精索静脉曲张患者精液质量及其不育患者手术前后精液变化的观察

The observation of semen quality changes in the patients with varicocele and infertile patients before and after varicoceletomy

目的观察精索静脉曲张(VC)患者的精液质量和精子形态学改变,以及VC不育患者手术前后精液的变化。方法121例VC患者精液按WHO标准常规分析并对精子形态学进行评价,23例健康男性精液检查结果作为对照。并对21例VC不育患者术前及术后的精液进行检测分析。结果121例VC患者的精子密度、(A+B)级活动力精子(%)、活率、有效精子数、活动精子数、活力指数以及正常形态精子比例较对照组明显降低(P<0.01);畸形精子中小头、锥形头和无定形头精子数较对照组增多(P<0.01)。21例VC不育患者手术后精子质量和精子形态学较术前明显改善。结论VC可以引起精液质量下降导致不育,精子形态学分析是判定VC患者精子受损的一个敏感指标,手术能有效地改善精液质量。

Objective To evaluate the semen quality and sperm morphology changes in the patients with varicocele and infertile patients before and after varicoceletomy. Methods Semen from 121 patients with varicocele were studied and those of 23 normal male were taken as the control. A comparison of their semen parameters both before and after varicoceletomy had been made in the 21 infertile patients. Semen analysis was performed based on the methods described in the WHO manual and sperm morphology was evaluated by WHO criteria. Results A significant reduction of sperm density, （A＋B） grade sperm percentage, sperm viability, number of effective sperm, motile sperm and sperm motility index, and an increase of small oval head, tapering head and amorphous head sperm were found in patients with varicocele comparing with those of the control （P〈0.01）. The increase of semen quality and sperm morphology were found in the 21 infertile patients after varicoceletomy. Conclusion The varicocele can reduce the semen quality, and sperm morphologic assessment with WHO criteria provides a sensitive measurement of sperm damage in the patients with varicocele, and the varicoceletomy can improve the semen quality.