拉莫三嗪对成年男性癫痫患者精液质量、性功能及性激素的影响

Effects of lamotrigine on sex hormone, seminal fluid and sexual function of male patients with epilepsy

目的探讨拉莫三嗪对成年男性癫痫患者的精液质量、性功能及性激素的影响。方法对2015年4月—2016年11月于四川省人民医院癫痫中心新诊断的16例成年男性全面性发作和部分性发作继发强直阵挛发作的癫痫患者予以拉莫三嗪(Lamotrigine,LTG)进行单药治疗。对患者治疗前和服药1年后的精液质量、性激素进行检测,同时采用国际勃起功能指数量表简化版问卷(Internatial index of erectile function,IIEF-5)评估其性功能情况。将治疗患者与20名健康志愿者,以及患者自身用药前后进行比较。结果 (1)成年男性癫痫组服药前精子总数、快速前向运动率、存活率及正常精子率均低于健康对照组(P<0.05);服药1年后精液各检测指标均有明显改善趋势,但无统计学差异;(2)成年男性癫痫患者治疗前的勃起功能得分明显低于健康对照组(P<0.05),比服药1年后低,但无统计学意义(P>0.05);(3)成年男性癫痫组治疗前分别与健康对照组及服药1年后相比较,性激素水平变化无明显差异;(4)成年男性癫痫患者的生育率显著低于健康对照组(P<0.05)。结论成年男性癫痫患者服用抗癫痫药物前即存在精液质量下降、性功能低下的情况;LTG对成年男性癫痫患者的精液质量、性功能可能有改善作用。

Objective To investigate the influence of Lamotrigine（LTG） on sex hormone, seminal fluid and sexual function in male epilepsy patients. Methods The blood sex hormone levels and sperm quality were detected in 20 normal controls and 16 male epilepsy patients in Epilepsy Center of Sichuan Province People＇s Hospital from April 2015 to November 2016. All participants were detected before taking medicine and after being treated with LTG monotherapy for 1 year. The international index of erectile function-5（IIEF-5） was employed to assess the sexual function in the groups above, and the results were compared. Results Compared with the control group, the total number of sperm, the rate of forward movement, survival, normal sperm and the score of IIEF-5 in the untreated group were less（P0.05）. LTG treatment group＇s sperm parameters and the score of IIEF-5 seemed improve, but there was no statistically significant difference（P0.05）. There was no significant difference in sexual hormones between the groups above（P0.05）.Conclusions Semen quality and the score of IIEF-5 in epileptic male decline more easily; LTG might improve the semen quality and sexual function, but no significant difference has being found.