亚临床型精索静脉曲张的超声诊断及精液质量分析

目的 探讨彩色多普勒超声（CDFI）对亚临床型精索静脉曲张（SVC）的诊断价值,分析和评估SVC对男性生育力的损害程度.方法 应用CDFI检测30例SVC患者精索静脉内径及反流情况,精液按WHO标准常规分析并对精子形态学进行评价,30例健康供精者彩色多普勒超声及精液检测结果作为对照.结果 SVC组精索静脉内径较对照组增宽（1.94 ±0.28）mm与（1.36±0.15）mm,P〈0.05],反流时间延长（1.33±0.22）s与（0.43±0.16）s,P〈0.05].SVC患者精子密度（20.2±5.1）10^6/ml与（86.3±9.6）]10^6/ml、活率（50.7±1.9）%与（78.5±3.6）]%、活力（41.5 ±2.3）%与（58.7 ±2.6）]%均明显低于对照组（均P〈0.05）,且精子畸形率明显升高（10.5 ±3.2）%与（4.8 ±1.7）%,P〈0.05].结论 CDFI可提供精索静脉曲张形态和血流动力学改变的双重信息,对SVC的诊断具有较大的实用价值.结合精液质量分析可以估测患者生育力的损害程度,为SVC的治疗提供科学的依据.

Clinical value of color doppler ultrasound in diagnosis of subclinical varicocele and analysis of semen quality

Objective To explore the diagnostic value of color doppler flow imaging (CDFI) on subclinical varicocele(SVC) and the weakening effect of SVC on male fertility.Methods Thirty patients with SVC were exam-ined by CDFI, the diameter and regurgitation duration of spermatic vein were recorded.All semen specimens were rou-tinely analyzed according to the WHO criteria for sperm morphology.Thirty healthy sperm donors were served as con-trols.Results CDFI displayed a widened diameter( 1.94±0.28 mm vs 1.36 ±0.15 mm, P < 0.05 ) and prolonged regurgitation duration(1.33 ±0.22)s vs(0.43 ±0.16)]s,P<0.05)of spermatic vein in patients with SVC.Sperm density(20.2±0.1)106/ml vs(86.3±0.6)]106/ml,motihty(50.7±0.9)% vs(78.5±3.6)]% and vitality (41.5 ±0.3)% vs (58.7 ±0.6)]% were significantly decreased in patients with SVC compared with those in con-trols (all P< 0.05) ,while the rate of teratospermia remarkably increased in SVC group(10.5±0.2)vs(4.8±1.7 )]%(P< 0.05 ).Conclusion CDFI was clinically valuable for diagnosis of SVC for its revealing morphological and hemodynamic changes of varicocele.When combined with semen quality analysis,which evaluates the weakening effect of SVC on male fertility, CDFI was suitable to provide the appropriate clinical approaches for SVC therapy.