肾移植对慢性肾功能不全尿毒症期患者睾丸体积及生育力指数的影响

目的 探讨肾移植对男性慢性肾功能不全尿毒症期患者睾丸体积及生育力指数的影响.方法 解放军第117医院肾移植中心30例慢性肾功能不全尿毒症期患者于肾移植术前以及术后1个月、3个月和1年应用彩超进行睾丸体积监测,并与20名正常男性的睾丸体积比较.另检测40例尿毒症期和40例肾移植受者的精液,并根据公式[精子密度(×106/mL)×精子活动力×精子正常形态率]计算出生育力指数.结果 慢性肾功能不全尿毒症期患者的睾丸体积术前左侧为(6.82±1.49)mL, 右侧为(7.46±1.89)mL;肾移植术后1个月、3个月和1年左侧分别为(8.25±1.67)mL、(9.31±1.56) mL和(9.80±1.51)mL,右侧分别为(9.18±1.76) mL、(10.41±1.43) mL和(11.09±1.45)mL,肾移植受者术后1个月、3个月和1年的睾丸体积均大于尿毒症期患者,差异有显著性意义(均P<0.01).正常对照组生育力指数为13.03(14.26),肾移植受者的生育力指数为7.19(10.18), 而尿毒症期患者的生育力指数仅为0.23(0.76).尿毒症期患者的生育力指数比肾移植受者和正常对照组均小,差异有显著性意义(均P<0.01). 结论 慢性肾功能不全尿毒症期患者睾丸体积缩小,生育力指数下降, 而成功的肾移植可以明显改善尿毒症期患者的睾丸体积及生育力指数.

Effect of kidney transplantation on male fertility index and testicular volume in uremia patients

Objective To investigate the effect of kidney transplantation on male fertility index and testicular volume in patients with uremia.Methods Testicular volume in 30 patients who underwent kidney transplantation for uremia was monitored by color ultrasound before and in 1,3 and 12 months after kidney transplantation. Semen samples from 40 uremia patients and 40 kidney transplant recipients were tested for fertility index (FI) calculation. FI=sperm concentration(×106/mL)×sperm viability ×sperm normal morphology rate. Another 20 and 40 normal male subjects served as control were measured testicular volume and FI, respectively.Results Testicular volume of uremia patients before surgery was(6.82±1.49)mL on the left side and (7.46±1.89) mL on the right side. In 1, 3, and 12 months after kidney transplantation, testicular volume on the left side increased to (8.25±1.67),(9.31±1.56),and (9.80±1.51) mL and that on the right side rose to (9.18±1.76),(10.41±1.43),(11.09±1.45) mL, respectively. FI was 13.03(14.26)in normal subjects, 7.19(10.18)in kidney transplant recipients, and 0.23(0.76) in uremia patients. Testicular volume and FI between uremia patients and after kidney transplant groups had statistical differences (P<0.01).Conclusion Male testicular volume and fertility index is reduced by uremia, and this reduction can be improved with successful kidney transplantation.