Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Nat Rev Urol. 2012 Dec;9(12):678-90. doi: 10.1038/nrurol.2012.197. Epub 2012 Nov 20.
Varicocele is recognized as the leading cause of male infertility because it can impair spermatogenesis through several distinct pathophysiological mechanisms. Current evidence supports oxidative stress as a key element in the pathophysiology of varicocele-related infertility, although these mechanisms have not yet been fully described. Measurement of the reactive oxygen species and other markers of oxidative stress, including the levels of the antioxidant enzymes catalase and superoxide dismutase, can provide valuable information on the extent of oxidative stress and might guide therapeutic management strategies. The testis can respond to varicocele-associated cell stressors, such as heat stress, ischaemia or production of vasodilators (for example, nitric oxide) at the expense of the generation of excessive reactive oxygen species. These responses have their own implications in exacerbating the underlying oxidative stress and on the subsequent infertility.
精索静脉曲张被认为是男性不育的主要原因，因为它可以通过几种不同的病理生理机制损害精子发生。目前的证据支持氧化应激是精索静脉曲张相关不育症病理生理学的关键因素，尽管这些机制尚未完全描述。活性氧和其他氧化应激标志物（包括抗氧化酶过氧化氢酶和超氧化物歧化酶的水平）的测量可以提供有关氧化应激程度的有价值信息，并可能指导治疗管理策略。睾丸可以对精索静脉曲张相关的细胞应激源（如热应激、缺血或血管扩张剂（如一氧化氮）的产生）作出反应，代价是产生过多的活性氧。这些反应本身就加剧了潜在的氧化应激，并导致随后的不育。
