手术治疗对精索静脉曲张患者外周血液睾酮水平影响的荟萃分析

Effects of surgical treatment on testosterone concentration in peripheral blood of patients with varicocele:aMeta-analysis

目的系统评价手术治疗精索静脉曲张对患者外周血睾酮水平的影响。方法计算机检索Embase、Pubmed、Cochranelibrary、CNKI及万方数据库,收集相关的RCT与NRCT,检索时限为1995年1月至2018年9月,由2名评价者严格按照纳入与排除标准选择试验、提取资料和评价质量后,使用RevMan5.3软件进行荟萃分析。结果纳入23篇研究,共计1888名患者。Meta分析结果显示:在本研究纳入的患者中,术后平均睾酮浓度较术前有所改善(MD=90.12,95%CI:60.00~120.25,P<0.00001)。结论精索静脉曲张会引起睾丸间质细胞功能紊乱,从而导致睾酮的合成和分泌减少。手术治疗可以显著提高精索静脉曲张患者外周血液中的睾酮浓度。

Objective To systematically evaluate the effects of surgical treatment of varicocele on the testosterone level. Methods Relevant randomized controlled trials and non-randomized controlled trials published during Jan.1995 and Sep.2018 were searched in the electronic databases of Embase,The Cochrane Library,PubMed,CNKI and Wanfang.The studies were screened by two independent reviewers according to the inclusion and exclusion criteria.After data were extracted and quality was evaluated, Meta -analysis was conducted using RevMan 5.3 software. Results A total of 23 studies were included,involving 1 888 cases.The meta-analysis results showed that the average testosterone level increased by 90.12 ng/dL after surgical treatment ( MD =90.12,95 % CI :60.00-120.25, P <0.000 01). Conclusion Varicocele may cause dysfunction of testicular Leydig cells,resulting in decreased testosterone synthesis and secretion.Surgical treatment can significantly improve the function of Leydig cells and increase the concentration of peripheral blood testosterone in patients with varicocele.