左卡尼汀对精子顶体酶活性低下男性不育患者的疗效分析  

L-carnitine improves sperm acrosin activity in male infertility patients

作　　者：孙理兰[1] 万秀霞[2] 张岩[1] 张玉花[1] 赵文杰[1] 王丹[1] 王金光 谢金龙 马华刚[1] SUN Li-lan;WAN Xiu-xia;ZHANG Yan;ZHANG Yu-hua;ZHAO Wen-jie;WANG Dan;WANG Jin-guang;XIE Jin-long;MA Hua-gang(Center of Reproductive Medicine,Weifang People's Hospital,Weifang,Shandong 261000,China;Virtual Chamber,Human Integrated Biological Functions Laboratory,School of Basic Medicine,Qingdao University,Qingdao,Shandong 266071,China)

机构地区：[1]潍坊市人民医院生殖医学中心,山东潍坊261000 [2]青岛大学基础医学院人体机能学实验室虚拟实验室,山东青岛266071

出　　处：《中华男科学杂志》2018年第12期1064-1068,共5页National Journal of Andrology

摘　　要：目的:观察左卡尼汀(LC)治疗精子顶体酶活性低下男性不育患者的疗效。方法:收集精子顶体酶活性低于正常值的男性不育患者212例,随机分为两组,治疗组口服LC 1. 0 g/次,3次/d;对照组给予维生素E软胶囊100 mg/次,3次/d,连续用药3个月。治疗前后分别检测精液常规参数与精子顶体酶活性。根据精液常规分析结果,将治疗组进一步分为少精子症组、弱精子症组和正常组。结果:治疗组中,与治疗前相比,治疗后前向运动精子百分率(PR%)明显提高[(36. 35±1. 26)%vs (32. 58±1. 13)%,P <0. 05],精子顶体酶活性显著提高[(58. 61±1. 93)μIU/106精子vs (37. 05±0. 66)μIU/106精子,P <0. 01]。而在对照组中,治疗后精子浓度、PR%、顶体酶活性较治疗前都有提高,但无显著差异。将治疗组进一步分组分析,治疗后少精子症组精子浓度较治疗前显著增高[(21. 82±4. 21)×106/ml vs (11. 27±0. 73)×10~6/ml,P <0. 01],弱精子症组PR%较治疗前显著提高[(29. 81±1. 88)%vs (20. 61±0. 85)%,P <0. 01],精子顶体酶活性弱精子症组较正常组和少精子症组提高更加显著[(60. 85±3. 04)μIU/106精子vs (56. 32±2. 86)、(57. 09±6. 31)μIU/106精子,P <0. 05]。结论:口服LC可以有效改善精子的顶体酶活性,且对弱精子症患者效果更明显。Objective: To evaluate the effect of L-carnitine( LC) on low sperm acrosin activity in infertile man. Methods: A total of 240 male infertility patients with low sperm acrosin activity were randomly assigned to an LC group( n = 180) and a control group( n = 60) to be treated with LC( 1g,tid) and vitamin E( VE) capsules( 100 mg,tid) respectively,both for 3 months. Based on the results of routine semen analysis, the patients in the experimental group were further divided into oligozoospermia,asthenozoospermia and normozoospermia subgroups. Semen parameters and sperm acrosin activity were examined before and after treatment. Results: Totally,220 of the patients completed the treatment and follow-up,163 in the LC medication and 57 in the VE control group. Compared with the baseline,the percentage of progressively motile sperm( PMS) was significantly increased in the LC group after 3 months of treatment( [32. 58 ± 1. 13]% vs [36. 35 ± 1. 26]%,P < 0. 05),and so was sperm acrosin activity( [37. 05 ± 0. 66]vs [58. 61 ± 1. 93]μIU/10~6 sperm,P < 0. 01). Sperm concentration,PMS and sperm acrosin activity were also improved in the VE control group after treatment,but with no statistically significant difference( P > 0. 05). In comparison with pretreatment,remarkable increases were observed after LC medication in sperm concentration in the oligozoospermia subgroup( [11. 27 ±0. 73] vs [21. 82 ± 4. 21] × 106/ml,P < 0. 01) and PMS in the asthenozoospermia patients( [20. 61 ± 0. 85]% vs [29. 81 ±1. 88]%,P < 0. 01). And sperm acrosin activity was even higher after treatment in the asthenozoospermia than in the oligozoospermia and normozoospermia subgroups( [60. 85 ± 3. 04]vs [56. 32 ± 2. 86]and [57. 09 ± 6. 31]μIU/106 sperm,P < 0. 05).Conclusion: L-carnitine can effectively elevate sperm acrosin activity in male infertility patients,particularly in those with asthenozoospermia.

关 键 词：左卡尼汀 精子顶体酶 少精子症 弱精子症 

分 类 号：R698.2[医药卫生—泌尿科学]