精索静脉曲张所致的睾丸及精液指标的异常(英文)

Abnormalities of the testes and semen parameters in clinical varicocele

目的分析精索静脉曲张患者睾丸及精液指标的变化,探讨其对于男性生殖功能的影响。方法回顾分析2003年以来在我院诊治的172例精索静脉曲张患者的资料,阴囊超声检测患者双侧睾丸的体积。收集167例患者的精液标本进行分析,同时收集163例青年健康志愿者的精液分析资料作为对照组。结果所有患者均存在左侧精索静脉曲张,其中63例为双侧精索静脉曲张,但大多数左侧精索静脉曲张的临床分级均高于右侧。患者左侧睾丸体积平均为(10.99±3.71)ml,右侧睾丸体积平均为(11.86±4.05)ml,左侧睾丸体积明显小于右侧(P<0.01)。与对照组比较,患者精液的理化指标(包括精子密度)无显著差异(P>0.05),但大多数患者的精子活力和活率均显著低于对照组(P<0.05)。单、双侧精索静脉曲张患者的精子密度、活力和活率无统计学差异(P>0.05)。结论精索静脉曲张可导致睾丸体积缩小。单侧精索静脉曲张可同时对双侧睾丸产生影响,并导致睾丸功能受损。精索静脉曲张导致男性睾丸功能受损,主要表现为患者精子活力和活率的下降。

Objective To investigate the abnormal changes in the testes and semen parameters in patients with varicose veins and analyze the possible relationship between clinical varicocele and infertility.Methods We retrospectively reviewed the records of 172 male patients consulting for varicocele in our hospital since 2003.All these patients were examined for the size of the testes with scrotal ultrasound.The semen samples of the patients with varicocele except for 5 under the age of 17 years were collected and analyzed,using the data of semen analyses of 163 healthy young male volunteers（aged 18-29 years） as control.Results All the 172 patients had left-sided varicose veins.Sixty-three patients were found to have bilateral varicocele,and in most of them,the clinical grades of the left-sided varicose veins were higher than those of the right-sided ones.The mean volume of the left testis of the patients was 10.99±3.71 ml,significantly smaller than that of the right one（11.86±4.05 ml,P0.01）.The physiochemical indices of the patients,including the voiding volume,semen pH,liquefaction time and sperm concentration,were normal or similar with those of the healthy volunteers（P0.05）.Almost all the patients’sperm motility and viability were significantly lower than those of the healthy volunteers（P0.05）.In addition,no significant difference was found in the sperm density,motility or viability between the patients with unilateral and bilateral varicocele（P0.05）.Conclusion Varicocele may decrease the testicular volume.Both unilateral and bilateral varicocele may have an effect on the bilateral testes to cause possible functional impairment of the testes manifested by decreased sperm motility and viability.