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目的:探讨精索静脉曲张(Varicocele,VC)患者精子DNA损伤程度以及精索静脉高位结扎术对精子DNA损伤的影响,并探讨精子DNA损伤的检测对评估VC患者生育能力及手术效果的可行性。方法:以WHO精液分析标准为指导对58例VC患者进行精液分析,并用精子染色质扩散实验(SCD)检测精子DNA损伤程度。其中24例VC患者行精索静脉高位结扎术,在术前和术后3个月行精液分析和精子DNA损伤的检测。以30例正常生育男性作为对照组。结果:VC伴有精液分析异常的患者精子DNA损伤程度为(33.64±7.11)%,明显高于对照组(10.78±5.01)%(P<0.001);VC精液分析正常的患者精子DNA损伤程度为(23.94±6.04)%,也明显高于对照组(P<0.001)。行精索静脉高位结扎术后3个月,精子DNA损伤程度较术前明显减少(P<0.001)。结论:VC可引起不同程度的精子DNA损伤;精索静脉高位结扎术能有效降低VC患者的精子DNA损伤程度;精子DNA损伤的检测是评估VC患者生育能力及手术效果可行性较好的指标。
Objective: To investigate the effect of sperm DNA damage in patients with varicocele (VC) and the effect of varicocele ligation on sperm DNA damage and to explore the feasibility of sperm DNA damage in assessing fertility and surgical outcome of VC patients . Methods: Semen analysis was performed on 58 VC patients guided by the WHO semen analysis standard. The degree of sperm DNA damage was detected by sperm chromatin diffusion test (SCD). Among them, 24 cases of VC patients underwent high ligation of spermatic vein, and semen analysis and sperm DNA damage were performed before and 3 months after operation. Thirty healthy male subjects were used as the control group. Results: The level of sperm DNA damage in patients with VC abnormalities was (33.64 ± 7.11)%, significantly higher than that in controls (10.78 ± 5.01)% (P <0.001). The degree of sperm DNA damage in patients with normal VC semen analysis was (23.94 ± 6.04)%, also significantly higher than the control group (P <0.001). Three months after high-grade ligation of spermatic vein, the DNA damage of sperm was significantly reduced (P <0.001). Conclusion: VC can cause different degrees of sperm DNA damage; high varicocele ligation can effectively reduce the degree of sperm DNA damage in patients with VC; sperm DNA damage is to assess the fertility of patients with VC and the feasibility of surgery is a good indicator.