精索静脉曲张不育患者显微手术后精液质量、精浆生殖激素水平及氧化应激水平临床研究

Clinical research on thesemen quality,seminal hormone and oxidative stress levels after microsurgery in patients with varicocele infertility

目的:探讨精索静脉曲张不育患者显微术后精液质量、精浆性激素水平和氧化应激水平的影响。方法:收集湖北医药学院附属人民医院2016年1月至2016年12月收治的采用腹股沟外环下显微精索静脉结扎术治疗40例单纯左侧精索静脉曲张不育患者的临床资料40例,Ⅱ°曲张20例,Ⅲ°曲张20例,观察术前及术后6个月患者的精液质量、精浆生殖激素水平及氧化应激水平等指标的变化情况。结果:与手术前比较,II度及III度曲张不育患者精子浓度、活动精子、正常形态精子明显改善,精子畸形指数明显降低,差异具有统计学意义(P <0. 05);精浆促卵泡激素(FSH)和促黄体素生成激素(LH)水平手术后均明显下降,睾酮(T)较术前明显升高,差异具有统计学意义(P <0. 05);精浆总抗氧化能力(TAC) II度及III度均较术前升高,差异具有统计学意义(P <0. 05)。结论:精索静脉曲张不育患者通过显微外科手术可明显改善精子质量,增强精浆总抗氧化能力水平,并且可明显降低精浆FSH和LH水平,提升睾酮水平。

Objective：To investigate the semen quality, seminal hormone and oxidative stress levels after microsurgery in patientswith varicocele infertility. Methods ： The clinical data of 40 patients who were treated by microsurgical varicocelectomy from January 2016 to December 2016 was analyzed, including 20 cases of Ⅱ°and 20 cases of Ⅲ°varicocele. Changes in semen quality, seminal hormone and oxidative stress levelsbetween preoperative and postoperative 6 months were observed. Results：Compared with that before operation, the sperm concentration, sperm activity and sperm shape was obviously improved in patientswith ⅡI° and Ⅲ° varicose infertilityand the sperm deformity index was decreased obviously, with statistically significant differences （P 〈 0. 05 ）. Seminal plasma follicle stimulating hormone （FSH） and luteinizing hormone （LH） level were significantly decreased after operation（ P 〈 0. 05 ）, and Testosterone （T） levelwas increased significantly after operation, all with statistically significant differences （P 〈 0. 05 ）. Seminal plasma total antioxidant capacity （TAC） of Ⅱ° and Ⅲ°were higher compared with preoperative, with statistically significant difference （ P 〈 0. 05 ）. Conclusions ： Microsurgery can obviously improve the sperm quality andtotal antioxidant capacity of seminal plasma of patients with varicocele infertility, while reduce the seminal plasma FSH and LH level and enhance the level of testosterone.