摘要: |
目的 研究分析抗精子抗体(AsAb)水平与精索静脉曲张(VC)患者行显微精索静脉结扎术前后精子质量的相关性。方法 收集我院2015年1月至2017年12月于我院就诊并行经外环口显微精索静脉结扎术的精索静脉曲张患者67例为病例组,同期同年龄层次育前检查未发现精索静脉曲张者67例为对照组,测定记录病例组手术前、术后3月、6月、12月以及对照组对象的AsAb阳性率、精液量、精子浓度、精子活动率、向前运动精子率以及精子畸形率,分析各项检测指标变化情况。 结果 对照组与病例组术前在AsAb阳性率、精子质量5项指标比较均有统计学意义,AsAb阳性率病例组术后3月与术前比较无统计学意义(P>0.05),术后6月、12月分别与术前比较有统计学意义(P<0.05)。精液量手术前后各组及对照组之间比较均无明显变化,亦无统计学意义(P>0.05)。精子浓度、精子活动率、向前运动精子率、精子畸形率4项精子质量指标病例组术后各组与术前对比均有明显改善,有统计学意义(p<0.05)。精子浓度、精子活动率术后12月与术后6月、3月对比均有进一步改善,且有统计学意义(p<0.05),但术后6月与术后3月对比无统计学意义(P>0.05)。精子畸形率术后各组之间对比无统计学意义(P>0.05)。向前运动精子率术后12月、6月均较术后3月有进一步改善,并有统计学意义(p<0.05),但术后12月与术后6月对比则无计学差异。Pearson相关性分析显示手术前后AsAb阳性率降低与精子浓度、精子活动率改善呈明显负相关,有统计学意义(p<0.05)。 结论 行显微精索静脉结扎术后患者AsAb阳性率明显降低,精子浓度、精子活动率、向前运动精子率以及精子畸形率改善明显,并且随着时间的延长,AsAb水平的降低程度与精子浓度、精子活动率改善有明显的相关性,有助于术后疗效的评估,但在更长时间后持续低水平的AsAb阳性率,是否有助于精子质量持续改善,值得进一步研究探讨。 |
关键词: 抗精子抗体 精子质量 精索静脉曲张 显微外科手术 |
DOI:10.12025/j.issn.1008-6358.2019.20190810 |
分类号: |
基金项目:上海宝山区科学技术委员会科研基金项目(编号: 16-E-19) |
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The analysis of anti-sperm antibody and semen quality in microsurgical varicocelectomy |
yuanhaichuan, songwu, guchaohui, lilianhong, luochengpeng
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Renhe hospital, Baoshan district, Shanghai
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Abstract: |
Objective: To analyze the anti-sperm antibody and semen quality in microsurgical varicocelectomy. Methods: 67 varicocele patients treated by microsurgical varicocelectomy on our hospital from Jan. 2015 to Dec. 2017 were enrolled in the study. 67 cases were enrolled in the control group in the same period. AsAb positive rate, sperm volume, sperm concentration, sperm motility, rate of sperm with forward movement, spermSabnormalitySrate were comparatively analyzed before surgery, 3rd month after surgery, the 6th month and the 12th month. Results: There is statistical difference of AsAb positive rate and semen quality between control group and preoperative (P<0.05). AsAb positive rate of postoperative 6 months and postoperative 12 months reduced comparedSwithSthatSpreoperative (P<0.05). There is no difference about AsAb positive rate between postoperative 3 months and preoperative (P>0.05). There was no difference about sperm volume in control group, postoperative and preoperative (P >0.05). There is statistical difference of sperm concentration, sperm motility, spermSabnormalitySrate and forward movement spermSrate between postoperative 3 months and preoperative, postoperative 6 months and preoperative, postoperative 12 months and preoperative(P<0.05). 6, 12 months after surgery, sperm concentration and sperm motility improved (P<0.05). There was no difference of sperm concentration and sperm motility between postoperative 6 months and postoperative 3 months. There is no difference of spermSabnormalitySrate in postoperative 12 months, postoperative 6 months, postoperative 3 months(P>0.05). And there is a remarkable improvement of the rate of sperm with forward movement between postoperative 6 months and postoperative 3 months, postoperative 12 months and postoperative 3 months (P<0.05). There is no difference of the rate of sperm with forward movement between postoperative 12 months and postoperative 6 months (P>0.05). Pearson correlation was used to analyze the correiation between semen quality and AsAb positive rate. Conclusion: microsurgical varicocelectomy can reduce AsAb positive rate, improve semen quality in treatment of patients with varicocele. The Pearson correlation quotieties showed that sperm concentration and sperm motility are both positive correlated with AsAb positive rate. |
Key words: varicocele anti-sperm antibody microsurgery semen quality |