精索静脉曲张对不育患者精液质量的影响

Effect of varicocele on semen quality in infertile patients

目的探讨精索静脉曲张对不育患者精液质量的影响。方法将我院收治的158例精索静脉曲张不育症患者依据超声及临床体格检查分为三组:53例Ⅰ级精索静脉曲张患者为Ⅰ组,65例Ⅱ级精索静脉曲张患者为Ⅱ组,40例Ⅲ级精索静脉曲张患者为Ⅲ组,选择有生育力的正常男性70例为对照组。采集所有研究对象的精液样本进行精液常规和精子形态学检查,分析精索静脉曲张因素对不育男性精液质量的影响以及其相关性。结果Ⅰ、Ⅱ、Ⅲ组的精子浓度、前向运动精子百分率及形态正常精子百分率均低于对照组,且Ⅰ组>Ⅱ组>Ⅲ组(P<0.05)。Ⅱ、Ⅲ组的曲线速率、直线速率、平均路径速率及精子头侧摆幅度均低于Ⅰ组及对照组(P<0.05);Ⅰ组的曲线速率、直线速率、平均路径速率均低于对照组(P<0.05)。精索静脉曲张程度分级与精子浓度、前向运动精子百分率、形态正常精子百分率均呈负相关(P<0.05)。结论精索静脉曲张不育患者的精子浓度、前向运动精子百分率、形态正常精子百分率与精索静脉曲张分级密切相关。

Objective To investigate the effect of varicocele on semen quality in infertile patients.Methods A total of 158 infertile patients with varicocele admitted in our hospital were divided into three groups according to ultrasonography and clinical physical examination:53 patients with gradeⅠvaricocele were in groupⅠ,65 patients with gradeⅡvaricocele were in groupⅡ,and 40 patients with gradeⅢvaricocele were in groupⅢ;seventy fertile normal males were selected as control group.The sperm samples of all study objects were collected for routine semen and sperm morphological examination,and the effect of varicocele on the semen quality of infertile men and their correlation were analyzed.Results The sperm concentration,forward motility sperm percentage and the percentage of sperm with normal morphology in the groupⅠ,ⅡandⅢwere lower than those in the control group,and those in the groupⅠ>groupⅡ>groupⅢ(P<0.05).The curvilinear velocity,straight-line velocity,average path velocity,amplitude of lateral head displacement in the groupⅡandⅢwere lower than those in the groupⅠand control group(P<0.05);the curvilinear velocity,straight-line velocity,average path velocity in the groupⅠwere lower than those in the control group(P<0.05).The degree of varicocele was negatively correlated with sperm concentration,forward motility sperm percentage and the percentage of sperm with normal morphology(P<0.05).Conclusion The sperm concentration,forward motility sperm percentage and the percentage of sperm with normal morphology in infertile patients with varicocele are closely related to the degree of varicocele.