隐睾患儿睾丸功能的评估
Evaluation of testicular function in cryptorchid children

目的 ·探讨不同年龄及不同类型隐睾对睾丸间质细胞、支持细胞功能的影响。方法 ·将病例组101例隐睾患儿按年龄、睾丸位置及隐睾程度分类，对照组为非泌尿系统疾病、外生殖器正常且无第二性征发育的男童。进行LHRH激发试验、hCG激发试验、血清抗苗勒管激素（AMH）及抑制素B（InhB）水平检测。结果 ·病例组患儿hCG激发后的睾酮(T)值在各年龄亚组间比较，0.5～1岁组明显高于其余年龄亚组；病例组AMH和InhB值均明显低于对照组。高位隐睾组hCG激发后的T值、AMH和InhB值均明显低于低位隐睾组。hCG激发后T值及AMH和InhB在单侧隐睾与双侧隐睾组间比较，差异均无统计学意义。结论 ·在青春期前隐睾最先影响睾丸支持细胞功能，隐睾对间质细胞功能的影响在1岁内无严重影响。隐睾对睾丸功能的影响与睾丸位置高低有关，与单双侧隐睾无关。
： Objective · To investigate the effects of different types of cryptorchidism on testicular Leydig-cells and Sertoli-cells function at different ages of prepubertal boys. Methods · One hundred and one prepubertal cryptorchid boys were classified into categories according to different ages, position of testes and unilateral-bilateral cryptorchidism and they were conducted luteinizing hormone releasing hormone(LHRH) stimulation test, human chorionic gonadotropin (hCG) stimulation test, serum-Anti-Müllerian-Hormone (AMH) and inhibin-B (InhB)detection. The control group consisted of prepubertal boys with normal external genitalia and no urinary system diseases. Results · In case group, testosterone levels were significantly higher in 0.5-1years patients than other subgroups after hCG stimulation. The AMH and InhB levels in the case group were obviously lower than the control group. Compared with low-position group, testosterone-values after hCG stimulation tests, AMH and InhB-values in high-position group were respectively significantly lower. Testosterone-values after hCG stimulation tests, AMH and InhB-values between unilateral group and bilateral group all had no significant difference. Conclusion · During the prepubertal period, the testicular Sertoli cells were firstly affected by cryptorchidism. The testicular Leydig cells were not seriously affected in the cryptorchid boys within 1year. The position of testes, not the unilateral or bilateral cryptorchidism, played a role in the normal testicular function