Ozturk Selcuk, Akbaba Kaan Turker, Kılıc Suleyman, Cıcek Tufan, Peskırcıoglu Levent, Tandogan Izzet, Gurlek Ahmet, Aydemır Ozbay, Ilerı Mehmet, Yetkın Ertan
1 Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
2 İslahiye State Hospital, Urology Clinic, Gaziantep, Turkey.
Phlebology. 2019 Mar;34(2):128-136. doi: 10.1177/0268355518777110. Epub 2018 May 24.
The aim of this study is to evaluate chronic venous disease symptoms by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in varicocele patients.
The study was designed as a prospective, case controlled study and conducted in four hospitals from Turkey. A total of 600 patients who admitted to urology outpatient clinic were enrolled to the study. After the exclusion of 44 patients who do not match the inclusion criteria, the remaining 556 patients were examined for the presence and grade of varicocele and subsequently examined clinically for the presence of chronic venous disease findings. Finally, patients were asked to answer the VEINES-Sym questionnaire consisting of 10 items. All patients' demographic parameters, cardiovascular risk factors, other co-morbid diseases and drug usage were noted.
Patients were classified into two groups: varicocele (+) group ( n = 269) and varicocele (-) group ( n = 287). VEINES-Sym scores of varicocele patients were lower compared to patients without varicocele (41.41 ± 5.21, 43.19 ± 3.22, respectively, p < 0.001). Grades of varicocele significantly but inversely correlated with VEINES-Sym score ( r = 0, -206, p = 0.001). Logistic regression analysis revealed that presence of varicocele irrespective of grading significantly and independently associated with the presence of aching (odds ratio: 2.054, 95% confidence interval: 1.265-3.338, p = 0.004) and throbbing (odds ratio: 2.586, 95% confidence interval: 1.353-4.943, p = 0.004).
Varicocele patients have lower VEINES-Sym scores compared to patients without varicocele and this finding is inversely correlated with the degree of the varicocele. This association supports the hypothesis that there may be a systemic vessel wall abnormality in venous disease patients. Patients with symptoms related to vascular dilatation in any territory may deserve to be assessed systematically with the support of further clinical studies.
本研究旨在通过使用精索静脉曲张患者的静脉功能不全流行病学和经济学研究-生活质量/症状（VEINES-QoL/Sym）问卷来评估慢性静脉疾病症状。
本研究设计为前瞻性病例对照研究，在土耳其的四家医院进行。共有600名泌尿外科门诊收治的患者纳入研究。排除44名不符合纳入标准的患者后，对其余556名患者进行精索静脉曲张的存在情况及分级检查，随后进行慢性静脉疾病体征的临床检查。最后，让患者回答由10个项目组成的VEINES-Sym问卷。记录所有患者的人口统计学参数、心血管危险因素、其他合并疾病及药物使用情况。
患者分为两组：精索静脉曲张（+）组（n = 269）和精索静脉曲张（-）组（n = 287）。精索静脉曲张患者的VEINES-Sym评分低于无精索静脉曲张的患者（分别为41.41±5.21、43.19±3.22，p < 0.001）。精索静脉曲张分级与VEINES-Sym评分显著负相关（r = -0.206，p = 0.001）。逻辑回归分析显示，无论分级如何，精索静脉曲张的存在与疼痛（比值比：2.054，95%置信区间：1.265 - 3.338，p = 0.004）和搏动（比值比：2.586，95%置信区间：1.353 - 4.943，p = 0.004）显著且独立相关。
与无精索静脉曲张的患者相比，精索静脉曲张患者的VEINES-Sym评分较低，且这一发现与精索静脉曲张程度呈负相关。这种关联支持了静脉疾病患者可能存在系统性血管壁异常的假说。任何区域有与血管扩张相关症状的患者可能值得在进一步临床研究的支持下进行系统评估。
