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术前血液参数在预测精索静脉曲张切除术成功率方面的作用是什么?

What is the role of pre-operative blood parameters in forecasting varicocelectomy success?

作者信息

Erdogan Omer, Ok Fesih, Carkci Serkan

机构信息

Siirt Training and Research Hospital, Siirt, Turkey.

出版信息

Andrology. 2021 May;9(3):916-921. doi: 10.1111/andr.12976. Epub 2021 Feb 7.

Abstract

BACKGROUND

We aimed to examine the effects of pre-operative blood values on varicocelectomy success.

MATERIALS AND METHODS

A total of 130 patients who underwent varicocelectomy in our clinic were retrospectively analyzed. Operation success was defined as the return of all semen parameters (concentration, progressive motility, and morphology) to normal values 6 months after surgery. The patients were separated as two groups as benefiting from the treatment (Group A) and not (Group B).

RESULTS

The best cut-off value for the neutrophil/lymphocyte ratio (NLR), which can predict varicocelectomy success, was assigned to be 2.27, with AUC of 0.859 (%95 CI 0.795-0.922). The highest sensitivity and specificity were 0.857 and 0.731 (p < 0.001). The best cut-off value for the mean platelet volüme (MPV) value, which can predict varicocelectomy success, was assigned to be 9.45, with AUC of 0.729 (%95 CI 0.639-0.819). The highest sensitivity and specificity were 0.655 and 0.635 (p < 0.001). Binary logistic regression analysis showed NLR ratio (odds ratio (OR): 11.2, p < 0.001) and MPV (OR: 2.65, p = 0.002) parameters as independent predictive factors in predicting varicocelectomy success.

DISCUSSION AND CONCLUSION

Our study showed that low NLR ratio (≤2.27) and high MPV (≥9.45) ratio levels may be a useful pre-operative predictive tool in identifying men who benefit most from varicocelectomy in infertile patients with varicocoele.

摘要

背景

我们旨在研究术前血液指标对精索静脉曲张切除术成功率的影响。

材料与方法

对在我院接受精索静脉曲张切除术的130例患者进行回顾性分析。手术成功定义为术后6个月所有精液参数(浓度、前向运动率和形态)恢复至正常水平。患者被分为两组,即治疗有效组(A组)和治疗无效组(B组)。

结果

可预测精索静脉曲张切除术成功率的中性粒细胞/淋巴细胞比值(NLR)的最佳截断值为2.27,曲线下面积(AUC)为0.859(95%置信区间0.795 - 0.922)。最高灵敏度和特异度分别为0.857和0.731(p < 0.001)。可预测精索静脉曲张切除术成功率的平均血小板体积(MPV)值的最佳截断值为9.45,AUC为0.729(95%置信区间0.639 - 0.819)。最高灵敏度和特异度分别为0.655和0.635(p < 0.001)。二元逻辑回归分析显示,NLR比值(比值比(OR):11.2,p < 0.001)和MPV(OR:2.65,p = 0.002)参数是预测精索静脉曲张切除术成功率的独立预测因素。

讨论与结论

我们的研究表明,低NLR比值(≤2.27)和高MPV(≥9.45)比值水平可能是一种有用的术前预测工具,可用于识别精索静脉曲张不育患者中最能从精索静脉曲张切除术中获益的男性。

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