不同类型睾丸微石症与成年男性精子质量关系的探究
发布时间：2019-05-28 15:58
【摘要】：研究背景及目的 睾丸微石症(Testicular microlithiasis, TM)作为临床上比较少见的一种男性生殖系统疾病,特点是弥散分布于睾丸实质内的多发点状钙化。在临床工作中,睾丸微石症常可以分为两种不同的疾病类型：即限制型睾丸微石症(Limited testicular microlithiasis, LTM)和经典型睾丸微石症(Classic testicular microlithiasis, CTM)。目前的研究对于TM发生率有逐渐升高的趋势已经逐步达成共识。当前,多数研究者倾向于将TM视为一种与男性生精功能有关的、具有临床意义的生殖系统疾病。针对TM包括其两种不同类型(CTM和LTM)的具体病因、发病机制等等而言,特别是和男性生育功能的关系,已经引起了很多研究者和临床医生的重视。因此,探讨睾丸微石症及其不同类型(CTM/LTM)和成年男性精子质量之间的关系是一项非常重要并有临床意义的研究,分析其相关性以及不同类型之间是否具有差异,可为今后临床工作中诊疗决策的实施提供帮助。 资料与方法 1.回顾性分析41例经超声检查诊断为睾丸微石症,并且精液常规检查发现精子的成年男性患者(即TM组)的临床资料。全部41例患者分为经典型睾丸微石症(CTM)和限制型睾丸微石症(LTM)两组。 2.另收集经超声检查诊断不伴有睾丸微石症并接受精液常规检查发现精子的11例成年男性(即非TM组)的临床资料进行分析。 3.采用SPSS18.0统计软件进行统计分析,两组独立样本均数间的两两比较采用Student's t检验,多组独立样本均数间的比较采用单因素方差分析(One-Way ANOVA),以P0.05为差异有统计学意义。 结果 1.全部41例TM患者中,共31例(75.61%)患者最终诊断为CTM,其他10例(24.39%)患者诊断为LTM。 2.TM组平均年龄是29.49±4.97岁,平均体质量指数(Body Mass Index, BMI)是25.39±4.07kg/m2,平均睾丸体积是16.94±3.59ml。其中CTM组的平均年龄是30.06±5.28岁,平均BMI是25.54±4.33kg/m2,平均睾丸体积是16.66±3.39ml；而LTM组的平均年龄是27.70±3.47岁,平均BMI是24.92±3.27kg/m2,平均睾丸体积是17.81±4.21ml。非TM组平均年龄是27.82±3.34岁,平均BMI是25.46±3.57kg/m2,平均睾丸体积是17.90±2.91ml。 3.TM组和非TM组两组在精子浓度(48.59±25.44×106/ml vs.89.06±36.03×106/ml)、精子总数(182.95±127.72×106vs.309.92±123.15×106)和非前向运动精子率(12.17±5.21%vs.18.10±7.27%)等三个方面的比较,差异均有统计学意义(P=0.000,0.005,0.003)。 4.CTM组、LTM组和非TM组三组在精子浓度(44.89±26.14×106/ml vs.60.06±20.16×106/ml vs.89.06±36.03×106/ml)、精子总数(160.33±106.50×106vs.253.05±165.74×106vs.309.92±123.15×106)、精子总活力(53.37±21.43%vs.71.28±16.96%vs.70.77±21.61%)、前向运动精子率(41.47±17.79%vs.58.28±15.73%vs.52.67±20.19%)、非前向运动精子率(11.90±5.63%vs.13.00±3.71%vs.18.10±7.27%)和不活动精子率(46.63±21.43%vs.28.72±16.96%vs.29.25±21.60%)等六个方面的比较,差异均有统计学意义(F=10.522,6.789,4.540,3.994,4.797,4.536; P=0.000,0.002,0.016,0.025,0.013,0.016)。 5.其中,CTM组与非TM组在精子浓度(44.89±26.14×106/ml vs.89.06±36.03×106/ml)、精子总数(160.33±106.50×106vs.309.92±123.15×106)、精子总活力(53.37±21.43%vs.70.77±21.61)、非前向运动精子率(11.90±5.63%vs.18.10±7.27%)和不活动精子率(46.63±21.43%vs.29.25±21.60%)等五个方面的比较,差异均有统计学意义(P=0.000,0.001,0.021,0.003,0.021)。 6.同时,LTM组与非TM组在精子浓度(60.06±20.16×106/ml vs.89.06±36.03×106/ml)和非前向运动精子率(13.00±3.71%vs.18.10±7.27%)等两个方面的比较,差异均有统计学意义(P=0.020,0.047)。 7.此外,CTM组和LTM组在精子总数(160.33±106.50×106vs.253.05±165.74×106)、精子总活力(53.37±21.43%vs.71.28±16.96%)、前向运动精子率(41.47±17.79%vs.58.28±15.73%)和不活动精子率(46.63±21.43%vs.28.72±16.96%)等四个方面的比较,差异均有统计学意义(P=0.043,0.021,0.013,0.021)。 结论 1.睾丸微石症能够影响到成年男性的精子质量。 2.与限制型睾丸微石症相对比,经典型睾丸微石症对成年男性精子质量的影响更显著。 3.睾丸微石症和成年男性精子质量之间存在关联,微石的程度与精子质量之间呈现出负相关的关系。
[Abstract]:Background and purpose of the study Testicular microlithiasis (TM) is a rare disease of male reproductive system in the clinic. It is characterized by the diffusion of multiple point-like calcium in the essence of the testis. In clinical work, the microlithiasis of the testis can be divided into two different types of diseases, namely, restricted testicular microlithiasis (LTM) and classic testicle microlithiasis (CTM). ). The current study has gradually reached a total of a gradual increase in the incidence of TM At present, most of the researchers are inclined to regard the TM as a reproductive system that is relevant to the male's spermatogenic function and has a clinical significance. The relationship between the specific causes of the TM, including its two different types (CTM and LTM), the pathogenesis, and the like, in particular the male