显微镜下经外环下精索静脉结扎术对精索静脉曲张患者精子质量、氧化应激水平及抗精子抗体水平的影响  

Effects of microsurgical subinguinal varicocelectomy on sperm quality, oxidative stress and anti-sperm antibody levels in patients with varicocele

作　　者：张俊杰[1] 杨阳 罗旋[1] 杜业芳[1] ZHANG Junjie;YANG Yang;LUO Xuan;DU Yefang(Department of Andrology,First People's Hospital of Jingmen,Jingmen,Hubei,448000,China)

机构地区：[1]荆门市第一人民医院泌尿男科,湖北荆门448000

出　　处：《临床泌尿外科杂志》2022年第4期278-282,共5页Journal of Clinical Urology

基　　金：荆门市科技计划项目(No:YDKY2017020)。

摘　　要：目的:探讨显微镜下外环下精索静脉结扎术(MSV)对精索静脉曲张患者精子质量、氧化应激水平及抗精子抗体水平的影响。方法:选取2018年2月—2020年3月诊治的144例精索静脉曲张患者作为研究对象,按照随机数字表法分为A组(予以MSV)、B组(予以腹腔镜下精索静脉高位结扎术)、C组(予以腹膜后精索高位结扎术),各48例。对比精子密度、A+B级精子、精子活率、ASA阳性率、SOD、TAC;分析TAC、SOD与精子密度、A+B级精子、精子活率的相关性;观察并发症发生率及复发率。结果:重复测量方差分析显示,三组精子密度、精子活率、TAC的时点、组间、交互比较,差异有统计学意义(P<0.05);三组A+B级精子、SOD的时点、交互比较,差异有统计学意义(P<0.05);三组A+B级精子、SOD的组间比较差异无统计学意义(P>0.05)。单因素方差比较,三组术前精子密度、A+B级精子、精子活率、SOD、TAC比较,差异无统计学意义(P>0.05);两两比较显示,术后3个月,A组和B组的精子密度、A+B级精子、精子活率、SOD、TAC高于C组(P<0.05)。A组和B组的ASA阳性率低于C组(P<0.05)。Pearson相关性分析显示,TAC、SOD与精子密度、A+B级精子、精子活率呈正相关(P<0.05)。A组的并发症发生率、复发率低于B组和C组(P<0.05)。结论:MSV治疗精索静脉曲张效果显著,能改善精子质量和降低氧化应激、抗精子抗体水平。Objective:To investigate the effect of microsurgical subinguinal varicocelectomy(MSV)on sperm quality,oxidative stress level and anti-sperm antibody level in patients with varicocele.Methods:A total of 144 patients with varicocele who were diagnosed and treated from February 2018to March 2020were selected as the research objects,and were divided into group A(MSV)and group B(laparoscopic high ligation of spermatic vein),group C(retroperitoneal high ligation of spermatic cord),48cases in each according to the random number table method.Sperm density,A+B grade sperm,sperm motility rate,ASA positive rate,SOD,TAC were compared.The correlation between TAC,SOD and sperm density,A+B grade sperm,sperm motility rate was analyzed.The complication rate and recurrence rate were observed.Results:Repeated measures analysis of variance showed that there were statistically significant differences in sperm density,sperm motility rate,time point of TAC,between groups,and interaction among the three groups(P<0.05).Interaction comparison,the difference was statistically significant in A+B grade sperm and SOD(P<0.05).There was no significant difference among the three groups in A+B grade sperm or SOD(P>0.05).One-way comparison of variance,before surgery,there was no significant difference in sperm density,A+B grade sperm,sperm motility rate,SOD or TAC among the three groups(P>0.05);Pairwise comparison showed that the sperm density,A+B grade sperm,sperm motility rate,SOD and TAC of group A and group B were higher than those of group C 3months after operation(P<0.05).The positive rate of ASA in group A or group B was lower than that in group C(P<0.05).Pearson correlation analysis showed that TAC and SOD were positively correlated with sperm density,A+B grade sperm and sperm motility rate(P<0.05).The complication rate and recurrence rate of group A was lower than that of group B or group C(P<0.05).Conclusion:MSV has a significant effect on treatment of varicocele,for it can improve sperm quality and reduce oxidative stress and anti-sperm

关 键 词：显微镜下外环下精索静脉结扎术 精索静脉曲张 精子质量 氧化应激 抗精子抗体 

分 类 号：R697[医药卫生—泌尿科学]