丙戊酸钠对男性癫痫患者生殖功能的影响

Effects of sodium valproate on reproductive function in male epilepsy patients

【目的】探讨丙戊酸钠(sodium valproate,VPA)对男性癫痫患者生殖功能的影响。【方法】检测32例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)的性激素水平,并进行精液浓度、精子活动率及精子形态学分析。采用国际勃起功能指数量表简化版问卷(IIEF-5)评估两组已婚者性生活满意度并进行比较。【结果】VPA组的生育率低于正常对照组(P=0.022,P<0.05)。与正常对照组比较,VPA组黄体生成素、卵泡刺激素水平显著降低(P<0.01),而泌乳素水平及生物活性雄激素/黄体生成素显著升高(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。癫痫治疗组中总精子畸形率及头部、体部尾部精子畸形率均显著高于正常对照组(P<0.01)。VPA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(P<0.01)。VPA组IIEF-5问题1、2、3及总得分显著低于正常对照组(P<0.01);问题4、5得分两组差异无统计学意义。【结论】VPA对男性癫痫患者生殖功能有一定的损害。

[Objective] To investigate the effects of sodium valproate （VPA） on reproductive function in male epilepsy patients. [ Method ] Sex hormone levels of 32 male epilepsy patients treated with VAP （VAP group） and 30 normal person （normal control group） were detected. Sperm concentration, sperm motility and sperm morphology were studied. The international index of erectile function-5 （IIEF-5） were used to assess the sex life satisfactory degree in the two groups, and the result were compared. [ Result]The Fertility rate of VPA group was significantly lower than normal control group（P 〈 0.05）. Compared with normal control group, the levels of luteinizing hormone and follicle stimulating hormone in VPA group was significantly lower （all P 〈 0.01）; and the levels of prolactin and bioactive and rogen/luteinizing hormone were significantly higher （all P 〈 0.01）. There were no statistical significance in the levels of testosterone, estradiolum and bioactive androgen/bioactive estrogen between the two groups. The total sperm malformation rate and head, body, tail sperm malformation rate in VAP group were significantly higher than normal control group （all P 〈 0.01）. The total sperm motility, grade A sperm 〈 25% and grade A＋B sperm〈50% were significantly lower than normal control group （all P 〈 0.01）. The scores of IIEF-5 questionnaires 1, 2, 3 and total score were significantly lower than normal control group （all P 〈 0.01）. There were no statistical significance in questionnaires 4,5 between the two groups. [Conclusion] VAP is injurious to reproductive function of male epilepsy patient in some degree.