| 陈舜,薛恩生,梁荣喜,陈剑晖,林晓东,张宇.超声分级结合血清生殖激素评估精索静脉曲张患者生育力[J].中国医学影像技术,2020,36(2):261~265 |
| 超声分级结合血清生殖激素评估精索静脉曲张患者生育力 |
| Ultrasonic grading combined with serum reproductive hormone in assessing fertility of patients with varicocele |
| 投稿时间：2019-06-06 修订日期：2019-09-16 |
| DOI：10.13929/j.issn.1003-3289.2020.02.021 |
| 中文关键词: 精索静脉曲张 不育,男性 超声检查 |
| 英文关键词:varicocele infertility,male ultrasonography |
| 基金项目:福建省卫生厅青年科研基金（2011-2-6）。 |
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| 中文摘要: |
| 目的 探讨超声分级结合血清生殖激素评估精索静脉曲张（VC）患者生育力的价值。方法 根据彩色多普勒超声所见，将90例VC并接受精索静脉高位结扎术患者分为A（Ⅰ级）、B（Ⅱ级）、C（Ⅲ级）3组，各30例；以30名正常生育男性纳入对照组（D组）。分别于术前、术后测定并分析各VC组血清生殖激素及精液质量的变化特点及相关性。结果 ①与D组比较，A、B、C组术前精子浓度、存活率及前向运动百分率（PR）均降低；血清卵泡刺激素（FSH）、黄体生成素（LH）升高，睾酮（T）、抑制素B（InhB）下降（P均<0.05）；A、B组与C组血清LH、FSH及T水平差异均有统计学意义（P均<0.05）；VC患者血清InhB水平与精子浓度（r=0.51，P<0.01）和PR（r=0.38，P<0.01）呈正相关；②除A组外，B、C组术后精液质量不同程度改善，血清InhB、FSH、LH水平较术前均有不同程度提高（P均<0.05），而T下降（P<0.05）；③相同超声级别VC组内，术前血清InhB水平较高者术后精液质量改善更显著。结论 VC患者术后生精功能改善程度与曲张程度密切相关，且受血清生殖激素水平等因素影响。超声分级结合血清生殖激素等可有效评估VC患者生育力。 |
| 英文摘要: |
| Objective To investigate the value of ultrasonic grading combined with serum reproductive hormones in assessing fertility of patients with varicocele (VC). Methods A total of 90 VC patients were classified into group A (grade Ⅰ), B (grade Ⅱ) and C (grade Ⅲ) according to color Doppler findings, each group included 30 cases. Thirty men with normal fertility were enrolled in control group (group D). All VC patients then underwent spermatic vein ligation. The semen quality and the levels of serum reproductive hormones of patients were measured before and after spermatic vein ligation, and the characteristics and correlations of changes of the above-mentioned indicators were analyzed. Results ①Before spermatic vein ligation, compared with group D, there were reductions of sperm concentration, sperm survival rate and forward movement percentage (PR), but increases of the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), also decreases of the levels of testosterone (T) and inhibin B in group A,B and C (all P<0.05).Statistically significant differences of FSH, LH and total T were found among group A, B and C. Serum inhibin B levels were positively corelated with sperm concentration (r=0.51,P<0.01) and PR (r=0.38,P<0.01). ②After spermatic vein ligation, VC patients in group B and C demonstrated improvement in serum quality, increases in the levels of inhibin B, FSH and LH, and a decrease in the total T level to a varying degree (all P<0.05). ③In the same grade VC group, patients with higher preoperative inhibin B level demonstrated more significant improvement in semen quality after spermatic vein ligation. Conclusion The improvement of testicular spermatogenic function is closely correlated with the ultrasonic grading of VC, as well as factors like the levels of serum reproductive hormones. Ultrasonic grading combined with serum reproductive hormones is effective for assessing the fertility of patients with VC. |
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