超生理剂量十一酸睾酮引起生精细胞凋亡的动态研究

Dynamic study on apoptosis of spermatogenic cells in normal fertile men treated with supraphysiological doses of injectable testosterone undecanoate

目的：以生精细胞凋亡作为指标探讨超生理剂量十一酸睾酮（ＴＵ）抑制精子发生的机制。方法：正常生育史男性２０例肌内注射ＴＵ，应用瑞－吉染色和ＴＵＮＥＬ法对精液中脱落细胞进行凋亡率的动态检测。结果：用药后精子密度和生精细胞数较用药前显著下降（Ｐ＜０．０１），精母细胞和精子细胞凋亡率则显著上升（Ｐ＜０．０１）。结论：ＴＵ具有显著的抑制精子发生的效应。其作用机制除通过抑制促性腺激素而导致睾丸内睾酮（Ｔ）浓度降低，继之使精子发生停滞外，还可能有促进生精细胞凋亡的作用。

Objectives: To study the mechanism of spermatogenicsuppressive effect of supraphysiological doses of testosterone undecanoate (TU). Methods: The apoptotic germ cells in semen plasma were detected with TUNEL and WrightGiemsa staining in 20 adult proven fertile men receiving 3 consecutive injection of TU at monthly intervals. Results: The sperm density and number of spermatogenic cells were decreased (P<0.01),while significant increase in number of apoptotic ratio of spermatocytes and spermatids (P<0.01) was found compared to the pretreated levels. Conclusions: In addition to TU suppresses gonadotropins leading to decrease in intratesticular T concentration and arrest of spermatogenesis, the increase in germ cell apoptosis may be an additional mechanism of the spermatogenicsuppressive effect of TU.