睾丸彩色多普勒超声在男性不育症中的临床价值

The Clinical Value of Color Doppler Ultrasound for Male Infertility

目的:研究睾丸彩色多普勒超声(Color Doppler ultrasound,CDU)在男性不育症(Male infertility,MI)中的临床价值。方法:从2012年3月到2013年3月,选择56例于我院就诊的疑似MI患者作为研究对象。全部患者均予以CDU诊断,分析所得诊断结果。另根据精索静脉曲张(Cirsocele,CIR)情况进行分组,分成亚临床型CIR组(Sub-clinical Cirsocele,SCIR)(8例)与临床型CIR组(Clinical Cirsocele,CCIR)(16例),显示出两组患者的睾丸和附睾、精索静脉、睾丸内动脉(ITA)、睾丸包膜动脉(CA);分析其收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)与男性不孕症精液质量及与精子数量的相关性。结果:56例受检者中,共计37例检出异常,占比66.07%,CCIR组的精索静脉最大内径(DR)、瓦氏试验最大内径(DV)、最大Vmax及返流的持续时间(TR)水平均显著高于SCIR组,差异均有统计学意义(均P<0.05)。根据Spearman法进行分析后发现男性不孕症精液质量及与精子数量与睾丸动脉(TA)、CA、PSV、EDV均呈正相关,与RI呈负相关;ITA、PSV、EDV与男性不孕症精液质量及与精子数量均呈负相关,与RI均呈正相关;此外,睾丸内动脉数量越多,精子数量越少。结论:CDU对MI疾病的诊断价值较高,结果较为准确,值得临床诊断推荐。

Objective： To study the clinical value of color doppler ultrasound（CDU）for male infertility（MI）. Methods： 56 cases of patients with suspected MI in our hospital administered from March 2012 to March 2013 were selected as research subjects. All patients were given CDU for diagnosis, the diagnosis resulting were analysed. Patients were divided into SCIR group（8 cases） and CCIR group（16 cases） according to CIR results. The testis and epididymis,spermatic vein, ITA, CA and TA of the two groups of patients were showed, and the relevance between its PSV, EDV, RI and sperm count and semen quality of the male infertility were analyzed. Results：In 56 cases of subjects, a total of 37 cases detected presented the result of anomalies, accounting for 66.07%.The Spermatic vein maximum internal diameter（DR）, Valsalva test maximum internal diameter（DV）, the maximum duration of Vmax and regurgitation（TR） of CCIR group were significantly higher than those of the SCIR group, the differences were statistically significant（P〈0.05）.According to the Spearman method analysis, semen quality and sperm count of the male infertility were positively correlated with TA and CA, PSV, EDV and negatively correlated with RI. The ITA, PSV, EDV were negatively correlated with male infertility and semen quality and quantity of sperm, and positively correlated with RI. In addition, the greater the number of testicular artery is, the less sperms count.Conclusion： CDU has higher value in the diagnosis of diseases of MI, and the results are more accurate, which is worthy of clinical diagnosis and recommendation.