精索静脉曲张患者不同部位及状态下精索静脉内径参数与精液检查结果的相关性研究

[Correlation of the inner diameter parameters of the spermatic vein in different positions and states of the varicocele patient with the results of seminal examination].

作者信息

Tong Yan-Yan, Liu Ju-Fang, Cui Xian-Lu, Ma Jing

机构信息

Department of Ultrasonography, Tongling Municipal Hospital, Tongling, Anhui 244000, China.

出版信息

Zhonghua Nan Ke Xue. 2016 Aug;22(8):710-714.

PMID:29019227

Abstract

OBJECTIVE

To study the correlation of the inner diameter parameters of the spermatic vein in different positions and states of the varicocele (VC) patient with the results of seminal examination.

METHODS

A total of 149 VC patients underwent ultrasonography, routine semen examination, and sperm morphological analysis. The parameters obtained from ultrasonography included the bilateral testis volume in a supine position, the largest spermatic vein diameter in a supine position at rest (DSR), the largest spermatic vein diameter in a supine position following Valsalva manoeuvre (DSV), the largest spermatic vein diameter in an upright position at rest (DUR), and the largest spermatic vein diameter in an upright position following Valsalva manoeuvre (DUV). Then we calculated the parameters △DS=DSV－DSR, △DU=DUV－DUR, △DR=DUR－DSR, and △DV=DUV－DSV and analyzed the correlation of the above parameters with the results of semen examination using the ROC curve.

RESULTS

Based on the results of semen examination, 119 (79.87%) of the patients were allocated to the abnormal group and the other 30 (20.13%) to the normal group. Statistically significant differences were observed between the two groups in △DU (P=0.007), △DR (P=0.0001), and △DV (P=0.04), but not in DSR (P=0.35), DSV (P=0.34), DUR (P=0.06), DUV (P=0.12), and △DS (P=0.64), nor in the volume of the testis affected (P=0.323). The area under the ROC curve was 0.55 for DSR, 0.57 for DSV, 0.64 for DUR, 0.62 for DUV, 0.49 for △DS, 0.28 for △DU, 0.86 for △DR, and 0.69 for △DV. The corresponding cutoff values were 2.25, 2.51, 2.48, 2.63, 0.30, 0.23, 0.25, and 0.20, the corresponding sensitivities of semen detection were 50.42%, 65.55%, 60.50%, 60.50%, 49.90%, 29.41%, 79.83%, and 65.55%, and the corresponding specificities were 56.67%, 63.33%, 63.33%, 63.33%, 56.67%, 33.33%, 80%, and 63.33%, respectively.

CONCLUSIONS

The difference between the largest spermatic vein diameters in supine and upright positions at rest provides a high diagnostic accuracy for semen detection and helps to predict abnormality in seminal examination for VC patients.

摘要

目的

研究精索静脉曲张（VC）患者不同部位及状态下精索静脉内径参数与精液检查结果的相关性。

方法

对149例VC患者进行超声检查、精液常规检查及精子形态分析。超声检查获取的参数包括仰卧位双侧睾丸体积、静息状态下仰卧位最大精索静脉直径（DSR）、瓦尔萨尔瓦动作后仰卧位最大精索静脉直径（DSV）、静息状态下站立位最大精索静脉直径（DUR）、瓦尔萨尔瓦动作后站立位最大精索静脉直径（DUV）。然后计算参数△DS = DSV－DSR、△DU = DUV－DUR、△DR = DUR－DSR、△DV = DUV－DSV，并采用ROC曲线分析上述参数与精液检查结果的相关性。

结果

根据精液检查结果，119例（79.87%）患者被归入异常组，另外30例（20.13%）归入正常组。两组在△DU（P = 0.007）、△DR（P = 0.0001）和△DV（P = 0.04）方面存在统计学显著差异，但在DSR（P = 0.35）、DSV（P = 0.34）、DUR（P = 0.06）、DUV（P = 0.12）、△DS（P = 0.64）以及患侧睾丸体积（P = 0.323）方面无显著差异。DSR的ROC曲线下面积为0.55，DSV为0.57，DUR为0.64，DUV为0.62，△DS为0.49，△DU为0.28，△DR为0.86，△DV为0.69。相应的截断值分别为2.25、2.51、2.48、2.63、0.30、0.23、0.25和0.20，精液检测的相应敏感度分别为50.42%、65.55%、60.50%、60.50%、49.90%、29.41%、79.83%和65.55%，相应特异度分别为56.67%、63.33%、63.33%、63.33%、56.67%、33.33%、80%和63.33%。