摘要
目的:观察显微镜下精索静脉结扎术(MSV)结合葡萄糖酸锌治疗精索静脉曲张性不育症的临床效果及血清抑制素B(INH B)、缺氧诱导因子1α(HIF-1α)水平变化;方法:选取2017年1月—2019年3月本院男科接受治疗的双侧精索静脉曲张患者87例,随机分为结合组43例、对照组44例,对照组给予单纯MSV术,结合组给予MSV术结合葡萄糖酸锌治疗3个月,对比两组治疗前后精液质量、治疗有效率、生殖激素水平、微量元素锌变化、血清及精浆HIF-1α水平变化,随访24个月配偶受孕率等指标。结果:治疗6个月后,结合组治疗有效率(90.7%)高于对照组(70.5%),精液量、a+b级精子活力、精子密度均高于对照组,畸形精子占比低于对照组,血清INH B、T水平高于对照组,血清LH、FSH水平低于对照组,血清及精浆锌含量高于对照组,血清及精浆HIF-1α水平低于对照组(均P<0.05);随访24个月,结合组患者配偶妊娠率(74.4%)高于对照组(47.7%)(P<0.05)。结论:MSV术结合葡萄糖酸锌可有效改善精索静脉曲张性不育症患者生殖内分泌功能,纠正微量元素锌失衡,促进精子生成,改善精子质量,提高患者配偶的受孕率。
Objective:To observe the clinical effect of microscopically ligation of spermatic vein(MSV)combined with zinc gluconate for treating patients with varicocele induced infertility,and to study the changes of the serum INHB and HIF-1αlevels of the patients.Methods:87 patients with bilateral varicocele were selected and randomly divided into two groups from January 2017 to March 2019.43 patients in the treatment group had been treated by MSV combined with zinc gluconate for three months,and 44 patients in the control group had been treated by MSV alone.The semen quality before and after treatment,treatment efficiency,reproductive endocrine hormone levels,trace element zinc changes,serum and seminal plasma HIF-1αlevels of patients,pregnancy rate of their wives in 24 months followed up,and other indicators were compared between the two groups.Results:6 months after treatment,the therapeutic effect of patients in the treatment group was 90.7%,which was significant higher than that(70.5%)of patients in the control group,and the amount of semen,a and b type sperm motility,the sperm density,and the serum levels of INH B and T,and the levels of serum and seminal plasma zinc of patients in the treatment group were also significant higher than those of patients in the control group,but the proportion of teratospermia,serum LH,FSH levels,and the serum and seminal plasma HIF-1αlevels of patients in the treatment group were significant lower than those of patients in the control group(all P<0.05).During the 24 months followed up period,the pregnancy rate of the wives of patients in the treatment group was 74.4%,which was significant higher than that(47.7%)of patients in the control group(P<0.05).Conclusion:MSV combined with zinc gluconate for treating patients with varicocele induced infertility can effectively improve their reproductive endocrine function,correct the imbalance of trace element zinc,promote sperm production,improve sperm quality,and can improve the pregnancy rate of the patients'spouses.
作者
李宏军
王裕中
张志超
LI Hongjun;WANG Yuzhong;ZHANG Zhichao(Qinhuangdao Military Industrial Hospital, Qinhuangdao City, Hebei Province, 066000)
出处
《中国计划生育学杂志》
2020年第8期1204-1207,1212,共5页
Chinese Journal of Family Planning
