特发性精液质量异常的诊断与治疗  

Diagnosis and treatment of idiopathic semen quality abnormalities

作　　者：陆金春[1] 黄宇烽[2] 

机构地区：[1]武警江苏总队南京医院检验科,江苏南京210028 [2]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《中华男科学杂志》2012年第1期3-10,共8页National Journal of Andrology

摘　　要：特发性精液质量异常包括特发性少、弱、畸形精子症、特发性无精子症以及特发性精液液化异常。导致特发性精液质量异常的可能原因包括年龄、附属性腺的非炎症性功能改变、感染因素、基因异常、精子线粒体改变、环境污染物的影响和细微的激素改变等。诊断特发性少、弱、畸形精子症和无精子症需要经过全面的病史询问、体格检查、精液分析、生殖激素检查、遗传学检查、免疫学检查等以排除已知的可能病因。特发性少弱畸形精子症的治疗包括使用克罗米芬、他莫西芬、重组FSH、安特尔、锌硒宝、左卡尼汀、重组生长激素、己酮可可碱等西药类、中成药以及中西医结合治疗等;特发性无精子症可在使用促精子生成药的基础上使用辅助生殖技术治疗;特发性精液液化异常主要通过中医药、中西医结合和体外处理技术治疗。随着诊断技术的发展,有望建立更加特异的精液质量异常的治疗措施和降低特发性精液质量异常的发生率。Idiopathic semen quality abnormalities include idiopathic oligozoospermia,asthenospermia,teratospermia,azoospermia and idiopathic abnormal semen liquefaction.The possible causes of idiopathic semen quality abnormality include age,non-inflammatory function changes of subsidiary gonadal organs,infection,genetic abnormalities,sperm mitochondrial changes,effects of environmental pollutants,and subtle hormonal changes.The diagnosis of idiopathic oligozoospermia,asthenospermia,teratospermia and azoospermia require detailed inquiry of the case history,physical examination,semen analysis,determination of reproductive hormones,genetic and immunological examinations,and so on,to exclude possible known causes.The treatment of idiopathic oligozoospermia,asthenospermia,and teratospermia may involve the use of Western medicines,such as clomiphene citrate,tamoxifen,recombinant FSH,Andriol,compound zinc and selenium,L-carnitine,recombinant growth hormone and pentoxifylline,the application of traditional Chinese drugs,or the combination of traditional Chinese and Western medicine.Idiopathic azoospermia can be treated by assisted reproductive technology based on the medication of spermatogenesis-promoting drugs,and idiopathic abnormal semen liquefaction can be managed with traditional Chinese drugs,integrated traditional Chinese and Western medicine,or in vitro semen processing technology.With the development of diagnostic technology,it is expected that more specific therapeutic methods will be established for idiopathic semen quality abnormalities and their incidence will be reduced.

关 键 词：特发性少精子症 特发性弱精子症 特发性畸形精子症 特发性无精子症 特发性精液液化异常 诊断 治疗 

分 类 号：R698.2[医药卫生—泌尿科学]