维生素D改善男性不育患者精液质量的有效性评估:系统评价和meta分析  

Efficacy of vitamin D in treating semen quality in patients with male infertility:a systematic reviewandmeta-analysis

作　　者：黄臻伟 张静茹 李得春 Huang Zhenwei;Zhang Jingru;Li Dechun(Baotou Medical College of Inner Mongolia University of Science and Technology,Baotou 014040,China;Department of Clinical Laboratory,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,China;Department of Clinical Laboratory,Baotou Central Hospital,Baotou 014040,China)

机构地区：[1]内蒙古科技大学包头医学院,包头014040 [2]内蒙古科技大学包头医学院第一附属医院检验科,包头014010 [3]包头市中心医院检验科,包头014040

出　　处：《中华生殖与避孕杂志》2024年第11期1184-1190,共7页Chinese Journal of Reproduction and Contraception

基　　金：内蒙古自然科学基金(2021MS08049)。

摘　　要：目的系统评价维生素D(vitamin D,VD)治疗男性不育的有效性。方法从PubMed、Embase、Web of science、中国知网、万方及维普数据库中鉴定和收集关于VD单用或联合用药治疗男性不育的随机对照试验(randomized controlled trial,RCT),患者分为试验组(给予VD或以VD为主的联合用药治疗)和对照组(给予安慰剂治疗)。利用RevMan5.4软件对最终纳入的研究进行meta分析。计算合并效应尺度以加权均数差(mean difference,MD)及其95%CI表示。结果最终纳入6项RCT,共计673例患者,研究基线具有可比性。精子总活力(MD=6.49,95%CI:2.75~10.22,P<0.001)和前向运动精子百分率(MD=5.03,95%CI:1.36~8.70,P=0.007)在试验组与对照组之间差异均有统计学意义,而精子总数(MD=5.56,95%CI:12.62~23.75,P=0.550)、精子浓度(MD=-0.30,95%CI:-4.81~4.21,P=0.890)、精液体积(MD=-0.04;95%CI:-0.18~0.09,P=0.510)和精子正常形态(MD=0.42;95%CI:-0.05~0.88,P=0.080)在试验组与对照组间差异均无统计学意义。结论VD在改善不育男性的精液质量方面有一定的疗效。但由于纳入RCT的样本数量有限,仍需更大样本的临床试验方案进一步证实这一论点。Objective:To systematically evaluate the efficacy of vitamin D(VD)in the treatment of male infertility.Methods:Randomized controlled trials(RCT)on male infertility treated with VD alone or in combination were identified and collected from PubMed,Embase,Web of science,CNKI,Wanfang and VIP databases.Patients were divided into experimental group(VD or combination therapy with VD as the main treatment)and control group(placebo treatment).A meta-analysis of the included studies was performed using RevMan5.4 software.The combined effect scale was calculated as the weighted mean difference(MD)and its 95%CI.Results:Six RCTs with a total of 673 patients were ultimately included,and the study baseline was comparable.Total sperm motility(MD=6.49,95%CI:2.75-10.22,P<0.001)and percentage of forward motile sperm(MD=5.03,95%CI:1.36-8.70,P=0.007)were significantly different between the experimental group and control group.Total sperm count(MD=5.56,95%CI:-12.62-23.75,P=0.550),sperm concentration(MD=-0.30,95%CI:-4.81-4.21,P=0.890),semen volume(MD=-0.04,95%CI:-0.18-0.09,P=0.510)and normal sperm morphology(MD=0.42,95%CI:-0.05-0.88,P=0.080)were not significantly different between the experimental group and control group.Conclusion:VD is effective in improving semen quality in the treatment of male infertility.However,due to the limited number of samples included in RCT,clinical trials with larger samples are still needed to further confirm this thesis.

关 键 词：维生素D 不育 男性 随机对照试验 META分析 

分 类 号：R698.2[医药卫生—泌尿科学]