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目的探讨血清抑制素B(INH-B)在睾丸扭转(Testicular Torsion, TT)患者术后生精功能监测中的应用价值.方法本研究设TT组和正常对照组.TT组为2009年8月至2012年3月间因TT在我院行一侧睾丸切除或固定+对侧睾丸固定患者24例,术前采血作INH-B检测,术后1、3、5、7、9、12个月复诊时查INH-B及精液常规,并询问患者术后遗精及生育情况,B超测定睾丸大小.另选择24例无睾丸萎缩、生精功能正常的非生殖系统疾病手术患者作为正常对照组,检测其手术前后的INH-B水平和精液数量与质量变化.结果24例TT的患者中2例病侧睾丸复位+双侧睾丸固定患者出现睾丸萎缩,22例对侧睾丸均正常大小或轻度代偿性增大.发病48h内就诊的15例患者,入院时INH-B结果均正常,术后3个月内INH-B水平先下降后缓慢上升至正常,9例发病在48h以上的患者,入院时8例INH-B均有不同程度下降,术后一年的随访中INH-B水平与入院前相比持续降低,低于正常值范围.对于保留睾丸的8例患者的随访研究表明,术后出现睾丸萎缩2例,其术后6个月的INH-B水平明显低于未出现睾丸萎缩的患者.对TT组及正常对照组共48例患者的跟踪检测结果显示,47例患者术后INH-B检测结果与睾丸体积、精液常规中精子密度与活力检测结果呈正相关.结论血清INH-B在睾丸扭转发生后即有变化,可以反映睾丸扭转术后生精功能恢复情况,可作为监测睾丸扭转患者术后生精功能并预测睾丸萎缩发生概率的有效指标.“,”Objective To investigate the value of serum inhibin B in spermatogenic function monitoring of postoperative patients with testicular torsion. Methods Total of 24 patients with testicular torsion, who underwent orchiectomy or orchiopexy, in addition with contralateral orchiopexy, were recruited in this study from August 2009 to March 2012. Levels of serum inhibin B in patients were detected preoperatively, and at 1, 3, 5, 7, 9, 12 months postoperatively respectively. Semen analysis of patients were performed at same time point. The conditions of spermatorrhea and fertility wwere inquired and the sizes of testes were measured by ultrasound. Another 24 cases without reproductive system disease, or testicular atrophy, and with normal spermatogenic function were enrolled as the controls.Results Of 24 patients with testicular torsion, 2 cases who underwent orchiopexy plus contralateral side orchiopexy had testicular atrophy,and 22 had normal size or slightly enlarged contralateral testis. Fiftycases who were admitted into hospital within 48 hours from onset of the disease showed normal level of serum inhibin B on admission day. In three months after the surgery, the level of inhibin B decreased first and then gradually rose to the normal level. While for the other 9 cases admitted beyond 48 hours from the onset of the disease, 8 of them had lower levelof serum inhibin B and after one year follow-up, the level of serum inhibin B it was still lower than normal value. For eight patients who retained testes after testicular torsion, 2 cases represented testicular atrophy, and their serum inhibin B levels were lower than that of patients without testicular atrophy after 6 months. The follow up study of the 48 cases showed that the inhibin B levels of 47 cases positively correlated with testicular volume, density and motility of sperm. Conclusion The level of serum inhibin B might be changed in the devlopment of testicular torsion, it can be used as indication for the recovery condition of spermatogenic function postoperatively, as well as predicting the risk of testicular atrophy.