摘要
目的对比精索静脉曲张(VC)的超声分型及手术前后精液中一氧化氮(NO)浓度和α糖苷酶(NAG)活性的变化,分析其与男性不育之间的相关性。方法彩色多普勒超声诊断的VC不育患者共150例,以精索静脉(PPV)反流程度、PPV最大内径(DR)、PPVDR和反流程度3种不同分级指标分为VCⅠ级、VCⅡ级、VCⅢ级,患者均行精索静脉高位结扎,术前术后均检测精液中NO浓度及NAG活性。结果以PPV反流程度为分级指标时,术前术后精液中NO浓度变化及NAG活性在VCⅠ级无显著性差异(P>0.05),VCⅡ、VCⅢ级有显著性差异(P<0.05)。以DR为分级指标时,术前术后精液中NO浓度变化在VCⅠ、VCⅡ级无显著性差异(P>0.05),VCⅢ级有显著性差异(P<0.05),术前术后精液中NAG变化在VCⅠ级无显著性差异(P>0.05),而在VCⅡ、VCⅢ级中有显著性差异(P<0.05),以DR和反流程度为分级指标时,术前术后精液中NO浓度变化及NAG活性在VCⅠ级无显著性差异(P>0.05),VCⅡ、VCⅢ级有显著性差异(P<0.05)。结论不同的分级标准对手术前后精液中NO浓度及NAG活性的评价有一定的影响。不同等级VC手术效果不同,超声诊断为VCⅠ级的患者是否有必要行手术治疗有待进一步探讨。
Objective It is to approach the correlation of ultrasonographic grading of varicocele（VC） with the changes of the concentration of nitric oxide（NO） and α-glycosidase（NAG） in semen after varicocelectomy.Methods 150 patients with VC were diagnosed by color doppler ultrasonography（CDU） and graded into 3 groups as VCI,VCII and VCIII,according to three different grading indexes the regurgitant volume of pampiniform plexus veins（PPV）,the maximum diameter of PPV and the combination of the regurgitant volume and the maximum diameter of PPV.All patients were underwent high ligation of the spermatic vein.And the concentration of NO and the activity of NAG in semen were detected before and after varicocelectomy according to the WHO guidelines.Results With the maximum diameter of PPV as the grading index,there were significant differences in the seminal NO and NAG of VCII and VCIII（P0.05）,but not of VCI（P0.05） before and after varicocelectomy,while based on the regurgitant volume of PPV or the combination of the regurgitant volume and the maximum diameter of PPV,there were insignificant differences in VCI（P0.05）,but there was no significant difference in VCⅡ and VCⅢ（P0.05）.Conclusion Different grading indexes influence the changes of the concentration of NO and activity of NAG in semen before and after varicocelectomy.Different grades of VC respond differently to varicocelectomy.Whether VCI necessitate varicocelectomy needs to be further investigated.
出处
《现代中西医结合杂志》
CAS
2011年第15期1828-1830,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine
