左卡尼汀在男性不育患者精子DNA损伤中的保护作用

L-carnitine protects sperm DNA damage in male infertility

目的探讨左卡尼汀口服液在男性不育患者精子DNA损伤中的保护作用。方法选择88例合并有精子DNA完整性异常[DNA碎片化指数(DNA fragmentation index,DFI)>15%]的不育症患者,分为左卡尼汀组44例和对照组44例:治疗组口服左卡尼汀口服溶液,1 g/次,3次/d;对照组服用五子衍宗丸,6 g/次,2次/d,共3个月。分别于治疗前及治疗3个月末,采用计算机辅助精子分析(computer-aided sperm analysis,CASA)系统与流式细胞术分别检测精液常规参数和DFI。使用SPSS13.0统计软件对治疗前后各项精液参数及DFI进行数据分析。结果治疗前2组精子浓度、精子总活率、前向运动精子百分比和DFI差异无统计学意义(P>0.05)。治疗3个月后,左卡尼汀组精子总活率[(47.28±17.65)%]与对照组[(33.82±14.33)%]及治疗前[(25.45±15.36)%]相比显著提高(P<0.01);前向运动精子百分比[(35.13±13.24)%]较对照组[(25.42±11.34)%]及治疗前[(19.87±10.88)%]显著提高(P<0.01);精子浓度[(30.74±15.51)×106/m L]较对照组[(24.46±15.36)×106/m L]及治疗前[(22.60±18.39)×106/m L]显著提高(P<0.05);DFI[(13.57±5.89)%]较对照组[(20.34±5.28)%]及治疗前[(23.83±6.32)%]显著下降(P<0.05)。对照组精液参数与治疗前相比有所改善,但差异均无显著性(P>0.05)。结论应用左卡尼汀口服液治疗男性不育可以显著改善精子活力与精子DNA完整性。

Objective To investigate the protective effect of L-carnitine on the sperm DNA damage in the patients with male infertility. Methods Eighty-eight infertile men with abnormal sperm DNA integrity [ DNA fragmentation index （DFI） 〉 15% ] admitted in Jinling Hospital from September 2012 to April 2014 were recaited in this study, and then randomly divided into a treatment group （44 patients） treated orally with L-carnitine （ 1 g, tid） and a control group （44 patients） treated with Wuziyanzong bolus （6 g, bid）, both for 3 months. Semen parameters were measured by computer assisted semen analysis （CASA） and sperm DFI was detected by flow cytometry before and after treatment. Results There were no significant differences in the DFI, sperm concentration, percentage of total sperm motility and progressive motility between the 2 groups before treatment （ P 〉 0.05 ）. After treatment for 3 months, remarkable improvement was observed in the percentage of total sperm motility in the treatment group [ （47.28 ± 17.65）% ], compared with the control group [ （33.82 ± 14.33 ） % ] and before treatment [ （25.45 ± 15.36） %, P 〉 0.01 ]. The progressive motility was higher in the treatment group [ （35.13 ± 13.24） % ]than in the control group [ （25.42 ± 11.34） % ] and before treatment [（19.87 ± 10.88）%, P 〈0.01]. The treatment group [（30.74 ± 15.51） x 106/mL] showed significant increase in the sperm concentration compared with the control group [ （24.46±15.36） × 106/mL] and before treatment [ （22.60 ± 18.39） × 106/mL, P 〈 0.05 ]. The sperm DFI was significantly decreased in the treatment group [ （13.57 ±5. 89）% ] and before treatment [ （23.83 ± 6. 32） %, P 〈 0. 05 ]. compared with the control group [ （20.34 ± 5.28 ） % ] After treatment, the above parameters had no significant changes in the control group （P 〉 0.05 ）. Conclusion L-carnitine may effectively improve the sperm motility and sperm DNA integrity in the patients with male infertility.