超声弹性成像应变率比值评估精索静脉曲张患者睾丸硬度的研究

摘要

目的 应用超声弹性成像应变率比值(strain ratio,SR)评估不同程度精索静脉曲张患者睾丸硬度,以此反映睾丸的生精功能.方法 选取精子密度正常的精索静脉曲张患者50例(50只左侧睾丸)为病例组,另选健康正常男性50例(50只左侧睾丸)为对照组,两组行超声弹性成像检查,计算阴囊壁与睾丸之间的SR.病例组分为亚临床型精索静脉曲张、精索静脉曲张Ⅰ度、Ⅱ度、Ⅲ度,分析病例组与对照组、病例组各亚临床型间SR的差异,以及精索静脉内径与SR、SR与精子密度之间的相关性.结果 病例组与对照组、病例组各亚临床型间SR两两比较差异均无统计学意义.相关眭分析显示,精索静脉曲张患者精索静脉内径与SR呈负相关(r=-0.459,P=-0.001);SR与精子密度呈正相关(r=-0.649,P=0.000).结论 SR可作为预测精子密度正常的精索静脉曲张患者随病变程度加重其睾丸硬度和睾丸生精功能变化趋势的参考指标.%ABSTRACT:Objective To explore the value of strain ratio(SR) by ultrasonic elastography in evaluating the testicular stiffness in patients with varicocele (VC) with different degrees of normal sperm density.Methods Fifty patients with normal sperm density(50 left testicles) were selected as the case group,and 50 normal healthy men (50 left testicles) were selected as the control group.All patients examined by ultrasonic elastography and the SR between scrotal wall and testicular were calculated.The case group was divided into subclinical VC,VC Ⅰ,VC Ⅱ and VC Ⅲ.According to the significant difference between the case group and the control group,and the each group of the subclinical cases,the correlation between the spermatic vein diameter and SR,SR and sperm density was analyzed.Results There was no significant difference of SR between the case group and the control group,and the each group of subclinical cases.Correlation analysis showed that SR was negatively correlated with the diameter of spermatic vein (r=-0.459,P=0.001),but positively correlated with sperm density (r=0.649,P=0.000).Conclusion SR can be used as a reference index to predict the normal sperm density which changes with the testicular stiffness and testicular spermatogenic function in VC patients.