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目的评估显微镜下精索静脉结扎术对精索静脉曲张患者的血清睾酮/雌二醇比值(T/E2)的影响。方法采用前瞻性临床对照研究的方法,将2018年6月至2020年6月在本院泌尿生殖男科就诊的91名精索静脉曲张患者根据患者意愿分为两组,手术治疗组48例,保守治疗组43例。手术治疗组患者接受显微镜下精索静脉结扎术;保守治疗组患者接受口服药物联合行为指导等保守治疗方案。两组均于治疗前和治疗后6个月检查精液参数和血清激素水平,比较两组患者治疗前后变化以及治疗后两组患者相关指标的差异。结果 (1)与治疗前比较,手术治疗组治疗后6个月精液参数(精液体积、精子浓度、精子前向运动活力、精子总活力)均显著改善(P<0.001),血清T水平显著升高而E2水平显著下降(P<0.001),T/E2比值显著升高(P<0.001);而保守治疗组治疗前后精液参数及血清T、E2水平以及T/E2比值均无显著差异(P>0.05)。(2)治疗后6个月,与保守治疗组比较,手术治疗组精液参数(精液体积、精子浓度、精子前向运动活力、精子总活力)均显著升高(P<0.05),血清T水平显著升高而E2水平显著降低(P<0.05),T/E2比值显著升高(P<0.001)。结论精索静脉曲张与血清T水平和T/E2的降低有关,而血清T水平和T/E2在显微镜下精索静脉结扎术后可以得到显著改善。
Abstract：Objective:To evaluate the effect of spermatic vein ligation under microscope on serum testosterone/estradiol ratio(T/E2) in patients with varicocele.Methods:In this prospective controlled clinical study, 91 varicocele patients were divided into two groups according to their wishes: 48 patients were surgically treated(surgical treatment group) and 43 patients were conservatively treated(conservative treatment group). The patients in the surgical treatment group received spermatic vein ligation under the microscope, and the patients in the conservative treatment group received oral drugs combined with behavioral guidance and other conservative treatment. The semen parameters and serum hormone levels were examined before and 6 months after treatment in both groups. The changes of the two groups before and after treatment and the differences of related indicators between the two groups were compared.Results:(1) Compared with those before treatment, semen parameters(semen volume, sperm concentration, sperm forward motility and total sperm motility) 6 months after treatment were significantly improved in the surgical treatment group(P<0.001). The serum T level was significantly increased while E2 level was significantly decreased(P<0.001),and T/E2 ratio was significantly increased(P<0.001). There were no significant differences in semen parameters, serum T & E2 levels and T/E2 ratio in conservative treatment group before and after treatment(P>0.05).(2) After 6 months of treatment, the semen parameters(semen volume, sperm concentration, sperm forward motility and total sperm motility) in the surgical treatment group were significantly increased compared with the conservative treatment group(P<0.05). The serum T level was significantly increased while the serum E2 level was significantly decreased(P<0.05),and the T/E2 ratio was significantly increased(P<0.001).Conclusions:Varicocele is associated with decreased serum T levels and T/E2 ratio, which can be significantly improved after spermatic vein ligation under microscope.
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基本信息:
中图分类号:R699.8
引用信息:
[1]秦红平,莫少康,阎一鑫,等.显微镜下精索静脉结扎术对血清睾酮/雌二醇比值的影响[J].生殖医学杂志,2021,30(09):1175-1179.
基金信息:
西北民族大学创新团队项目(31920200019)
2021-09-15
2021-09-15