低剂量克罗米芬治疗特发性少精弱精症的效果及对精浆附睾蛋白4水平的影响

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维普

中文摘要：目的探讨低剂量克罗米芬治疗特发性少精弱精症的效果及对精浆附睾蛋白4水平的影响.方法选择2013年1月~2015年6月在第二军医大学附属上海长海医院就诊的特发性少弱精子症患者183例,采用随机数字法将183例患者分为3组,维生素组61例给予维生素E治疗,克罗米芬组61例给予低剂量克罗米芬治疗,联合组61例同时给予维生素E和克罗米芬治疗,疗程均为12个周.观察治疗前后精液量、精子密度、精子活力、精子存活率、精浆活性氧物质(reactive oxygen species,ROS)、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、人附睾蛋白4(human epididymis protein 4,HE4)、卵泡刺激素、黄体生成素、睾酮浓度.治疗结束后对患者随访1年,观察女方自然受孕率.结果克罗米芬组治疗后精子密度、精子存活率、A级精子和A+B级精子与同期维生素组比较均显著升高(P<0.05),联合组治疗后精子密度、精子存活率、A级精子和A+B级精子与同期克罗米芬组和维生素组比较均显著升高(P<0.05).3组治疗后HE4水平与治疗前比较均显著降低(P<0.05),且三组间比较差异均有统计学意义(P<0.05).克罗米芬组和联合组治疗后卵泡刺激素、黄体生成素、睾酮与治疗前比较均显著升高(P<0.05),且联合组与同期克罗米芬组比较差异均无统计学意义.维生素组、克罗米芬组和联合组1年妊娠率分别为24.59%、42.62%和62.29%(P<0.05).结论克罗米芬治疗特发性少弱精症效果优于维生素E,2者联合具有协同作用.

外文标题：Effect of low dose clomiphene in treatment of idiopathic oligoasthenospermia and therapeutic effect on sperm epididymal protein 4 levels

外文摘要：Objective To investigate therapeutic effect of the low dose clomiphene treatment of idiopathic oligoasthenospermia and effect on sperm epididymal protein level 4.Methods183 cases of idiopathic oligoasthenospermia were divided into three groups, vitamin group of 61 patients were given vitamin E,clomiphene group(61 cases)treated with low dose clomiphene, combined group of 61 patients were given low dose clomiphene and vitamin E, lasted for 12 weeks.Semen volume, sperm density, sperm motility, sperm survival rate and sperm reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), human epididymis protein 4 (HE4), follicle stimulating hormone, luteinizing hormone, testosterone concentration were observed before and after treatment.After treatment, the patients were followed up for 1 year, the observation of the natural pregnancy rate after treatment.ResultsSperm density, sperm survival rate and sperm and a A+B grade sperm in the clomiphene group were significantly higher comparedwith the vitamin group (P< 0.05), sperm density, sperm survival rate and sperm and a A+B grade sperm in the combined group were significantly increasedcompared with clomiphene group and vitamin group (P< 0.05),levels of HE4 after treatment was significantly lower compared with before treatment (P< 0.05), And the difference between the three groups were statistically significant (P< 0.05).Follicle stimulating hormone, luteinizing hormone, testosterone in clomiphene group and combined group after treatment, were significantly increased compared with before treatment (P< 0.05), and the combined group had no statistically difference compared with clomiphene group.The pregnancy rate in 1 year of vitamin group, clomiphene group and combined group were 24.59%, 42.62% and 62.29% (P< 0.05).ConclusionClomiphene treatment of idiopathic asthenospermia is better than vitamin E, the combination of the two has a synergistic effect.

外文关键词：

idiopathic oligospermia and asthenospermiaclomiphene citratevitamin Eepididymis protein 4oxidative stress

作者：

施飞、印惠荣、松迪、林莎莎、许亚军

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作者单位：

第二军医大学附属上海长海医院生殖中心,上海200433

关键词：

特发性少弱精症克罗米芬维生素E 附睾蛋白4 氧化应激

出版年：

2017

DOI：