精索静脉曲张患者阴囊温度与精液质量的关系

Preliminary exploration of the correlation between scrotal temperature and semen quality in patients with varicocele

目的探索基于精准电生理诊断医用红外热成像仪下精索静脉曲张(varicocele,VC)患者阴囊温度与精液质量之间的关系。方法纳入VC患者62例。使用精准电生理诊断医用红外热像仪为每例患者拍摄3张不同姿势的红外热像图,第1张用于分析左和右腋窝平均温度,第2张用于分析右侧阴囊温度,第3张用于分析左侧阴囊温度。利用阴囊平均相对温度差(核心平均温度减去双侧阴囊平均温度)进行比较。探索阴囊平均相对温度差与精液质量之间的关系。结果Ⅰ~Ⅱ度VC患者阴囊平均相对温度差为1.65(0.40,2.70)℃,大于Ⅲ度VC患者阴囊平均相对温度差为1.38(-0.03,2.28)℃,但差异无统计学意义(P>0.05);阴囊平均相对温度差<1℃的Ⅲ度VC患者精子密度(22.01±20.33)×10^(6)·mL^(-1);精子总数(81.47±67.62)×10^(6);前向运动精子百分率(progressive motility,PR)(16.44±7.42)%;精子总活力率(total motility,PR+NP)(21.34±9.38)%,低于阴囊平均相对温度差>2℃的Ⅲ度VC患者,其中精子密度、精子总数、PR、PR+NP差异有统计学意义(P<0.05);阴囊平均相对温度差<1℃的Ⅰ~Ⅱ度VC患者精子密度(41.66±14.67)×10^(6)·mL^(-1),精子总数(171.57±86.07)×10^(6),小于阴囊平均相对温度差>2℃的Ⅰ~Ⅱ度VC患者(P<0.05);精子密度<15×10^(6)·mL^(-1)的患者,阴囊平均相对温度差为0.94(-0.83,1.46),小于精子密度≥15×10^(6)·mL^(-1)的患者的阴囊平均相对温度差[1.69(0.40,2.70)℃],差异有统计学意义(P<0.05);精子总数<39×10^(6)/一次射精的患者,阴囊平均相对温度差为0.97(-0.42,1.37),低于精子总数≥39×10^(6)/一次射精的患者的阴囊平均相对温度差[1.66(0.38,2.62)],差异有统计学意义(P<0.05)。结论对于VC患者,阴囊温度升高到一定程度(阴囊平均相对温度差<1℃)情况下可影响睾丸生精、精子密度和精子总数与阴囊温度之间存在负相关性,阴囊温度升高,精子密度、精子总数下降。对于VC患者,如果阴囊温度升高1℃以上应提前干预,在治疗上可更为积极。

Objective To investigate the correlation between scrotal temperature and semen quality in patients with varicocele(VC)based on precise electrophysiological diagnosis medical infrared thermal imaging camera.Methods This study included 62 patients with VC.Using a precise electrophysiological diagnosis medical infrared thermal imaging camera,three infrared thermal images were taken for each patient in different positions.The first image is used to analyze the average temperature of the left and right axilla,the second for the temperature of the right scrotum,and the third for the temperature of the left scrotum.Comparisons were made using the mean relative scrotal temperature difference(mean core temperature minus mean bilateral scrotal temperature).To investigate the correlation between mean relative scrotal temperature difference and semen quality.Results The average relative temperature difference of scrotum was 1.65(0.40,2.70)℃for GradeⅠandⅡpatients,higher than that in GradeⅢpatients(1.38℃,P>0.05).The sperm density of patients with GradeⅢVC with an average relative temperature difference of scrotum<1℃was 22.01±20.33 million/ml;the total sperm count was 81.47±67.62 million;PR was 16.44±7.42%;and PR+NP was 21.34±9.38%;which were significantly lower than the Patients with GradeⅢVC with an average relative temperature difference>2℃(P<0.05).In GradeⅠandⅡpatients with an average relative temperature difference of scrotum<1℃,the sperm density was 41.66±14.67 million/ml,and the total number of sperm was 171.57±86.07 million;which were significantly less than those in GradeⅠandⅡpatients with the average relative temperature difference of the scrotum>2℃(P<0.05).For patients with sperm density<15 million/ml,the average relative temperature difference of scrotum was 0.94(-0.83,1.46),significantly lower than that of patients with sperm density≥15 million/ml(P<0.05).For patients with total sperm count<39 million/one ejaculate,the mean relative temperature difference of scrotum was 0.97(-0.42,1.37),significantly lower than that of patients with total sperm count≥39 million/one ejaculation(P<0.05).Conclusion For patients with VC,scrotal temperature increases to an extent(average relative temperature difference of scrotum<1℃)can affect testicular spermatogenesis.There is a negative correlation between sperm density and total sperm count and scrotal temperature.For patients with VC,if the scrotal temperature increases by more than 1℃,early intervention should be performed,and the treatment can be more active.