Mazo E B, Koriakin M V, Evseev L P, Akopian A S
Urol Nefrol (Mosk). 1990 Mar-Apr(2):50-8.
Selective renal phlebography, phlebotonometry, selective analysis of the blood from the renal veins and vena cava inferior for the activity of plasma renin, catecholamines, prostaglandins E2, pO2 and pCO2, peripheral blood analysis for levels of progesterone, androstendione, testosterone, ACTH, ACTH-tolerance test, orchidometry, ejaculate microscopy, evaluation of seminal plasma testosterone, trochanter index and parameters of sexual maturation were performed during the treatment of 70 patients with left varicocele. Based on the results the authors concluded that not only the left testicle, but the left adrenal was involved in the course of organic renal venous hypertension. A significant feedback correlation was revealed between the peripheral blood progesterone and the left kidney venous pressure (r = -0.50, p less than 0.01) and between the peripheral blood progesterone and the number of motile spermatozoa in the ejaculate (r = -0.31, p less than 0.05). Pathogenesis of organic renal venous hypertension and spermatogenesis failure were supplemented by the conclusion that the left adrenal central vein was the first to involve into the compensation of venous hypertension. Retrograde alterations in the direction of the blood flow in the left adrenal central vein resulted in the abnormal stimulation of steroidogenesis in the cortical layer. The excessive production of antiandrogenic steroid hormones by the left adrenal gland was a cause of spermatogenesis damage in both testicles. The blockage of the left adrenal androgenic hormones of the hypothalamo-hypophyseal system can deteriorate the process.(ABSTRACT TRUNCATED AT 250 WORDS)
在对70例左侧精索静脉曲张患者的治疗过程中,进行了选择性肾静脉造影、静脉血压测量、对肾静脉和下腔静脉血进行血浆肾素、儿茶酚胺、前列腺素E2、氧分压和二氧化碳分压活性的选择性分析、对周围血中孕酮、雄烯二酮、睾酮、促肾上腺皮质激素水平的分析、促肾上腺皮质激素耐量试验、睾丸测量、精液显微镜检查、精浆睾酮评估、转子指数及性成熟参数评估。基于这些结果,作者得出结论:不仅左侧睾丸,而且左侧肾上腺都参与了器质性肾静脉高压的病程。外周血孕酮与左肾静脉压力之间(r = -0.50,p < 0.01)以及外周血孕酮与精液中活动精子数量之间(r = -0.31,p < 0.05)均显示出显著的反馈相关性。关于器质性肾静脉高压和生精功能衰竭的发病机制补充如下结论:左侧肾上腺中央静脉首先参与静脉高压的代偿。左肾上腺中央静脉血流方向的逆行改变导致皮质层类固醇生成异常刺激。左侧肾上腺过度产生抗雄激素类固醇激素是双侧睾丸生精功能受损的原因。下丘脑 - 垂体系统对左侧肾上腺雄激素的阻断会使该过程恶化。(摘要截选至250字)