fertility function, has led to the weight of many researchers and clinicians Therefore, the study of the relationship between testicular microlithiasis and its different types (CTM/ LTM) and the quality of adult male sperm is a very important and clinically meaningful study to analyze its correlation and whether there is a difference between different types I can provide some help for the implementation of diagnosis and treatment decision in the future clinical work. Co., Ltd. Materials and Methods 1. Retrospective analysis of 41 cases of testicular microlithiasis diagnosed by an ultrasonic examination, and the semen was routinely examined for adult male patients (i.e., TM) of the sperm. The clinical data of all 41 patients were divided into typical testicular microlithiasis (CTM) and constrained testicular microlithiasis (L (TM) two groups.2. A further collection of 11 adult male (i.e., non-TM) male (i.e., non-TM) who were not accompanied by testicular microlithiasis and were routinely examined for semen were also collected. 3. The data of the bed was analyzed.3. The statistical analysis was carried out by using the SPSS18.0 statistical software. The two of the two groups of independent samples were tested by Student's t. The comparison between the number of independent samples and the number of independent samples was one-Way ANOVA. to be poor Results 1. In total of 41 patients with TM,31 (75.61%) of the total 41 patients were diagnosed as CTM and 10 other patients (24 The mean age of the (39%) patients was 29.49 to 4.97 years and the mean body mass index (BMI) was 25.39 to 4.07 kg/ m2 and the mean testis The volume was 16.94 to 3.59 ml. The mean age of the CTM group was 30.06 to 5.28 years, the mean BMI was 25.54 to 4.33 kg/ m2, the mean testis volume was 16.66 to 3.39 ml, and the mean age of the LTM group was 27.70 to 3.47 years, with an average BMI of 24.92 and 3.27 kg/ m2, with an average testis The mean age of the non-TM group was 27.82-3.34 years, the mean BMI was 25.46-3.57 kg/ m2, and the average testis The total sperm concentration (48.59, 25.44,106/ ml vs. 89.06-36.03-106/ ml), the total number of sperm (182.95% 127.72-106 vs. 309.92-123.15-106) and the non-anterior exercise sperm rate (12.17% 5.21% vs. 18.10% 7.27%) were statistically significant (P = 0 The sperm concentration (44.89, 26.14,106/ ml vs. 60.06, 20.16,106/ ml vs. 89.06, 36.03,106/ ml), total sperm count (160.33, 106.50,106 vs. 253.05, 165.74,106 vs. 309.92, 16.96% vs. 70.77 and 21.61% vs. 71.28, 16.96% vs. 70.77 and 21.61%), and the forward-moving sperm rate (41.47% 17.79% vs. 58.28)15 were in the CTM group, the LTM group, and the non-TM group. The differences were statistically significant (F = 10.522, 6.789, 4.540, 3.994, 4.797, 4.536; P = 0.000, 0.002, 0.016) for six aspects of the non-active sperm rate (11.90, 5.63% vs. 13.00, 3.71% vs. 18.10 and 7.27%) and the non-active sperm rate (46.63% 21.43% vs. 28.72, 16.96% vs. 29.25% 21.60%). (0.025, 0.013, 0.016).5. In the CTM group and non-TM group, the sperm concentration (44.89-26.14-106/ ml vs. 89.06-36.03-106/ ml), total sperm count (160.33-106.50-106 vs. 309.92-123.15-106), total sperm motility (53.37%) The difference was statistically significant (P = 0.000, 0.0, 21.43% vs. 70.77% 21.61), non-anterior exercise sperm rate (11.90% 5.63% vs. 18.10% 