精索静脉曲张患者手术前后抗精子抗体的变化及意义

The change of antisperm antibodies in the serum to the surgical treatment of varicocele and its significance

目的探讨手术治疗精索静脉曲张（VC）对患者血清中抗精子抗体（ASAB）的影响。方法分析60例左侧Ⅱ°VC患者。20例作为观察对照（A组）；20例行保留睾丸动脉的精索静脉高位结扎术（B组）；20例行不保留睾丸动脉的精索静脉高位结扎术（C组）。酶联免疫法定量测定血清中抗精子抗体IgG、IgM含量。SPSS16．0软件进行统计学分析。结果三组术前IgM、IgG总体比较无统计学意义（F=0．59，P：0．5583；F=0．98，P=0．3808），术前IgM、IgG各组间两两比较均亦无统计学差异；三组术后IgM、IgG总体比较有统计学意义（F=29．47，P〈0．001；F=30．45，P〈0．001），且术后IgM、IgG各组间两两比较均有统计学意义，其中B组与C组IgM、IgG比较均有统计学意义（Q=3．1357，p〈0．05；Q=3．1733，p〈0．05）。A组前后ASAB水平变化无统计学意义（P〉0．05）。B、C两组术前术后ASAB水平差异均有显著性意义（P〈0．01）。结论左侧Ⅱ°VC患者经腹腔镜手术治疗后血清中ASAB水平降低，且保留睾丸动脉效果更佳。

Objectives To investigate the level of anti - sperm antibodies （ASAB） in the serum of the patient with varicocele （VC） before and 3 - 9 months after surgery. Methods 6o cases of patients with Ⅱ ° VC in left were chosen to measured serum ASAB in our study. 20 cases were observed as control group （A group） ; 20 cases were reserved the testicular artery in surgery （ B group） ; 20 cases didnl preserved the testicular artery in surgery （ C group）. The level of ASAB in the serum （ IgM and IgG） were performed before and 39 months after surgery,as measured by ELISA in a quantitative way. The data were analyzed by SPSSI6.0 software. Results Before surgery, three groups of IgM, IgG were no statistically significant overall （ F = 0.59, p = 0. 5583 ; F = 0.98, p = 0. 3808 ）, and there were no statistically significant between any 2 groups in lgM, IgG ; After surgery, three groups of IgM, IgG overall comparison were statistically significant （ F = 29.47, p 〈0. 001 ; F = 30.45, p 〈 0.001 ）, the differences be- tween any 2 groups were statistically significant in IgM, IgG, In particular, the differences between B group and C group in IgM, IgG were statistically significant （ Q = 3.1357, p 〈 0.05 ; Q = 2.8271, p 〈 o. 05 ）. In A group, AS- AB levels before surgery and after surgery showed no statistically significant （ all p 〉 0.05 ）. In group B and C, preoperative and postoperative ASAB levels were differences, and the difference was statistically significant （all p 〈 0. 01 ）. Conclusions Laparoscopic treatment of Ⅱ ° VC in left can decrease serum levels of ASAB,and preserve the testicular artery is more effective.