睾丸动脉及精索静脉血流流速与精液质量的关系

发布时间：2018-08-11 16:10

【摘要】：目的:精索静脉曲张(VC varicocele)是引起男性不育的重要因素之一,在不育男性中发病率很高,世界卫生组织把精索静脉曲张列为男性不育的首要原因。目前,对于精索静脉曲张引起男性不育的机制尚不完全明确,本研究通过测量睾丸动脉及精索静脉血流流速、阴囊温度、精液质量,探讨睾丸动脉及精索静脉血流流速与阴囊温度的关系,进一步了解睾丸动脉及精索静脉血流流速与精液质量的关系,对认识精索静脉曲张引起男性不育的机制有一定的参考价值。方法:纳入郑州大学第一附属医院男科门诊2015年8月至2016年11月就诊的247例男性不育患者,180例合并有左侧精索静脉曲张患者设定为实验组,67例无精索静脉曲张的不育患者设定为对照组,实验组及对照组患者均经彩超证实。在180例左侧精索静脉曲张患者中,34例为Ⅰ°曲张,120例为Ⅱ度曲张,26例为Ⅲ度曲张。测量两组睾丸动脉血流流速、精索静脉血流流速、阴囊温度及精液质量(A级+B级),对两组测量指标进行对比研究;再给予曲张组患者行显微镜下精索静脉结扎术,术后3个月测量精液质量、阴囊温度,对术前及术后测量指标进行对比研究。结果:VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)睾丸动脉血流流速分别为(13.80±2.82)cm/s、(13.76±2.65)cm/s、(13.81±2.39)cm/s,对照组为(14.00±2.45)cm/s,二者无明显差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)精索内静脉血流流速分别为(2.78±0.53)cm/s、(2.65±0.62)cm/s、(2.48±0.50)cm/s,对照组为(3.49±0.40)cm/s,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)左侧睾丸温度分别为(36.58±0.22)℃、(36.66±0.22)℃、(36.95±0.23)℃,对照组左侧为(36.15±0.18)℃,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)右侧睾丸温度分别为(36.53±0.22)℃、(36.65±0.22)℃、(36.93±0.23)℃,对照组右侧为(36.15±0.17)℃,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)精子活力分别为(32.74±1.30)%、(30.58±1.28)%、(25.37±1.54)%,对照组精子活力(36.82±1.68)%,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)术后精液质量分别为(38.82±1.29)%、(40.64±1.29)%、(31.56±1.29)%,术前精液质量分别为(32.74±1.30)%、(30.58±1.30)%、(25.37±1.54)%,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)术后右侧阴囊温度分别为(36.20±0.21)℃、(36.20±0.21)℃、(36.32±0.21)℃,术前右侧阴囊温度分别为(36.53±0.22)℃、(36.93±0.22)℃、(36.65±0.23)℃,二者有统计学差异(P0.05);VC患者组(Ⅰ度、Ⅱ度、Ⅲ度)术后左侧阴囊温度分别为(36.20±0.21)℃,(36.21±0.21)℃、(36.34±0.21)℃,术前左侧阴囊温度分别为(36.58±0.22)℃(36.95±0.22)℃、(36.66±0.23)℃,二者有统计学差异(P0.05)。结论:VC患者组精索静脉血液回流速度较对照组缓慢,可能是引起睾丸温度增高的原因之一,阴囊温度升高影响精子的生成及成熟,进而造成了精液质量下降,引起男性不育。精索静脉血流速度缓慢可能是精索静脉曲张引起男性不育的原因之一。
[Abstract]:Objective: varicocele (VC varicocele) is one of the important factors that cause male infertility. The incidence of varicocele is very high in infertile men. The World Health Organization lists varicocele as the primary cause of male infertility. At present, the mechanism of male infertility caused by varicocele is not completely clear. The blood flow velocity of testicular artery and varicocele, scrotum temperature, semen quality were measured. To investigate the relationship between the blood flow velocity of testicular artery and spermatic vein and scrotal temperature, and the relationship between blood flow velocity of testicular artery and spermatic vein and semen quality. It has certain reference value for understanding the mechanism of male infertility caused by varicocele. Methods: from August 2015 to November 2016, 247 male infertile patients with varicocele were enrolled in the andrology clinic of the first affiliated Hospital of Zhengzhou University. 180 patients with varicocele were selected as experimental group (67 cases without varicocele). The infertile patients were set as the control group, The patients in the experimental group and the control group were confirmed by color Doppler ultrasound. Of 180 patients with varicocele on the left side, 34 cases were 鈪，

本文编号：2177504