不同程度精索静脉曲张患者精液质量及精子形态分析

Analysis of sperm morphology and semen quality of patients with varicocele in varying degrees

目的观察不同程度精索静脉曲张（VC）患者精液质量及精子形态。方法121例VC患者分为I、Ⅱ、Ⅲ度共3组，其精液按WHO标准常规分析并对精子形态进行评价，23例健康男性精液检查结果作为对照。结果不同程度VC患者与对照组比较，精液各项常规指标及正常形态精子百分率均下降（P〈0．01），畸形精子中，小头、锥形头和无定形头精子均增多（P〈0．01，P〈0．05，P〈0．01）。不同程度VC患者间比较，常规检查各项指标无明显差异（P〉0．05），形态检查Ⅲ度VC组正常形态精子百分率低于Ⅱ度VC组（P〈0．01），而Ⅱ度VC组与I度VC组差异无统计学意义（P〉0．05）。具体畸形精子类别比较，Ⅲ度VC组的无定形精子百分率明显高于Ⅱ度VC组（P〈0．01）。结论精液常规检查不能区分不同程度VC对精液损害的影响，而精子形态检查可反映不同程度VC患者的精子状态。因此，VC患者不但应行精液常规检查还应行精子形态检查。

Objective To evaluate the semen quality and sperm morphology in the patients with different grades of varicocele. Methods Semen from 121 patients with varicocele which were divided into three groups, gradeI, grade II and grade m, were studied and those of 23 normal male were taken as the control. Semen analysis was performed with the methods described in the WHO manual and sperm morphology was evaluated by WHO criteria. Results A significant reduction of semen quality and sperm morphology and an increase of small oval head, tapering head and amorphous head sperm were found in patients with different grades of varicoeele comparing with those of the control. There was no difference in routine analysis between different groups. A reducetion of normal morphology percentage in grade Ⅲ were found comparing with grade Ⅱ （P 〈 0.01 ）. An increase of amorphous head sperm in grade Ⅲ was found comparing with that of sperm in grade Ⅱ （ P 〈 0.01 ）. Conclusions The routine semen analysis can not distinguish seminal damage between different grades of varieocele, but the sperm morphology can reflect the sperm state. Therefore, the patients with varicocele should not only get routine semen analysis but also check the sperm morphology.