阿片类镇痛药体外对精子运动影响的临床研究  

Clinical study of opioid analgesic effect on the sperm motility in vitro

作　　者：王志丰[1] 刘庆德[1] 严英[1] 应向荣[2] 

机构地区：[1]绍兴第二医院麻醉科,浙江绍兴312000 [2]绍兴市人民医院泌尿外科,浙江绍兴312000

出　　处：《中国性科学》2016年第4期138-140,共3页Chinese Journal of Human Sexuality

摘　　要：目的:探讨阿片类镇痛药体外对精子运动的影响性,以期提高临床用药安全性,降低不良反应。方法:选取2010年7月到2013年1月40例精子活力精液标本,每份分为13份,1份为对照,分别在3种浓度下6种不同阿片类镇痛药在恒温箱孵育4h,运用计算机系统分析精子活力。结果:芬太尼、阿芬太尼、舒芬太尼、布托啡诺在1×10^(-5)mg/m L、2×10^(-3)mg/m L、0.05mg/m L浓度下其精子活力均较对照组低,两者比较差异均有统计学意义(P<0.05);布托啡诺1×10^(-5)mg/m L与对照组比较差异无统计学意义(P>0.05),而在2×10^(-3)mg/m L、0.05mg/m L比较差异均有统计学意义(P<0.05);地佐辛在1×10^(-5)mg/m L与对照组比较差异无统计学意义(P>0.05),而在0.05 mg/m L、0.5mg/m L比较差异均有统计学意义(P<0.05);喷他佐辛在3×10^(-5)mg/m L、0.05mg/m L和对照组比较差异无统计学意义(P>0.05),而在0.5mg/m L时比较差异有统计学意义(P<0.05)。15min后浓度为0.05mg/m L的芬太尼、舒芬太尼、阿芬太尼、布托啡诺、地佐辛中的精子均有衰减现象,舒芬太尼和芬太尼中精子衰减幅度无统计学差异(P>0.05),而它们与布托啡诺、地佐辛和阿芬太尼比较差异均有统计学意义(P<0.05)。结论:低浓度布托啡诺、地佐辛对精子活动无影响,高浓度则完全抑制精子活力,低浓度芬太尼、阿芬太尼、舒芬太尼则显著抑制精子活力,而高浓度喷他佐辛则促进精子活动。Objectives：To investigate the opioid analgesic effect on sperm motility in vitro in order to improve clinical drug safety and reduce complications.Methods：40 cases of semen samples from July 2010 to January2013 were divided into 3 groups,with 13 samples in each group.Respectively,the three groups were incubated for4 h in three concentrations of six different opioid analgesics.Computer systems analysis of sperm motility was done on the samples.Results：Sperm motility of fentanyl,alfentanil,sufentanil,butorphanol at 1×10^-5mg / mL and 2×10^-3mg / mL,0.05 mg / mL concentration was lower than that in control group,with statistically significant difference （P〈0.05）;final concentrations of butorphanol of the two group were 1×10^-5mg / mL,without statistically significant difference （P〉0.05）.While in the concentration of 2×10^-3mg / mL,0.05 mg / mL,the differences were statistically significant （P〈0.05）;final concentration of Dezocine was 1×10^-5mg / mL,without statistically significant difference （P〉0.05）.In the concentration of 0.05 mg / mL and 0.5mg / mL,the differences were statistically significant （P〉0.05）;comparing 3×10^-5mg / mL,0.05 mg / mL concentration of pentazocine with the control group,the difference was not statistically significant （P〈0.05）.Compared with 0.5mg / mL,the differences were statistically significant （P〈0.05）.The differences of fentanyl,sufentanil,alfentanil,butorphanol,dezocine in attenuation magnitude of concentration of 0.05 mg / mL sperm 15 min after the treatment were statistically significant （P〈0.05）,but the difference with fentanyl had no significant difference （P〉0.05）.Conclusion：The low concentration of butorphanol and dezocine has no effect on sperm motility.High concentration of butorphanol and dezocine can completely inhibit sperm motility.Low concentration of fentanyl,alfentanil and sufentanil significantly suppress sperm motility,and high concentrations of pentazocine can improve sperm motility.

关 键 词：阿片类镇痛药 精子活力 

分 类 号：R9[医药卫生—药学]