丙戊酸钠对男性癫痫患者生殖功能的影响

Influnce of sodium valproate on reproductive function in male epilepsy patients

目的探讨丙戊酸钠(VPA)对男性癫痫患者生殖功能的影响。方法对32例应用VPA单药治疗≥6个月的男性癫痫患者(VPA组)及30名健康对照者(正常对照组)的血液性激素水平、精液质量进行检测;采用国际勃起功能指数量表简化版问卷(IIEF-5)评估两组已婚者的性功能评估,并进行比较。结果与正常对照组比较,VPA组的生育率显著降低(P<0.05),血液中黄体生成素、卵泡刺激素水平显著降低,泌乳素水平及生物活性雄激素/黄体生成素显著升高(均P<0.01)。两组间睾酮、雌二醇水平、生物活性雄激素/生物活性雌激素及精液浓度差异无统计学意义;VPA组总精子畸形率及头部、体部尾部精子畸形率显著高于正常对照组,总精子活动率、A级精子<25%及A+B级精子<50%的比率均显著低于正常对照组(均P<0.01);IIEF-5总分及问题1、2、3得分显著低于正常对照组(均P<0.01)。结论 VPA可损害男性癫痫患者的生殖功能。

Objective To investigate the influnce of sodium valproate （VPA） on reproductive function in male epilepsy patients. Methods The blood sex hormone levels and sperm guality were detected in 32 male epilepsy patients treated with VPA ≥ 6 months （VAP group ） and 30 normal controls （normal control group ）. The international index of erectile function-5 （ IIEF-5 ） were employed to assess the sexual function in married persons in the two groups, and the results were compared. Results Compared with normal control group, the fertility rate of ~PA group was significantly lower （ P 〈 0. 05 ） ; the blood levels of luteinizing hormone and follicle stimulating hormone were significantly lower, and the levels of prolactin and bioaetivity androgen/luteinizing hormone were significantly higher （all P 〈 0. 01 ）. There were no statistical significance in the levels of testosterone, estradiolum and bioactivity androgen/bioactivity estrogen between the two groups. The total sperm malformation rate and head, body, tail of sperm malformation rate in VAP group were significantly higher than normal control group, and the total sperm motility, the ratio of grade A sperm 〈 25 % and grade A ＋ B sperm 〈 50% were significantly lower than normal control group （all P 〈 0. 01 ）. The total scores of IIEF-5 and score of questionnaires l, 2, 3 were significantly lower than normal control group （all P 〈 0. 01 ）. Conclusions VPA can damage the reproductive function for male epilepsy patient.