7.27%) and non-active sperm rate (46.63% 21.43% vs. 29.25% 21.60%), etc. 1, 0.021, 0.003, 0.021).6. At the same time, the difference between the LTM group and the non-TM group in the sperm concentration (60.06-20.16-106/ ml vs. 89.06-36.03-106/ ml) and the non-anterior exercise sperm rate (13.00-3.71% vs. 18.10-7.27%) was poor In addition, the total sperm count (160.33-106.50-106 vs. 253.05-165.74-106), total sperm motility (53.37-21.43% vs. 71.28-16.96%), total sperm motility (41.47-17.79% vs. 58.28-15.73%) and non-active sperm-rate (46.63-21.43) in the total number of sperm (160.33-106.50-106 vs. 253.05-165.74-106), total sperm motility (53.37-21.43% vs. 71.28-16.96%), total sperm motility (41.47-17.79% vs. 58.28-15.73%), and non-active sperm-rate (46.63-21.43 The difference was statistically significant (P <0.01). = 0 .043, 0.021, 0.013, 0.021 Conclusion 1. The testicular microlithiasis can affect the sperm quality of adult male. The relative ratio of microlithiasis in the pill is more significant than that of typical testicular microlithiasis on the quality of adult male sperm.3. Microlithiasis in the testis and adult male
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R697.22
本文编号：2487182
[Abstract]:Background and purpose of the study Testicular microlithiasis (TM) is a rare disease of male reproductive system in the clinic. It is characterized by the diffusion of multiple point-like calcium in the essence of the testis. In clinical work, the microlithiasis of the testis can be divided into two different types of diseases, namely, restricted testicular microlithiasis (LTM) and classic testicle microlithiasis (CTM). ). The current study has gradually reached a total of a gradual increase in the incidence of TM At present, most of the researchers are inclined to regard the TM as a reproductive system that is relevant to the male's spermatogenic function and has a clinical significance. The relationship between the specific causes of the TM, including its two different types (CTM and LTM), the pathogenesis, and the like, in particular the male fertility function, has led to the weight of many researchers and clinicians Therefore, the study of the relationship between testicular microlithiasis and its different types (CTM/ LTM) and the quality of adult male sperm is a very important and clinically meaningful study to analyze its correlation and whether there is a difference between different types I can provide some help for the implementation of diagnosis and treatment decision in the future clinical work. Co., Ltd. Materials and Methods 1. Retrospective analysis of 41 cases of testicular microlithiasis diagnosed by an ultrasonic examination, and the semen was routinely examined for adult male patients (i.e., TM) of the sperm. The clinical data of all 41 patients were divided into typical testicular microlithiasis (CTM) and constrained testicular microlithiasis (L (TM) two groups.2. A further collection of 11 adult male (i.e., non-TM) male (i.e., non-TM) who were not accompanied by testicular microlithiasis and were routinely examined for semen were also collected. 