精索静脉曲张不育患者睾丸组织剪切波速度值与精液质量的相关性

Correlation of shear wave velocity of testicular tissue and semen quality in patients with varicocele

目的分析精索静脉曲张(VC)患者睾丸组织剪切波速度(SWV)值与精液质量的相关性。方法 2011年9月至2014年9月深圳市中医院收治的VC患者60例(VC组),其中VCⅠ级22例,VCⅡ级24例,VCⅢ级14例。选择同期深圳市中医院体检的健康志愿者32名作为健康对照组。所有受检者均行常规超声检查及睾丸组织声脉冲辐射力弹性成像检查。采用配对t检验比较VC组患者与健康对照组受检者睾丸组织SWV值及精液质量差异;采用方差分析比较不同级别VC组患者SWV值及精液质量差异,进一步组间两两比较采用SNK-q检验;采用Pearson相关分析法分析VC患者睾丸组织SWV值与精液质量的相关性。结果 VC组患者睾丸组织SWV值高于健康对照组受检者,且差异有统计学意义[(0.59±0.11)m/s vs(0.24±0.06)m/s,t=-16.695,P<0.01];VC组患者睾丸组织SWV值随着VC级别的增加而增大,且任意2个级别VC组患者睾丸组织SWV值差异均有统计学意义(q=7.581、5.184、9.231,P值均<0.01)。VC组患者精子密度、精子活率均小于健康对照组受检者,且差异均有统计学意义[(42.43±7.03)×106/ml vs(83.22±11.28)×106/ml,(49.02±7.55)%vs(58.92±7.82)%,t=21.343、5.917,P值均<0.01]。VC组患者精子密度、精子活率随着VC级别的增加而减小,且任意2个级别VC组患者精子密度、精子活率差异均有统计学意义(精子密度:q=12.051、5.885、-7.323;精子活率:t=7.315、6.027、-4.640;P值均<0.01)。VC组患者睾丸组织SWV值与精子密度、精子活率均呈显著负相关(r=-0.728、-0.667,P值均<0.05)。结论睾丸组织SWV值可评价VC患者睾丸组织硬度,可为判断VC患者精液质量提供一定的依据。

Objective To analyze the correlation between shear wave velocity（SWV） of testicular tissue and sperm quality in patients with varicocele（VC）. Methods Totally 60 patients with VC（group VC） were treated in Shenzhen Chinese Traditional Medical Hospital from September 2011 to September 2014. Among them, 22 cases were in VCI grade, 24 cases were in VCII grade, and 14 cases were in VCIII grade. Health control group was selected from 32 healthy volunteers during the same period. All subjects underwent routine ultrasound examination and testicular tissue acoustic pulse radiation imaging. The paired t test was used to compare the difference of SWV values and sperm quality between VC group and control group. The variance analysis was used to compare the difference of SWV value and sperm quality among different VC patient subgroups. The SNK-q test was used to compare between the two VC subgroups. Results The SWV value of testis tissue in VC group was higher than that in control group, and the difference was statistically significant [（0.59±0.11） m/s vs（0.24±0.06） m/s, t=-16.695, P 〈0.01]. SWV value of testicular tissue in patients with VC group increased with the increase of the VC level, and there were significant differences in the SWV value of testicular tissue between the 2 VC subgroups（q=7.581, 9.231, 5.184, all P 〈0.01）. The sperm density, sperm motility rate in VC group were less than that in control group, and there were statistically significant differences [（42.43±7.03）×106/ml vs（83.22±11.28）×106/ml,（49.02±7.55）%vs（58.92±7.82）%, t=21.343, 5.917, both P 〈0.01]. Sperm density, sperm survival rate in VC patients decreases with the increase of the VC level, and the differences of sperm density, sperm survival rate in two VC subgroups were statistically significant（q=12.051, 5.885,-7.323, 7.315, 6.027,-4.640, all P 〈0.01）. There were significant negative correlation between SWV value and sperm density, sperm motility rate in VC patients（r=-0.728,-0.667, both P 〈0.05）. Conclusion SWV value of testicular tissue can be used to evaluate the stiffness of testicular tissue in patients with VC, which can provide complementary information on the quality of semen in VC patients.