摘要
目的探讨术前血液参数对显微镜精索静脉结扎术治疗精索静脉曲张不育患者效果的预测价值。方法回顾性分析2016年6月至2021年1月西安市人民医院和空军军医大学唐都医院收治的110例精索静脉曲张患者的临床资料。手术成功定义为术后6个月所有精液参数(精子浓度、前向运动性和形态等)恢复到正常值。将患者分为治疗有效组(A组,78例)和治疗无效组(B组,32例)。比较两组患者术前血液参数的差异。用Spearman相关分析确定血液参数[中性粒细胞/淋巴细胞比值(NLR)和平均血小板体积(MPV)]与显微镜精索静脉结扎术成功的关系。用受试者工作特征(ROC)曲线分析血液参数(NLR和MPV)对显微镜精索静脉结扎术成功的预测价值。结果两组患者术前的临床基本特征、性激素水平比较差异无统计学意义(均P>0.05);两组患者血液参数中的NLR、MPV比较差异有统计学意义(均P<0.05),余血液参数比较差异无统计学意义(P>0.05)。术前,两组患者的精液参数比较,差异无统计学意义(均P>0.05)。术后,A组患者的精液量、精子浓度、前向运动、精子形态均较术前明显改善(均P<0.05),而B组患者各参数较术前差异均无统计学意义(均P>0.05)。术前NLR与精索静脉结扎术手术成功率呈负相关(r=-0.719,P<0.01),MPV与精索静脉结扎术手术成功率呈正相关(r=0.522,P<0.01)。ROC曲线分析精索静脉结扎术成功的预测变量的阈值,NLR的最佳临界值为2.01(P<0.01),MPV的最佳临界值为11.45(P<0.01)。结论低NLR(<2.01)和高MPV(>11.45)可能是一种有用的术前预测工具,可用于确定精索静脉曲张不育患者中能从显微镜精索静脉结扎术中获益最大的群体。
Objective To investigate the predictive value of preoperative blood parameters on the efficacy of microscopic varicocele ligation in the treatment of infertility patients with varicocele.Methods The clinical data of 110 patients with varicocele admitted to Xi′an People′s Hospital and Tangdu Hospital of Air Force Military Medical University from June 2016 to January 2021 were analyzed retrospectively.Successful operation was defined as the restoration of all semen parameters(sperm concentration,forward motility,morphology,etc.)to normal values 6 months after operation.The patients were divided into effective treatment group(group A,78 cases)and ineffective treatment group(group B,32 cases).The blood parameters of the two groups were compared before operation.Spearman correlation analysis was used to determine the relationship between blood parameters[neutrophil/lymphocyte ratio(NLR)and mean platelet volume(MPV)]and the success of microscopic varicocele ligation.The predictive value of blood parameters(NLR and MPV)to the success of microscopic varicocele ligation was analyzed by receiver operating characteristic(ROC)curve.Results There was no significant difference in clinical characteristics,and sex hormone levels between the two groups before operation(all P>0.05);There were statistically significant differences in NLR and MPV in blood parameters between the two groups(both P<0.05),and there was no significant differences in other blood parameters(both P>0.05).There was no significant difference in semen parameters between the two groups before operation(all P>0.05).After operation,the semen volume,semen concentration,forward movement and sperm morphology of patients in group A were significantly improved compared with those before operation(all P<0.05),while the parameters of patients in group B had no significant difference compared with those before operation(all P>0.05).There was a negative correlation between preoperative NLR and the success rate of spermatic vein ligation(r=-0.719,P<0.01),and a positive
作者
李瑞晓
唐启胜
雷永华
武国军
倪建鑫
Li Ruixiao;Tang Qisheng;Lei Yonghua;Wu Guojun;Ni Jianxin(Urology and Nephrology Hospital,Xi′an People′s Hospital(Xi′an Fourth Hospital),Xi′an 710002,China;Department of Urology,the Second Affiliated Hospital of the Air Force Medical University,Xi′an 710038,China)
出处
《中国医师杂志》
CAS
2022年第11期1687-1691,共5页
Journal of Chinese Physician
