| 陈舜.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): |
| 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 |
| Fertility assessment for patients with varicocele by ultrasound grading combined with serum reproductive hormone |
| 投稿时间：2019-06-06 修订日期：2020-02-17 |
| DOI： |
| 中文关键词: 超声检查 精索静脉曲张 男性不育 精液分析 血清抑制素 |
| 英文关键词::Ultrasonography varicocele male infertility semen analysis inhibin B |
| 基金项目:福建省卫生厅青年科研基金（NO:2011-2-6） |
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| 中文摘要: |
| 摘要: 目的 探讨超声分级结合血清生殖激素对评估精索静脉曲张(VC)患者生育力的价值。 方法 采用彩色多普勒超声将VC分为A组（I级）、B组（II级）、C组（III级）三组，每组30例，所有患者均行精索静脉高位结扎术，测定并分析各组术前术后血清生殖激素及精液质量的变化特点及相关性，并以30例正常生育男性为对照组（D组）。 结果 与 D 组比较，A组、B组、C组三组术前的精子浓度、存活率及前向运动百分率（PR）均降低；血清FSH、LH升高，T、InhB下降，差异均有统计学意义(p<0.05)；A组、B组与C组血清LH 、FSH及T水平差异均有统计学意义(p<0.05)。病例组血清InhB水平与精子浓度（r=0.51，p<0.01）和PR（r=0.38，p<0.01）存在相关性；除A组外，B组、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，而T下降，差异均有统计学意义(p<0.05)；同一超声分级VC组别内，术前血清InhB水平较高者术后精液质量改善可较显著。 结论 VC患者术后生精功能的改善程度不仅与曲张程度密切相关，同时还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 role of ultrasonic grading combined with serum reproductive hormones in fertility assessment for patients with varicocele(VC).Methods Patients with VC considered for the study were classified into three groups on color Doppler: group A ( grade I ),group B (grade II)and group C(grade III),each group of 30 cases. All patients with VC underwent spermatic vein ligation. The semen quality and the levels of serum reproductive hormones of patients in all three groups were measured before and after spermatic vein ligation，of which the change characteristic and correlation were then analyzed. Thirty men with normal fertility served as the control group(group D). Results Compared with those in the control group, there was a reduction in sperm concentration,sperm survival rate and forward movement percentage (PR), an increase in the levels of follicular stimulating hormone (FSH) and luteinizing hormone (LH) ,and a decrease in the levels of total T and inhibin B of patients with VC before spermatic vein ligation (P<0.05); there were statistically significant differences in the FSH, LH and total T among the group A, group B and group 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).Comparing patients with VC before and after spermatic vein ligation, only those in group B and group C demonstrated an improvement in serum quality , an increase in the levels inhibin B, FSH and LH and a decrease in the total T level to a varying degree after spermatic vein ligation(p<0.05). In the same varicocele grade group, patients with higher preoperative inhibin B level demonstrated a more significant improvement in semen quality after spermatic vein ligation .Conclusion The results of our study have shown that the improvement of testicular spermatogenic function is closely correlated with the grade of VC as well as factors like the levels of serum reproductive hormones.In summary, ultrasonic grading combined with serum reproductive hormones is one of effective clinical methods to assess the fertility of patients with VC. |
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