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目的:探讨亚临床型精索静脉曲张不育患者手术治疗前后精液质量、性激素和抗精子抗体的变化。方法:选择在我院泌尿科住院治疗的亚临床型精索静脉曲张不育患者50例,入院后均经腹膜后精索内静脉高位结扎术,分别在术前和术后3个月进行精液检查、性激素水平和抗精子抗体阳性率的检测。结果:亚临床型精索静脉曲张不育患者手术治疗3个月后精子密度和精子活力较术前明显提高(P<0.05),精子畸形率较术前明显降低(P<0.05);血清卵泡刺激素(FSH)、黄体生成素(LH)水平和抗精子抗体阳性率较术前明显降低(P<0.05或P<0.01),血清睾丸酮(T)水平较术前明显升高(P>0.05)。46例患者获随访,随访时间12～80个月,平均2.5年,受孕25例,受孕率高达54.3%。结论:亚临床型精索静脉曲张不育患者尽早行手术治疗可降低血清性激素FSH、LH水平和AsAb阳性率,提高血清T水平,改善精子生成的内分泌环境,从而提高患者精液质量和受孕率。
Objective: To investigate the changes of semen quality, sex hormones and antisperm antibodies in patients with subclinical varicocele infertility before and after surgery. Methods: Fifty patients with subclinical varicocele infertility who were hospitalized in our hospital for urology were enrolled. All patients underwent retroperitoneal spermatico-venous ligation after admission. Sperm Check, sex hormone levels and anti-sperm antibody positive rate of detection. Results: The sperm densities and sperm motility in subclinical varicocele patients were significantly increased 3 months after operation (P <0.05), and the sperm deformity rate was significantly lower than that before operation (P <0.05). Serum follicles The levels of FSH, LH and antisperm antibody were significantly lower than those before operation (P <0.05 or P <0.01), while serum testosterone (T) levels were significantly higher than those before operation (P> 0.05 ). 46 patients were followed up for 12 to 80 months, an average of 2.5 years, 25 cases of pregnancy, pregnancy rate as high as 54.3%. Conclusions: Surgical treatment of subclinical varicocele as soon as possible can reduce the serum FSH, LH levels and AsAb positive rate, raise the level of serum T, improve the endocrine environment of sperm production, and improve the sperm quality and conception rate of patients.