克罗米芬联合β胡萝卜素对精索静脉曲张伴不育高位结扎术后精子质量和性激素的影响

温泉 张大田(通讯作者)

125200辽宁省绥中县医院1

121000辽宁医学院附属第一医院泌尿外科2

克罗米芬联合β胡萝卜素对精索静脉曲张伴不育高位结扎术后精子质量和性激素的影响

温泉1张大田(通讯作者)2

125200辽宁省绥中县医院1

121000辽宁医学院附属第一医院泌尿外科2

目的：探讨克罗米芬联合β胡萝卜素对精索静脉曲张(VC)伴不育高位结扎术后患者的影响。方法：2013年1月-2014年1月采用精索静脉曲张高位结扎手术治疗的精索静脉曲张伴不育患者100例，分两组。对照组术后采用克罗米芬治疗，观察组在此基础上加上β胡萝卜素，对比两组疗效。结果：两组患者治疗后的精子质量明显优于治疗前，观察组治疗后的精子质量改善效果明显优于对照组，差异有统计学意义(P＜0.05)。两组患者治疗后的性激素水平明显优于治疗前，观察组治疗后的性激素水平改善效果明显优于对照组，差异有统计学意义(P＜0.05)。结论：克罗米芬联合β胡萝卜素能够有效改善精索静脉曲张高位结扎手术治疗精索静脉曲张伴不育患者的术后精子质量和性激素水平，效果显著。

克罗米芬；β胡萝卜素；精索静脉曲张；不育高位结扎术；精子质量

β胡萝卜素是一种抗氧化剂，根据相关资料显示，其有可能会提高精索静脉曲张伴不育的手术效果[1]，但未见到相关临床文献报道，为此，笔者在这方面做了试探性的研究，采用克罗米芬联合β胡萝卜素治疗精索静脉曲张伴不育患者，观察此疗法对VC伴不育患者的高位结扎术后精子质量和性激素水平的改善情况。现将研究结果报告如下。

资料与方法

2013年1月-2014年1月采用计算机随机抽样法抽取VC伴不育患者100例作为研究对象，分为观察组和对照组，两组各50例。观察组年龄25～40岁，平均(30.05±5.81)岁，病程2～10年，平均(6.05±3.14)年，VC的严重程度按Lyon分级标准：Ⅰ度5例，Ⅱ度35例，Ⅲ度10例；左侧VC 41例，双侧VC 9例。对照组年龄25～39岁，平均(29.15±4.97)岁，病程3～10年，平均(5.91±2.86)年，VC的严重程度，按Lyon分级标准：Ⅰ度5例，Ⅱ度32例，Ⅲ度13例；左侧VC 42例，双侧VC 8例。两组患者一般资料方面比较，差异无统计学意义(P＞0.05)。

治疗方法：所有患者均在硬膜外麻醉下，行经腹股沟精索静脉高位结扎手术，手术过程均顺利，术中、术后均未发生明显的不良反应。出院后，观察组口服克罗米芬25 mg/d，用药25 d，停药5 d，30 d为1个疗程，连用3个月，联合口服β胡萝卜素6 mg/d，连用3个月。对照组仅用克罗米芬进行治疗，用法同观察组。两组治疗时间均为3个月。精原细胞发育为成熟精子约需64～72 d，因此分别在术前、术后3个月、术后6个月行精液常规、性激素水平的检测。分别检测卵泡刺激素(FSH)、促黄体生成素(LH)、睾酮(T)。

统计学方法：采用SPSS 19.0统计学软件分析结果，计量资料以(fffffd±s)表示，组间比较采用t检验，计数资料以率表示，采用χ2检验，P＜0.05为差异有统计学意义。

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

科研项目辽宁省科技厅资助项目，项目编号：2011225015

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