睾丸微石症患者超声及临床特点分析  

Analysis of Ultrasound and Clinical Features of Testicular Microlithiasis in Patients

作　　者：李昊 穆维娜[1] LI Hao;MU Wei-na(Department of Ultrasound,the First Central Hospital of Baoding,Baoding,Hebei 071000,China)

机构地区：[1]保定市第一中心医院超声科,河北保定071000

出　　处：《临床误诊误治》2020年第11期65-69,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题计划项目(20181489)。

摘　　要：目的分析睾丸微石症(testicular microlithiasis,TM)患者超声及临床特点。方法选取符合纳入及排除标准的TM 80例作为观察组,另选取同期于该院进行体检并自愿参与本研究的健康体检者80例作为对照组。两组均行彩色多普勒超声检查,观察组结合“萤火虫”成像技术,比较两组睾丸相关指标、双侧精索静脉相关指标及实验室相关指标,并统计观察组合并睾丸疾病情况。结果观察组双侧睾丸体积均明显小于对照组;双侧精索静脉最大内径(DR)、反流持续时间(TR)、最大反流速度(Vmax)及Valsava试验最大内径(DV)明显长或快于对照组,血清人绒毛膜促性腺激素(HCG)、乳酸脱氢酶(LDH)及甲胎蛋白(AFP)水平明显高于对照组,差异有统计学意义(P<0.01)。两组睾丸动脉峰值流速(PSV)、阻力指数(RI)及血清睾酮(T)、雌二醇(E 2)水平比较差异无统计学意义(P>0.05)。观察组合并不育症10例;行阴囊彩色多普勒超声检查发现精索静脉曲张23例,阴囊肿胀15例,腮腺炎性睾丸炎13例,睾丸肿瘤10例,附睾肿物9例。结论TM患者双侧精索静脉DR、TR、Vmax、DV及血清HCG、LDH、AFP水平普遍较长或高,或可作为检测指标为男性不育症和睾丸肿瘤的预防提供帮助。彩色多普勒超声结合“萤火虫”成像技术可较好地诊断TM及其合并的其他睾丸疾病。Objective To analyze ultrasound and clinical features of testicular microlithiasis(TM)in patients.Methods Eighty patients with TMs that met the inclusion and exclusion criteria were selected as the observation group,and 80 healthy persons who underwent physical examination and volunteered to participate in the study in the hospital during the same period were selected as the control group.Both groups underwent color Doppler ultrasonography."Firefly"imaging technology was applied to the observation group.Testicular-related indexes,indexes related to bilateral spermatic cord vein and related laboratory indexes were compared,and the combined testicular disease was statistically observed.Results The volume of bilateral testis in the observation group was significantly smaller than that in the control group.The maximum internal diameter(DR)of bilateral spermatic cord vein,duration of regurgitation(TR),maximum velocity(Vmax),maximum internal diameter(DV)of the Valsava test were significantly longer or faster than those of the control group,and the levels of serum human chorionic gonadotropin(HCG),lactate dehydrogenase(LDH),and alpha-fetoprotein(AFP)were significantly higher than those of the control group(P<0.01).There was no significant difference in peak flow velocity(PSV),resistance index(RI),serum testosterone(T),and estradiol 2(E 2)levels between the two groups(P>0.05).Ten cases in observation group had infertility.Color Doppler ultrasonography of the scrotum showed 23 cases of varicocele,15 cases of scrotal swelling,13 cases of adenitis orchitis,10 cases of testicular tumors,and 9 cases of epididymal tumors.Conclusion The DR of bilateral spermatic cord vein,TR,Vmax,DV and serum HCG,LDH,AFP levels of TM patients are generally longer or higher,which may be used as detection indicators to help prevent male infertility and testicular tumors.Color Doppler ultrasonography combined with"firefly"imaging technology can be used to better diagnose TM and other testicular diseases.

关 键 词：睾丸微石症 睾丸疾病 超声检查 睾丸体积 绒毛膜促性腺激素 人 乳酸脱氢酶 

分 类 号：R697.22[医药卫生—泌尿科学]