3. The data of the bed was analyzed.3. The statistical analysis was carried out by using the SPSS18.0 statistical software. The two of the two groups of independent samples were tested by Student's t. The comparison between the number of independent samples and the number of independent samples was one-Way ANOVA. to be poor Results 1. In total of 41 patients with TM,31 (75.61%) of the total 41 patients were diagnosed as CTM and 10 other patients (24 The mean age of the (39%) patients was 29.49 to 4.97 years and the mean body mass index (BMI) was 25.39 to 4.07 kg/ m2 and the mean testis The volume was 16.94 to 3.59 ml. The mean age of the CTM group was 30.06 to 5.28 years, the mean BMI was 25.54 to 4.33 kg/ m2, the mean testis volume was 16.66 to 3.39 ml, and the mean age of the LTM group was 27.70 to 3.47 years, with an average BMI of 24.92 and 3.27 kg/ m2, with an average testis The mean age of the non-TM group was 27.82-3.34 years, the mean BMI was 25.46-3.57 kg/ m2, and the average testis The total sperm concentration (48.59, 25.44,106/ ml vs. 89.06-36.03-106/ ml), the total number of sperm (182.95% 127.72-106 vs. 309.92-123.15-106) and the non-anterior exercise sperm rate (12.17% 5.21% vs. 18.10% 7.27%) were statistically significant (P = 0 The sperm concentration (44.89, 26.14,106/ ml vs. 60.06, 20.16,106/ ml vs. 89.06, 36.03,106/ ml), total sperm count (160.33, 106.50,106 vs. 253.05, 165.74,106 vs. 309.92, 16.96% vs. 70.77 and 21.61% vs. 71.28, 16.96% vs. 70.77 and 21.61%), and the forward-moving sperm rate (41.47% 17.79% vs. 58.28)15 were in the CTM group, the LTM group, and the non-TM group. The differences were statistically significant (F = 10.522, 6.789, 4.540, 3.994, 4.797, 4.536; P = 0.000, 0.002, 0.016) for six aspects of the non-active sperm rate (11.90, 5.63% vs. 13.00, 3.71% vs. 18.10 and 7.27%) and the non-active sperm rate (46.63% 21.43% vs. 28.72, 16.96% vs. 29.25% 21.60%). (0.025, 0.013, 0.016).5. In the CTM group and non-TM group, the sperm concentration (44.89-26.14-106/ ml vs. 89.06-36.03-106/ ml), total sperm count (160.33-106.50-106 vs. 309.92-123.15-106), total sperm motility (53.37%) The difference was statistically significant (P = 0.000, 0.0, 21.43% vs. 70.77% 21.61), non-anterior exercise sperm rate (11.90% 5.63% vs. 18.10% 7.27%) and non-active sperm rate (46.63% 21.43% vs. 29.25% 21.60%), etc. 1, 0.021, 0.003, 0.021).6. At the same time, the difference between the LTM group and the non-TM group in the sperm concentration (60.06-20.16-106/ ml vs. 89.06-36.03-106/ ml) and the non-anterior exercise sperm rate (13.00-3.71% vs. 18.10-7.27%) was poor In addition, the total sperm count (160.33-106.50-106 vs. 253.05-165.74-106), total sperm motility (53.37-21.43% vs. 71.28-16.96%), total sperm motility (41.47-17.79% vs. 58.28-15.73%) and non-active sperm-rate (46.63-21.43) in the total number of sperm (160.33-106.50-106 vs. 253.05-165.74-106), total sperm motility (53.37-21.43% vs. 71.28-16.96%), total sperm motility (41.47-17.79% vs. 58.28-15.73%), and non-active sperm-rate (46.63-21.43 The difference was statistically significant (P <0.01). = 0 .043, 0.021, 0.013, 0.021 Conclusion 1. The testicular microlithiasis can affect the sperm quality of adult male. The relative ratio of microlithiasis in the pill is more significant than that of typical testicular microlithiasis on the quality of adult male sperm.3. Microlithiasis in the testis and adult male
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R697.22
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