CAJ | 학술논문

目的：探讨大鼠隐睾模型的建立和胚胎干细胞睾丸内原位注射对热损伤所致的睾丸生精功能损害的疗效。方法：Wistar 大鼠20只，取右睾丸手术建立隐睾模型，于7、10、14、21及28 d 后行隐睾下降固定术，下降后选取不同的时间点行附睾穿刺液及睾丸病理检查；另 Wistar 大鼠20只，随机分为 A 组（n＝10）和 B 组（n＝10）。A 组左睾丸为干细胞组（ES），右睾丸为自身空白对照（NPBS）；B 组左睾丸为组间对照组（JPBS）。各组在隐睾建模2周后行隐睾下降固定术并同时行睾丸内原位注射处理，2周后比较生精小管的直径（d）、精小管百分率（r）和生精小管的 Johnsen 评分（z）。结果：隐睾建模后10、14、21、30 d及隐睾复降后2月的附睾穿刺液中均未能发现精子，睾丸复降的中后期，部分生精小管的生精细胞层数仍然存在不同程度的恢复，含有生精细胞的 d 继续增加（P﹤0.05）；干细胞注射后各组附睾穿刺液内均未见精子，ES 组与 NPBS 组生精小管 z 差异有统计学意义（P﹤0.05）。结论：短期的睾丸热损伤是可逆的，超过10 d 则严重影响到睾丸的生精功能，原位注射胚胎干细胞在本实验中尚不能证实对睾丸损伤有修复作用，但此研究方向仍具有极高的可行性。
목적：탐토대서은고모형적건립화배태간세포고환내원위주사대열손상소치적고환생정공능손해적료효。방법：Wistar 대서20지，취우고환수술건립은고모형，우7、10、14、21급28 d 후행은고하강고정술，하강후선취불동적시간점행부고천자액급고환병리검사；령 Wistar 대서20지，수궤분위 A 조（n＝10）화 B 조（n＝10）。A 조좌고환위간세포조（ES），우고환위자신공백대조（NPBS）；B 조좌고환위조간대조조（JPBS）。각조재은고건모2주후행은고하강고정술병동시행고환내원위주사처리，2주후비교생정소관적직경（d）、정소관백분솔（r）화생정소관적 Johnsen 평분（z）。결과：은고건모후10、14、21、30 d급은고복강후2월적부고천자액중균미능발현정자，고환복강적중후기，부분생정소관적생정세포층수잉연존재불동정도적회복，함유생정세포적 d 계속증가（P﹤0.05）；간세포주사후각조부고천자액내균미견정자，ES 조여 NPBS 조생정소관 z 차이유통계학의의（P﹤0.05）。결론：단기적고환열손상시가역적，초과10 d 칙엄중영향도고환적생정공능，원위주사배태간세포재본실험중상불능증실대고환손상유수복작용，단차연구방향잉구유겁고적가행성。
Objective:To investigate the effect of orthotopic injection of embryonic stem(ES)cells as a treatment for impaired spermatogenesis of the testes caused by thermal damage in a rat model of cryptorchidism. Methods:Unilateral cryptorchidism in the right testis was surgically induced in 20 Wistar rats. Orchidopexy was performed on days 7,10,14,21 and 28. Epididymis puncture and testicular biopsy were done at different time points. Another 20 rats were randomly divided into groups A and B(n = 10 each). For group A,ES cells were injected in the left testis(group ES)with the right testis as interclass control(group NPBS). For group B,the left testis in group B was intraclass control( group JPBS). Orchidopexy were performed at 2 weeks after surgical cryptorchidism in 3 groups,and meanwhile,orthotopic ES cell injection was given. Then epididymis puncture and testicular biopsy were done 2 weeks later. The diameter( d),percentage( r) and Johnsen score( z) of seminiferous tubules were compared in 3 groups.Results:No sperm was found in the epididymis puncture fluid on days 10,14,21 and 30 after surgical cryptorchidism and at 2 months after orchidopexy. However,certain recovery of seminiferous tubule structure remained at the mid-to-late time points after orchidopexy,along with increase in <br> diameter of seminiferous tubules(P﹤0.05). No sperm was found in the epididymis puncture fluid after ES cells injection. But the seminiferous Johnsen scores were significantly different between group ES and group NPBS(P﹤0.05).Conclusion:While short term thermal damage of the testis is reversible,such damage lasting over 10 days could seriously damage spermatogenesis function. Although orthotopic injection of ES cells did not appear to help repair the testicle damage during our study period,the feasibility of our attempt remains promising.