精索静脉曲张不育患者精子质量及其超微结构的研究  

Semen quality and sperm ultrastructure in infertile men with varicocele

作　　者：马华刚[1] 赵文杰[1] 卢洪凯[1] 

机构地区：[1]潍坊市人民医院生殖医学科,山东潍坊261041

出　　处：《中华男科学杂志》2013年第8期704-709,共6页National Journal of Andrology

摘　　要：目的:研究精索静脉曲张不育患者精液质量及精子超微结构的变化。方法:不育伴精索静脉曲张患者118例作为实验组(VC组),正常自愿捐精者76例作为对照组,对其精液常规、精浆生化及外周血内分泌水平进行检测,并应用扫描和透射电镜技术对精子的超微结构进行观察。结果:VC组精液常规检查中,精子浓度、前向运动能力、存活率显著低于正常组(P<0.05),精液量、非前向运动能力无差异(P>0.05),精浆生化各项指标中,果糖浓度无显著差异,中性α-葡糖苷酶、锌离子浓度均显著低于正常组(P<0.05),外周血FSH、LH、T、E2水平均无统计学差异(P>0.05)。扫描电镜检查示正常形态精子比率低于对照组[(56.76±15.32)%vs(12.34±6.58)%,P<0.05],精子异常主要发生在头颈部,透射电镜检查示精子畸变以尖头为主,且伴有分化异常的复杂畸形。结论:VC可导致少-弱-畸精子症,进而引起不育,其原因可能是由于精浆微环境及超微结构的改变。Objective： To examine and analyze semen quality and sperm ultrastructural characteristics of infertile patients with varicocele. Methods： This study included 118 infertile patients with varicocele （the VC group） and 76 normal semen donors （the control group）. We obtained routine semen parameters, seminal plasma biochemical markers and the levels of reproductive hormones in the subjects, and observed the changes in sperm structure under the scanning electron microscope and transmission electron microscope. Results： Compared with the normal control, the VC patients showed significantly decreased sperm concentration, sperm progressive motility, sperm viability （P 〈 0. 05 ） , but no remarkable difference in semen volume and non-progressive motility （P 〉 0.05 ）. The concentrations of zinc and a-glycoside enzyme in the seminal plasma were markedly reduced in the VC group in compari- son with the controls （ P 〈 0. 05 ） , but there was no significant difference in the level of fructose （ P 〉 0.05 ） , nor in such seminal plasma biochemical markers as FSH, IM, T and E,2 between the two groups （ P 〉 0. 05 ）. The percentage of morphologically normal sperm was dramatically lower in the VC than in the control group （ [56.76 ± 15.32] % vs [ 12.34 ±6.58] %, P 〈 0.05 ）, and the sperm deformities were mostly in the head and neck, mainly tapering pin head accompanied by complex abnormal differentiation. Conclusion： This study demonstrated that VC may lead to oligo-astheno-terato zoospermia, and hence male infertility, which may be attributed to the changes of seminal plasma microenvironment and sperm uhrastructure.

关 键 词：精索静脉曲张 男性不育 精子超微结构 

分 类 号：R698.2[医药卫生—泌尿科学]