which is a prerequisite for AsAb
formation. The testicular hyperthermia and the antis perm immunologic response are related to infertility.
Key words Varicocele Infertility ,male
作者單位:221002 徐州醫(yī)學(xué)院附屬醫(yī)院泌尿外科
我們對(duì) 35 例精索靜脈曲張(VC)患者 ,22
例正常人行遠(yuǎn)紅外陰囊測(cè)溫及血清抗精子抗體
(AsAb)測(cè)定 ,并行睪丸活檢免疫組化染色檢測(cè)
IgG、 IgM 及 IgA三種AsAb。報(bào)告如下。
資料與方法
一、臨床資料
左側(cè) VC 患者 35 例 ,平均年齡 2513 歲。
曲張程度 Ⅰ級(jí) 7 例 , Ⅱ級(jí) 21 例 , Ⅲ級(jí) 7 例。其
中精液正常者 14 例(精子總數(shù) ≥20 ×108
/ L ,1
小時(shí)活動(dòng)率 ≥016) ;精液異常者 18 例 ,包括無(wú)
精癥 7 例 ,少精癥 11 例 ......
變化和臨床研究(附編者按)
鄭駿年 謝叔良 連保羅 陳家存 顧 驤 溫儒民 陳仁富 王軍啟
摘要 為了進(jìn)一步探討精索靜脈曲張(VC)與不育癥的關(guān)系 ,對(duì) 22 例正常人 ,35 例左側(cè) VC患者行
遠(yuǎn)紅外陰囊測(cè)溫及血清抗精子抗體(AsAb)測(cè)定 ,及睪丸組織免疫組化染色檢測(cè)三種 AsAb ( IgM、 IgG、IgA)含量。結(jié)果發(fā)現(xiàn):精液異常 VC患者睪丸溫度顯著升高( P < 01001) ,睪丸溫度與靜脈曲張程度無(wú)
關(guān) ,而與精子總數(shù)、活動(dòng)率呈顯著負(fù)相關(guān)( P < 0101) ;VC患者血清 AsAb陽(yáng)性率 57 % ,顯著高于正常人
( P < 01025) ;睪丸 IgM陽(yáng)性率 53 % , IgG 73 % ,均顯著高于正常人。IgM、 IgG含量與睪丸溫度呈顯著正
相關(guān)( ( P < 0101 , P < 0104) 。其中 IgM含量與睪丸生精功能呈顯著負(fù)相關(guān)( P < 0101) 。病理檢查發(fā)現(xiàn)
Sertoli細(xì)胞變性。認(rèn)為 VC患者同時(shí)存在睪丸溫度升高及抗精子免疫反應(yīng) ,共同損害生精功能 ,睪丸溫
度升高使 Sertoli細(xì)胞變性 ,破壞血睪屏障導(dǎo)致自身免疫反應(yīng)發(fā)生。
關(guān)鍵詞 精索靜脈曲張 不育癥 ,男性
The mechanism of varicocele 2induced infertil ity Zheng J unnian , Xie S hul iang , L ian Baoluo , et al . Depart2
ment of Urology , The A f f il iated Hospt ial of Xuz hou Medical Col lege , Xuz hou 221002
Abstract Scrotal temperature and antis permatozoal antibody (AsAb) were measured in 22 normal men
and 35 left varicocele patients. The immunolocalization of AsAb( IgM , IgG, IgA) was studied in the testicular
tissue of 15 normal men and 15 varicocele patients with immunohistochemist ry. The testicular temperature of
varicocele patients with poor semen was significantly higher than those of normal men ( P < 01001) . There was
no correlation between the testicular temperature and the degree of varicocele. There was negative correlation
between testicular temperature and sperm count or sperm motility ( P < 0101) . The positive rate of serum
AsAb in varicocele patients was 57 % ,significantly higher than that in normal men ( P < 01025) . The positive
rates of IgM and IgG in testicular tissue of varicocele patients were 53 % and 73 % res pectively ,being signifi2
cantly higher than those of normal men ( P < 0105 , P < 0101) . There was positive correlation between testicu2
lar temperature and the content of IgM or IgG ( P < 0101 , P < 0104) ,and the content of IgM was related to
impaired spermatogenesis. Degeneration of sertoli cells was observed on testicular bio psy. The result suggests
that testicular hyperthermia leads to the disru ption of the blood testis barrier which is a prerequisite for AsAb
formation. The testicular hyperthermia and the antis perm immunologic response are related to infertility.
Key words Varicocele Infertility ,male
作者單位:221002 徐州醫(yī)學(xué)院附屬醫(yī)院泌尿外科
我們對(duì) 35 例精索靜脈曲張(VC)患者 ,22
例正常人行遠(yuǎn)紅外陰囊測(cè)溫及血清抗精子抗體
(AsAb)測(cè)定 ,并行睪丸活檢免疫組化染色檢測(cè)
IgG、 IgM 及 IgA三種AsAb。報(bào)告如下。
資料與方法
一、臨床資料
左側(cè) VC 患者 35 例 ,平均年齡 2513 歲。
曲張程度 Ⅰ級(jí) 7 例 , Ⅱ級(jí) 21 例 , Ⅲ級(jí) 7 例。其
中精液正常者 14 例(精子總數(shù) ≥20 ×108
/ L ,1
小時(shí)活動(dòng)率 ≥016) ;精液異常者 18 例 ,包括無(wú)
精癥 7 例 ,少精癥 11 例 ......
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