Klaiber E L, Broverman D M, Pokoly T B, Albert A J, Howard P J, Sherer J F
Fertil Steril. 1987 Mar;47(3):481-6. doi: 10.1016/s0015-0282(16)59059-1.
Data on cigarette smoking, testicular varicoceles, seminal fluid indexes, and oligospermia were examined in 160 young men without known disease and in 94 husbands in infertile couples. The combination of smoking and testicular varicoceles is strongly related to the incidence of oligospermia, defined as sperm count less than or equal to 20 X 10(6)/ml, in each sample. Smokers with testicular varicoceles, in each sample, had a disproportionately high incidence of oligospermia. In the combined sample of 254 men, the smokers with testicular varicoceles had an incidence of oligospermia approximately ten times greater than that in nonsmokers with testicular varicoceles and approximately five times greater than that in men who smoked but were without testicular varicoceles. This relationship of cigarette smoking and testicular varicoceles to oligospermia has not been previously reported. The pathophysiologic basis of the interaction between smoking and varicoceles was theorized to be due to an increased secretion of catecholamines from the adrenal medulla, induced by cigarette smoking. The elevated catecholamine concentrations in the renal vein would then reach the testes via retrograde flow down the internal spermatic vein in men with testicular varicoceles, resulting in seminiferous tubule damage.
对160名无已知疾病的年轻男性以及94对不育夫妇中的丈夫进行了关于吸烟、精索静脉曲张、精液指标和少精子症的数据检查。在每个样本中，吸烟与精索静脉曲张的合并情况与少精子症（定义为精子计数小于或等于20×10⁶/ml）的发生率密切相关。在每个样本中，患有精索静脉曲张的吸烟者少精子症的发生率异常高。在这254名男性的合并样本中，患有精索静脉曲张的吸烟者少精子症的发生率大约是非精索静脉曲张吸烟者的10倍，大约是吸烟但无精索静脉曲张男性的5倍。吸烟和精索静脉曲张与少精子症之间的这种关系此前尚未见报道。吸烟与精索静脉曲张相互作用的病理生理基础据推测是由于吸烟诱导肾上腺髓质儿茶酚胺分泌增加。然后，精索静脉曲张男性肾静脉中升高的儿茶酚胺浓度会通过沿精索内静脉逆行流动到达睾丸，导致生精小管损伤。
