溫泉 張大田(通訊作者)

125200遼寧省綏中縣醫(yī)院1

121000遼寧醫(yī)學(xué)院附屬第一醫(yī)院泌尿外科2

克羅米芬聯(lián)合β胡蘿卜素對精索靜脈曲張伴不育高位結(jié)扎術(shù)后精子質(zhì)量和性激素的影響

溫泉1張大田(通訊作者)2

125200遼寧省綏中縣醫(yī)院1

121000遼寧醫(yī)學(xué)院附屬第一醫(yī)院泌尿外科2

目的：探討克羅米芬聯(lián)合β胡蘿卜素對精索靜脈曲張(VC)伴不育高位結(jié)扎術(shù)后患者的影響。方法：2013年1月-2014年1月采用精索靜脈曲張高位結(jié)扎手術(shù)治療的精索靜脈曲張伴不育患者100例，分兩組。對照組術(shù)后采用克羅米芬治療，觀察組在此基礎(chǔ)上加上β胡蘿卜素，對比兩組療效。結(jié)果：兩組患者治療后的精子質(zhì)量明顯優(yōu)于治療前，觀察組治療后的精子質(zhì)量改善效果明顯優(yōu)于對照組，差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。兩組患者治療后的性激素水平明顯優(yōu)于治療前，觀察組治療后的性激素水平改善效果明顯優(yōu)于對照組，差異有統(tǒng)計(jì)學(xué)意義(P＜0.05)。結(jié)論：克羅米芬聯(lián)合β胡蘿卜素能夠有效改善精索靜脈曲張高位結(jié)扎手術(shù)治療精索靜脈曲張伴不育患者的術(shù)后精子質(zhì)量和性激素水平，效果顯著。

克羅米芬；β胡蘿卜素；精索靜脈曲張；不育高位結(jié)扎術(shù)；精子質(zhì)量

β胡蘿卜素是一種抗氧化劑，根據(jù)相關(guān)資料顯示，其有可能會提高精索靜脈曲張伴不育的手術(shù)效果[1]，但未見到相關(guān)臨床文獻(xiàn)報(bào)道，為此，筆者在這方面做了試探性的研究，采用克羅米芬聯(lián)合β胡蘿卜素治療精索靜脈曲張伴不育患者，觀察此療法對VC伴不育患者的高位結(jié)扎術(shù)后精子質(zhì)量和性激素水平的改善情況。現(xiàn)將研究結(jié)果報(bào)告如下。

資料與方法

2013年1月-2014年1月采用計(jì)算機(jī)隨機(jī)抽樣法抽取VC伴不育患者100例作為研究對象，分為觀察組和對照組，兩組各50例。觀察組年齡25～40歲，平均(30.05±5.81)歲，病程2～10年，平均(6.05±3.14)年，VC的嚴(yán)重程度按Lyon分級標(biāo)準(zhǔn)：Ⅰ度5例，Ⅱ度35例，Ⅲ度10例；左側(cè)VC 41例，雙側(cè)VC 9例。對照組年齡25～39歲，平均(29.15±4.97)歲，病程3～10年，平均(5.91±2.86)年，VC的嚴(yán)重程度，按Lyon分級標(biāo)準(zhǔn)：Ⅰ度5例，Ⅱ度32例，Ⅲ度13例；左側(cè)VC 42例，雙側(cè)VC 8例。兩組患者一般資料方面比較，差異無統(tǒng)計(jì)學(xué)意義(P＞0.05)。

治療方法：所有患者均在硬膜外麻醉下，行經(jīng)腹股溝精索靜脈高位結(jié)扎手術(shù)，手術(shù)過程均順利，術(shù)中、術(shù)后均未發(fā)生明顯的不良反應(yīng)。出院后，觀察組口服克羅米芬25 mg/d，用藥25 d，停藥5 d，30 d為1個(gè)療程，連用3個(gè)月，聯(lián)合口服β胡蘿卜素6 mg/d，連用3個(gè)月。對照組僅用克羅米芬進(jìn)行治療，用法同觀察組。兩組治療時(shí)間均為3個(gè)月。精原細(xì)胞發(fā)育為成熟精子約需64～72 d，因此分別在術(shù)前、術(shù)后3個(gè)月、術(shù)后6個(gè)月行精液常規(guī)、性激素水平的檢測。分別檢測卵泡刺激素(FSH)、促黃體生成素(LH)、睪酮(T)。

統(tǒng)計(jì)學(xué)方法：采用SPSS 19.0統(tǒng)計(jì)學(xué)軟件分析結(jié)果，計(jì)量資料以(fffffd±s)表示，組間比較采用t檢驗(yàn)，計(jì)數(shù)資料以率表示，采用χ2檢驗(yàn)，P＜0.05為差異有統(tǒng)計(jì)學(xué)意義。

Influence of clomiphene citrate combined beta carotene on the sex hormones and sperm quality of patients with varicocele and sterile high ligation

Wen Quan1,Zhang Datian(Corresponding author)2
The Hospital of Suizhong County,Liaoning Province 1252001
Urology Surgery,the First Hospital Affiliated to Liaoning Medical School 1210002

Objective:To explore the influence of clomiphene citrate combined beta carotene on the sex hormones and sperm quality of patients with varicocele and sterile high ligation.Methods:100 cases of patients with varicocele and sterility treated with high ligation surgical from January 2013 to January 2014 were divided into two groups.The control group were treated with clomiphene citrate after surgery and the observation group were treated with beta carotene on the basis of clomiphene citrate.WE compared the curative effect of the two groups.Results:The sperm quality of the two groups after the treatment were better than before,and the sperm quality of the observation group improved more than that of the control group after the treatment,and the differences were statistically significant(P＜0.05).The sex hormone levels of the two groups after the treatment were better than before,and the sex hormone levels of the observation group improved more than that of the control group after the treatment,and the differences were statistically significant(P＜0.05).Conclusion:Clomiphene citrate combined beta carotene could improve the sex hormones and sperm quality of patients with varicocele and sterile high ligation effectively and the effect was remarkable.

Clomiphene citrate;Beta carotene;Varicocele;Sterile high ligation;Sperm quality

10.3969/j.issn.1007-614x.2015.6.1

科研項(xiàng)目遼寧省科技廳資助項(xiàng)目，項(xiàng)目編號：2011225015

Research projectProjects funded by science and technology agency of Liaoning province,the project number:2011225015