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目的:观察精索静脉曲张(VC)大鼠附睾指数,附睾精子活率,附睾组织中低氧诱导因子1α(HIF-1α)、p53的表达及上皮组织的变化,探讨VC大鼠附睾功能降低的机制。方法:90只SD大鼠随机分为手术组、假手术组和正常对照组,每组30只。手术组建立SD大鼠左侧VC模型,采用假手术建立假手术组,正常对照组不作任何处理。各组大鼠均于手术组术后49 d断颈处死。处死前大鼠称重,处死后左侧附睾称重,收集附睾尾部精子,以计算机辅助精子分析系统行精子活率检测;应用Western印迹检测附睾组织中HIF-1α和p53的表达变化;HE染色观察附睾上皮组织的情况。结果:手术组27只大鼠建模成功。3组大鼠附睾指数差异无统计学意义[(40.53±1.76)×10-5、(43.31±1.58)×10-5、(44.10±2.62)×10-5,P>0.05];手术组大鼠精子活率[(71.86±5.07)%]和前向运动精子百分率[(42.26±4.45)%]均显著低于假手术组[(78.51±4.50)%、(49.08±4.19)%]和正常对照组[(79.24±2.70)%、(52.23±2.23)%](P均<0.05);手术组大鼠附睾组织HIF-1α和p53相对表达量[1.74±0.16、1.71±0.11]均显著高于假手术组[0.32±0.08、0.56±0.13]和正常对照组[0.12±0.03、0.25±0.06](P均<0.01);手术组附睾管上皮细胞与另外两组相比明显疏松无序并且数量减少。结论:VC导致附睾组织低氧并可能使附睾功能降低。
Objective: To observe the changes of epididymis index, epididymal sperm motility, epididymal tissue hypoxia inducible factor 1α (HIF-1α), p53 expression and epithelial tissue in varicocele (VC) rats, Mechanisms. Methods: Ninety SD rats were randomly divided into operation group, sham operation group and normal control group, 30 rats in each group. In the operation group, the left VC model was established in SD rats. The sham operation group was established by sham operation. The normal control group received no treatment. The rats in each group were sacrificed 49 days after operation. The rats were weighed before sacrifice and the left epididymis were weighed after sacrifice. The sperm motility of the epididymis was collected and the sperm motility of the epididymis was measured by computer-aided sperm analysis system. The expression of HIF-1α and p53 in the epididymis was detected by Western blotting. Observation of epididymal epithelial tissue. Results: Twenty-seven rats in the operation group were modeled successfully. There was no significant difference in epididymis index between the three groups ([(40.53 ± 1.76) × 10-5, (43.31 ± 1.58) × 10-5, (44.10 ± 2.62) × 10-5, P> 0.05] (71.86 ± 5.07)% and the percentage of forward motile sperm (42.26 ± 4.45)% in the sham operation group were significantly lower than those in the sham operation group (78.51 ± 4.50)% and (49.08 ± 4.19)%, respectively (79.24 ± 2.70)% and (52.23 ± 2.23)%, respectively (all P <0.05). The relative expressions of HIF-1α and p53 in the epididymis of the operation group were significantly higher than that of the control group [1.74 ± 0.16 and 1.71 ± 0.11] (0.32 ± 0.08,0.56 ± 0.13) in the sham group and [0.12 ± 0.03,0.25 ± 0.06] in the normal control group (all P <0.01). The epididymal epithelial cells in the operation group were significantly loose and disorderly compared with the other two groups amount reduced. Conclusion: VC causes hypoxemia in the epididymis and may reduce the function of the epididymis.