摘要
目的:评估精索静脉结扎术对精索静脉曲张患者精液总抗氧化能力(TAC)的影响。方法:共纳入就诊于湖北省荆门市第一人民医院男科的40例精索静脉曲张不育男性患者、40例正常男性(对照组)进行研究。经诊断,所有患者均患原发性不育症或者继发性不育。将精索静脉曲张患者分为触诊不明显(G I)精索静脉曲张组(16例)和触诊明显精索静脉曲张组(GⅡ-Ⅲ)(24例)。所有患者均接受显微镜下精索静脉结扎术。评估了所有患者的精液TAC水平和各项精子参数。将术前精子数量、精子活力、精子形态和精液TAC水平与精索静脉结扎术后3~6个月的相同参数,以及对照组进行比较。结果:精索静脉结扎术后,患者的精子数量(术前18.01±1.88,术后24.20±7.60,P=0.040)、活动精子(术前17.90±8.90,术后23.90±7.90,P=0.001)、NF(术前10.20±3.02,术后19.30±7.05,P <0.001)及精液TAC水平(术前2.52±0.28,术后3.72±0.20,P=0.031)均高于手术之前,差异具有统计学意义(P <0.05);且术后与对照组比较,精子数量(精索静脉曲张患者24.20±7.60,对照组29.40±8.30,P=0.156),精子活力(精索静脉曲张患者23.90±7.90,对照组30.50±8.00,P=0.465),NF(精索静脉曲张患者19.30±7.05,对照组23.90±7.90,P=0.085)及精液TAC水平(精索静脉曲张患者3.72±0.20,对照组2.78±0.20,P=0.666),差异没有统计学意义(P>0.05)。然而,根据对患者的精索静脉曲张等级的评估,只有GⅡⅢ级精索静脉曲张患者手术前后的NF(术前6.16±2.50,术后10.00±6.41,P=0.040)、TAC(术前2.36±0.23,术后2.66±0.15,P=0.040)水平差异具有统计学意义(P <0.05)。当根据精液参数对患者进行分组时,少精症(OAT)组的TAC水平有统计学差异(手术前2.46±0.34,手术后2.80±0.19,P=0.000)。结论:精索静脉结扎术可以显著改善GⅡ-Ⅲ精索静脉曲张患者精液的总抗氧化能力。
Objective:To evaluate the effect of spermatic vein ligation on the total antioxidant capacity(TAC)of semen in patients with varicocele.Methods:Forty infertile male patients with varicocele and 40 healthy controls(control group)were admitted to our hospital for primary or secondary infertility.Patients with varicocele were divided into two groups:nonobvious palpation(GI)varicocele group(16 cases)and obvious palpation(GⅡ-Ⅲ)varicocele group(24 topics).All patients underwent microscopical ligation of the spermatic vein.The semen TAC level and sperm parameters of all patients were evaluated.The preoperative sperm quantity,sperm motility,sperm morphology,and semen TAC level were compared with the same parameters 3~6 months after spermatic vein ligation and the control group.Results:After spermatic vein ligation,the sperm count(preoperative 18.01±1.88,postoperative 24.20±7.60,P=0.040),motile sperm(preoperative 17.90±8.90,postoperative 23.90±7.90,P=0.001),NF(10.20±3.02 before operation,19.30±7.05 after operation,P<0.001)and semen TAC level(2.52±0.28 before operation,3.72±0.20 after operation,P=0.031)were higher than those before operation,and the difference was statistically significant(P<0.05);and compared with the control group after operation,sperm count(varicocele patients 24.20±7.60,control group 29.40±8.30,P=0.156),sperm motility(varicocele patients 23.90±7.90,control group 23.90±7.90 30.50±8.00,P=0.465),NF(varicocele patients 19.30±7.05,control group 23.90±7.90,P=0.085)and semen TAC level(varicocele patients 3.72±0.20,control group 2.78±0.20,P=0.666),the difference was not statistically significant(P>0.05).However,according to the evaluation of the patients'varicocele grade,only patients with GII-III varicocele had NF before and after surgery(6.16±2.50 preoperatively,10.00±6.41 postoperatively,(P=0.040),TAC(preoperatively 6.16±2.50,(P=0.040).2.36±0.23,postoperative 2.66±0.15,P=0.040)level difference was statistically significant(P<0.05).When the patients were grouped according to semen parameters,there was a statistically significant difference in TAC levels in the oligospermia(OAT)group(2.46±0.34 before surgery,2.80±0.19 after surgery,(P=0.000).Conclusion:Spermatic vein ligation significantly improves the total antioxidant capacity of semen in patients with GII-III varicocele.
作者
张俊杰
杨阳
罗旋
杜业芳
ZHANG Junjie;YANG Yang;LUO Xuan(The First People's Hospital of Jingmen City,Hubei Jingmen 448000,China)
出处
《河北医学》
CAS
2022年第11期1902-1906,共5页
Hebei Medicine
基金
湖北省荆门市科技计划项目,(编号:YDKY2017020)。
