摘要目的 检测包皮环切和尿道下裂患儿性激素水平,探讨性激素水平与尿道下裂的关系.方法 选择50例包皮环切和137例尿道下裂患儿,采用放免法检测双氢睾酮(DHT)值和光免法检测性激素全套.结果 包皮环切者和尿道下裂患儿DHT值比较差异有统计学意义[(64.51±32.10)pg/ml vs(46.72±28.94)pg/ml,P＜0.05],Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型尿道下裂患儿DHT值分别为(50.20±32.90) pg/ml,(46.63±25.67) pg/ml,(51.60±32.16) pg/ml,(39.02±26.32) pg/ml,各型之间差异无统计学意义(P=0.29),尿道下裂各型和包皮环切者之间差异有统计学意义(P=0.00);尿道下裂患儿性激素水平中黄体生成素(LH)和睾酮(T)较包皮环切者明显减低(P＜0.05),卵泡刺激素(FSH)、雌二醇(E2)、催乳素(PRL)之间比较差异无统计学意义(P＞0.05),尿道下裂各型间FSH比较差异无统计学意义(P＞0.05).结论 尿道下裂患儿可能存在T的分泌不足或5α还原酶(SRD5A)活性不足和功能缺陷,尿道下裂患儿的LH-T轴可能存在分泌不足伴T值低下,虽有部分的尿道下裂患儿T值正常,但这并不能说明在孕期雄激素产生是正常的.

abstractsObjective To investigate the differences in sex hormone levels between hypospadias and circumcision groups.Methods Fifty cases of circumcision and 137 cases of hypospadias the dihydmtestosterone (DHT) value was tested with radioimmunoassay,and testosterone was tested with lightimmunoassay.Results DHT value was (64.51 ±32.10)pg/ml in circumcision group,and (46.72 ±28.94)pg/ml in hypospadias group (P ＜0.05).DHT value in hypospadias type Ⅰ,Ⅱ,Ⅲ,and Ⅳ were (50.20 ±32.90)pg/ml,(46.63 ±25.67)pg/rnl,(51.60 ±32.16)pg/ral,and (39.02 ±26.32)pg/ml,respectively (P =0.29).The differences between circumcision and hypospadias groups were statistically significant (P =0.00).Luteinizing hormone (LH) and testosterone (T) in children with hypospadias were significantly lower than those in children in the circumcision group (P ＜ 0.05).No statistically significant difference was found between two groups in follicle-stimulating hormone (FSH),estradiol (F2),and prolactin (PRL) (P ＞ 0.05).No statistically significant differences were found in FSH among all types of hypospadias (P ＞ 0.05).Conclusions Inadequate secretion of T or activity insufficiency and functional deficiency of 5 alpha reductase (SRD5A) are likely found in children with hypospadia.Inadequate secretion and low T value might be found in LH-T shaft in children with hypospadia.The normal T value in some children with hypospadia does not show that androgens produced during pregnancy are normal.