基于氧化应激效应探讨精索静脉曲张患者显微结扎术对精子DNA碎片及试管婴儿临床结局的影响指数  

To investigate the effect of microsurgical ligation on sperm DNA fragmentation index in patients with varicocele based on oxidative stress effect

作　　者：熊涌[1] 马玲 郑小挺 张明亮[1] 熊奇 XIONG Yong;MA Ling;ZHENG Xiaoting;ZHANG Mingliang;XIONG Qi(Nanchang Reproductive Hospital,Affiliated Hospital of Nanchang Institute of Medical Sciences,Nanchang 330004,China)

机构地区：[1]南昌市生殖医院,南昌市医学科学研究所附属医院,江西南昌330004

出　　处：《临床医药实践》2024年第9期651-654,660,共5页Proceeding of Clinical Medicine

摘　　要：目的:探讨精索静脉显微结扎术对精索静脉曲张(VC)患者精子DNA碎片指数(DFI)及临床结局的影响。方法:选取VC伴有精子DNA碎片异常并行辅助生殖技术治疗的患者80例,按照随机数字表法分成观察组和对照组,每组40例。观察组行精索静脉显微结扎术,术后联合左卡尼汀口服溶液治疗;对照组单纯采用左卡尼汀口服溶液治疗。疗程3个月。治疗后,观察两组患者精子DNA碎片指数(DFI)、精子浓度、前向运动精子百分比(PR)及临床结局指标的变化。结果:治疗后,观察组总有效率高于对照组(P<0.05);观察组DNA碎片指数明显低于对照组(P<0.05),观察组精子浓度、PR明显高于对照组(P<0.01)。观察组受精率、卵裂率、优质胚胎率、养囊成功率及妊娠率均高于对照组(P<0.05)。结论:精索静脉曲张结扎术后联合左卡尼汀口服溶液能明显改善精索静脉曲张患者的精子质量,同时能修复患者精子DNA的完整结构,对体外受精(IVF)的临床结局有促进作用,疗效优于单纯运用左卡尼汀口服溶液治疗。Objective:To investigate the effect of microsurgical ligation of spermatic vein on sperm DNA fragmentation index(DFI)and clinical outcome in patients with varicocele(VC).Methods:A total of 80 patients with VC accompanied by abnormal sperm DNA fragmentation and treated with assisted reproductive technology(ART)in the Department of Reproductive Andrology,Nanchang Reproductive Hospital were selected and randomly divided into two groups according to the random number table method.There were 40 cases in the observation group and 40 cases in the control group.The observation group was treated with microsurgical ligation of spermatic vein and combined with levocarnitine oral solution after operation.The control group was treated with levocarnitine oral solution alone.The treatment course of the two groups was 3 months.The changes of sperm DNA fragmentation index,sperm concentration,percentage of forward movement sperm(PR)and clinical outcome indexes were observed in the two groups.Results:After treatment,the total effective rate of the two groups was compared,and the observation group was higher than the control group(P<0.05).Compared with the sperm treatment of the two groups,the DNA fragmentation index of the observation group was significantly lower than that of the control group(P<0.05),and the sperm concentration of the observation group was significantly higher than that of the control group(P<0.05).The percentage of PR sperm(forward motile sperm)was significantly higher than that of the control group(P<0.01).In the comparison of clinical outcomes,the fertilization rate,cleavage rate,high-quality embryo rate,capsular success rate and pregnancy rate in the observation group were higher than those in the control group(P<0.05).Conclusion:The combination of antioxidant therapy after varicocele ligation can significantly improve the sperm quality of patients with varicocele,repair the complete structure of sperm DNA,and promote the clinical outcome of in vitro fertilization(IVF).The curative effect is better than that

关 键 词：精索静脉曲张 左卡尼汀口服溶液 DNA碎片指数 精子 

分 类 号：R697.24[医药卫生—泌尿科学]