显微镜下精索静脉结扎术治疗精索静脉曲张对精浆线粒体功能障碍的影响  

Effect of microscopically ligation of spermatic vein in the treatment of varicocele on spermatic mitochondrial dysfunction

作　　者：张永立 李小满 黄松柏 马力 曹辉彩[2] ZHANG Yongli;LI Xiaoman;HUANG Songbai;MA Li;CAO Huicai(Department of Extrathoracic Urology,Lixian Hospital,Lixian 071400,Hebei,China;Laboratory Department,Baoding First Central Hospital,Baoding 071000,Hebei,China)

机构地区：[1]蠡县医院胸外泌尿外科,河北蠡县071400 [2]保定市第一中心医院检验科,河北保定071000

出　　处：《中国性科学》2023年第1期19-22,共4页Chinese Journal of Human Sexuality

基　　金：保定市科学技术计划项目(2141ZF150)。

摘　　要：目的 分析显微镜下精索静脉结扎术治疗精索静脉曲张对精浆线粒体功能障碍的影响。方法 选取2020年2月至2021年9月在蠡县医院接受不孕症评估的105例精索静脉曲张不育男性患者,均接受显微镜下精索静脉结扎术。在术前和术后3个月收集两次精液样本,分析精浆线粒体活性、精子核DNA的完整性和线粒体呼吸评估。结果 患者术后3个月Ⅰ级细胞较术前增多,Ⅲ级细胞较术前减少(P<0.05),Ⅱ级细胞和Ⅳ级细胞与术前比较无统计学差异(P>0.05);患者术后3个月Ⅰ级细胞和Ⅱ级细胞百分比较术前增多,Ⅲ级细胞和Ⅳ级细胞占比较术前减少(P<0.05)。患者术后3个月DNAⅠ级量和Ⅱ级量较术前升高,DNAⅢ级和Ⅳ级量较术前减少(P<0.05)。患者术后3个月的呼吸控制率(RCR)、V3、V4等参数较术前升高(P<0.05)。患者术后3个月的精子浓度、活动精子率、正常形态精子率较术前升高,不活动精子率、血清活性氧代谢物(ROM)和精子脂质过氧化物(LPO)水平较术前降低(P<0.05)。结论 精索静脉曲张患者呈现出更高百分比的DNA断裂细胞和线粒体不活跃的精子,显微镜下精索静脉结扎术能保持精索静脉曲张患者DNA完整性并显著改善精浆线粒体功能障碍。Objective To investigate the effect of microscopically ligation of spermatic vein in the treatment of varicocele on spermatic mitochondria dysfunction. Methods 105 male infertility patients with varicocele who were evaluated for infertility in Lixian Hospital from February 2020 to September 2021 were selected, and all of them underwent microscopic ligation of the spermatic vein.Semen samples were collected before surgery and three months after surgery for analysis of seminal plasma mitochondrial activity, sperm nuclear DNA integrity, and mitochondrial respiration assessment. Results The number of grade Ⅰ cells increased three months after surgery compared with that before surgery, and the number of grade Ⅲ cells decreased(P<0.05),and there was no statistical difference between grade Ⅱ cells and grade Ⅳ cells three months after surgery compared with that before surgery(P>0.05).The percentage of grade Ⅰ cells and grade Ⅱ cells increased three months after surgery compared with that before surgery, and the percentage of grade Ⅲ cells and grade Ⅳ cells decreased(P<0.05).Three months after surgery, the level of DNA Ⅰ and Ⅱ increased compared with that before surgery, and the level of DNA Ⅲ and Ⅳ decreased(P<0.05).Three months after surgery, RCR, V3, V4 and other parameters were higher than those before surgery(P<0.05).Three months after surgery, sperm concentration, motile sperm volume and sperm morphology were increased compared with that before surgery, while inactive sperm volume, serum reactive oxygen metabolites(ROM) and sperm lipid peroxide(LPO) levels were decreased(P<0.05). Conclusions Men with varicocele showed a higher percentage of DNA broken cells and sperm with mitochondrial inactivity.Microscopic varicocele ligation preserves DNA integrity and significantly improves mitochondrial dysfunction in patients with varicocele.

关 键 词：显微镜下精索静脉结扎术 精浆线粒体 线粒体活性 DNA完整性 

分 类 号：R697[医药卫生—泌尿科学]