中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
28期
40-43
,共4页
周忠民%马洪波%王彤%郑杰%王延珍
週忠民%馬洪波%王彤%鄭傑%王延珍
주충민%마홍파%왕동%정걸%왕연진
成年人%精索静脉曲张%白蛋白尿%胡桃夹现象
成年人%精索靜脈麯張%白蛋白尿%鬍桃夾現象
성년인%정색정맥곡장%백단백뇨%호도협현상
Adult%Varicocele%Albuminuria%Nut-cracker phenomenon
目的 探讨成年人胡桃夹现象(NCP)与精索静脉曲张的相关性及意义.方法 回顾性分析226例以无症状性血尿和(或)直立性蛋白尿(微量白蛋白尿)就诊的并经彩色多普勒超声诊断明确的成年NCP患者的临床特点,以左肾静脉受压前后比值≥2为诊断NCP现象标准,将其中184例男性NCP患者作为研究组,将同期参加体检且与之年龄匹配的男性156例,经彩色多普勒超声检查无NCP作为对照组,检查两组精索静脉曲张发病率,并比较.在研究组,详细检查NCP相关指标,采用Logistic回归分析研究NCP与精索静脉曲张的相关性.结果 研究组左侧亚临床型精索静脉曲张患者22例,精索静脉曲张患者47例,总发病率37.50%(69/184);对照组亚临床型精索静脉曲张患者13例,精索静脉曲张患者8例,总发病率13.46%(21/156).两组比较差异有统计学意义(P=0.000).研究组左侧亚临床型精索静脉曲张患者脊柱左侧肾静脉内径(8.41±0.11)mm,脊柱前肾静脉内径(3.65±0.11)mm,二者比值2.31±0.06.肠系膜上动脉(SMA)与腹主动脉(AA)夹角(15.95±0.59)°;左侧精索静脉曲张患者脊柱前肾静脉内径(3.43±0.08)mm,脊柱左侧肾静脉内径(8.72±0.14)mm,二者比值2.54±0.08,SMA与AA夹角(14.54±0.53)°.在研究组,Logistic回归分析表明SMA与AA夹角越小、脊柱左侧肾静脉内径越大、年龄越大,男性NCP患者越容易并发左侧精索静脉曲张(P=0.001).结论 成年男性NCP患者左侧精索静脉曲张发病率显著高于同年龄段非NCP成年男性,这表明在成年男性中,NCP是精索静脉曲张的一个重要病因,二者密切相关.
目的 探討成年人鬍桃夾現象(NCP)與精索靜脈麯張的相關性及意義.方法 迴顧性分析226例以無癥狀性血尿和(或)直立性蛋白尿(微量白蛋白尿)就診的併經綵色多普勒超聲診斷明確的成年NCP患者的臨床特點,以左腎靜脈受壓前後比值≥2為診斷NCP現象標準,將其中184例男性NCP患者作為研究組,將同期參加體檢且與之年齡匹配的男性156例,經綵色多普勒超聲檢查無NCP作為對照組,檢查兩組精索靜脈麯張髮病率,併比較.在研究組,詳細檢查NCP相關指標,採用Logistic迴歸分析研究NCP與精索靜脈麯張的相關性.結果 研究組左側亞臨床型精索靜脈麯張患者22例,精索靜脈麯張患者47例,總髮病率37.50%(69/184);對照組亞臨床型精索靜脈麯張患者13例,精索靜脈麯張患者8例,總髮病率13.46%(21/156).兩組比較差異有統計學意義(P=0.000).研究組左側亞臨床型精索靜脈麯張患者脊柱左側腎靜脈內徑(8.41±0.11)mm,脊柱前腎靜脈內徑(3.65±0.11)mm,二者比值2.31±0.06.腸繫膜上動脈(SMA)與腹主動脈(AA)夾角(15.95±0.59)°;左側精索靜脈麯張患者脊柱前腎靜脈內徑(3.43±0.08)mm,脊柱左側腎靜脈內徑(8.72±0.14)mm,二者比值2.54±0.08,SMA與AA夾角(14.54±0.53)°.在研究組,Logistic迴歸分析錶明SMA與AA夾角越小、脊柱左側腎靜脈內徑越大、年齡越大,男性NCP患者越容易併髮左側精索靜脈麯張(P=0.001).結論 成年男性NCP患者左側精索靜脈麯張髮病率顯著高于同年齡段非NCP成年男性,這錶明在成年男性中,NCP是精索靜脈麯張的一箇重要病因,二者密切相關.
목적 탐토성년인호도협현상(NCP)여정색정맥곡장적상관성급의의.방법 회고성분석226례이무증상성혈뇨화(혹)직립성단백뇨(미량백단백뇨)취진적병경채색다보륵초성진단명학적성년NCP환자적림상특점,이좌신정맥수압전후비치≥2위진단NCP현상표준,장기중184례남성NCP환자작위연구조,장동기삼가체검차여지년령필배적남성156례,경채색다보륵초성검사무NCP작위대조조,검사량조정색정맥곡장발병솔,병비교.재연구조,상세검사NCP상관지표,채용Logistic회귀분석연구NCP여정색정맥곡장적상관성.결과 연구조좌측아림상형정색정맥곡장환자22례,정색정맥곡장환자47례,총발병솔37.50%(69/184);대조조아림상형정색정맥곡장환자13례,정색정맥곡장환자8례,총발병솔13.46%(21/156).량조비교차이유통계학의의(P=0.000).연구조좌측아림상형정색정맥곡장환자척주좌측신정맥내경(8.41±0.11)mm,척주전신정맥내경(3.65±0.11)mm,이자비치2.31±0.06.장계막상동맥(SMA)여복주동맥(AA)협각(15.95±0.59)°;좌측정색정맥곡장환자척주전신정맥내경(3.43±0.08)mm,척주좌측신정맥내경(8.72±0.14)mm,이자비치2.54±0.08,SMA여AA협각(14.54±0.53)°.재연구조,Logistic회귀분석표명SMA여AA협각월소、척주좌측신정맥내경월대、년령월대,남성NCP환자월용역병발좌측정색정맥곡장(P=0.001).결론 성년남성NCP환자좌측정색정맥곡장발병솔현저고우동년령단비NCP성년남성,저표명재성년남성중,NCP시정색정맥곡장적일개중요병인,이자밀절상관.
Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.
