精索静脉高位结扎术对精子DNA碎片的影响  

High ligation of the spermatic vein and sperm DNA fragmentation

作　　者：胡杨杨[1] 林礼彰[1] 李澄棣[1] 蔡健[1] 

机构地区：[1]温州医学院附属第一医院泌尿外科,浙江温州325000

出　　处：《中华男科学杂志》2011年第10期897-901,共5页National Journal of Andrology

摘　　要：目的:探讨精索静脉高位结扎术对精子DNA碎片影响及手术效果的评价。方法:精索静脉曲张(Varicocele,VC)患者34例,均行精索静脉高位结扎术。术前和术后3个月按WHO推荐方法进行精子运动指标(10项)、精子巴氏染色形态分析和精子DNA碎片分析检测。结果:VC患者术后正常精子形态比例明显高于术前,有显著性差异(P<0.01),术后精子DNA碎片比率、精子畸形指数(Sperm deformity index,SDI)和多种异常指数(Multiple anomalies index,MAI)均明显低于术前,有显著性差异(P<0.01);术后精子浓度、b级精子率均较术前升高,有显著性差异(P<0.05);术后a级精子比率、(a+b)级精子比率均比术前明显升高,有显著性差异(P<0.01)。VCⅠ级、Ⅱ级、Ⅲ级组术后精子DNA碎片比率均较术前明显降低,差异有统计学意义(P<0.01);亚临床型VC组术后精子DNA碎片比率与术前无显著差异(P>0.05)。VC术后大晕环精子比率较术前明显增多,有显著性差异(P<0.01);术后中晕环、小晕环、无晕环精子比率均较术前降低,有显著性差异(P<0.01)。结论:行精索静脉高位结扎术能有效改善VC患者的精子质量。Objective： To investigate the effect of high ligation of the spermatic vein（HLSV） on DNA fragmentation in varicocele（VC） patients.Methods： Thirty-four VC patients underwent HLSV.Sperm motion indexes and the results of papanicolaou staining and DNA fragmentation detection were analyzed before and 3 months after the operation according to the WHO guidelines.Results： Compared with pre-operation,HLSV achieved a significant increase in the percentage of morphologically normal sperm（P0.01）,and remarkable decreases in DNA fragmentation,sperm deformity index（SDI） and multiple anomalies index（MAI）（P0.01）.The patients also showed significant increases in sperm concentration and the percentages of grade b sperm（P0.05） and grade a and a＋b sperm（P0.01） after the operation.The post-operative percentages of sperm DNA fragmentation in those with grades Ⅰ-Ⅲ VC were markedly lower（P0.01）,but showed no significant difference from that in those with subclinical VC（P0.05）.The percentage of big-halo sperm was significantly increased（P0.01）,while those of the medium-,small-and non-halo sperm remarkably decreased（P0.01） after HLSV.Conclusion： HLSV can effectively improve the sperm quality of VC patients.

关 键 词：精索静脉曲张 精索静脉高位结扎术 精子DNA碎片 

分 类 号：R699[医药卫生—泌尿科学]