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目的：探究精索静脉曲张（varicocele, VC）男性不育症患者显微外科治疗后精浆瘦素（Leptin）水平与精子凋亡率的改变并分析两者的相关性。方法选取2011年1月至2011年12月在仁济医院泌尿男科就诊左VC伴少、弱精子症患者50例进行精索内静脉显微结扎治疗，另选取因女方因素不孕而采用体外受精-胚胎移植（In vitro fertilisation-Embryo Transfer，IVF-ET）处理、并成功使配偶怀孕的精液30份作为对照组。检测各组常规精液参数，放射免疫法检测精浆Leptin，Annexin+PI法测定精子凋亡率。观察比较VC患者术前及术后3个月以上指标变化情况，对数据进行统计学分析。结果 VC组术前精子浓度、活力及活率均显著低于对照组（P＜0.01），精子凋亡率及精浆Leptin水平显著高于对照组（P＜0.01），精子凋亡率与精子浓度及精子活力之间存在负相关性（P＜0.01、P＜0.05），精浆Leptin水平与精子凋亡率之间存在显著正相关性（P＜0.01）。VC术后3个月精子浓度显著升高（P＜0.01），精子活力及活率升高有统计学意义（P＜0.05），精子凋亡率显著低于术前（P＜0.01），精浆Leptin水平亦显著低于术前（P＜0.01）。结论 VC患者精浆精子凋亡率及精浆Leptin水平均显著增高，VC显微外科治疗有助于改善生精环境、降低凋亡，提高精液质量。另外，精浆Leptin水平与精子凋亡之间存在一定相关性，Leptin可能是促精子凋亡因子之一。“,”control group (P<0.05). The sperm apoptosis rate was negatively correlated with the sperm concentration and (A+B) grade sperm percentage (P<0.01, P<0.05). The level of leptin in semen plasma was positively correlated with the sperm apoptosis rate (P<0.05). The increase of semen parameters were found in the patients after microsurgery (P<0.05). The level of leptin in semen plasma was decreased after microsurgery (P<0.05), while the sperm apoptosis rate was also decreased (P<0.05). Conclusion Varicocele might contribute to the high level of Leptin in seminal plasma and the sperm apoptosis, whereas, microsurgery will bring benefit for the condition. Leptin has significant correlation with the sperm apoptosis rate in both pre-and after microsurgery. So Leptin may be one of the pro-apoptotic factors to the sperm.