男性癫痫患者生殖功能影响因素的初步研究

Preliminary study in the influencing factors of reproductive function in male patient with epilepsy

目的通过分析基线资料、精液、性激素和性功能相关指标,了解男性癫痫患者(Male patients with epilepsy,MPWE)与健康男性的差异,探讨影响MPWE生殖功能的相关危险因素,降低不育风险。方法收集2019年2月—2020年2月在大理大学第一附属医院神经内科住院和门诊就诊的112例MPWE资料。选取与调查组年龄相匹配的健康男性志愿者67名作为对照组。所有研究对象完成精液及性激素指标检测。有性生活经历者需完成国际勃起功能指数量表简化版问卷(IIEF-5)和早泄诊断工具自测量表(PEDT)。MPWE完成其生活质量评定量表(QOLIE-31)。比较MPWE与健康对照者的基线资料、精液质量、性激素水平和性功能问卷评分。此外,根据男性生殖功能异常诊断标准,将MPWE分为生殖功能异常组和正常组,采用单因素分析及二元Logistic回归分析,MPWE生殖功能的相关危险因素。结果与健康对照组相比,MPWE已婚和已育的比例、睾酮水平、精子浓度、精子存活率和IIEF-5得分显著降低(P<0.05)。MPWE生殖功能异常组与正常组相比,年龄、体重指数、癫痫发作频率和药物类型存在显著差异(P<0.05);QOLIE-31量表得分中,异常组的总分和精力显著低于正常组(P<0.05)。二元Logistic回归分析提示,精力[B=-0.033,OR=0.967,95%CI(0.937,0.999)],年龄[B=0.879,OR=2.408,95%CI(1.070,5.416)],癫痫发作频率[B=1.788,OR=5.976,95%CI(2.031,17.589)]。结论 MPWE的生殖功能较健康男性低下,且总分、精力、年龄、体重指数、癫痫发作频率和药物类型会明显影响MPWE的生殖功能。其中精力、年龄和癫痫发作频率是影响MPWE生殖功能的独立危险因素,且生殖功能异常与年龄和癫痫发作频率呈正相关,而与精力得分呈负相关。

Objective To analyse baseline information, semen, sex hormones and sexual function to understand the differences between male patient with epilepsy(MPWE) and healthy men. At the same time, we preliminarily evaluated the risk factors related to reproductive function in MPWE to provide clinical method for reducing the risk of infertility.Methods We collected data of 112 MPWE in the Department of Neurology, First Affiliated Hospital of Dali University from February 2019 to February 2020. Sixty-seven healthy male volunteers matching the age of the survey group were selected. All men completed semen and sex hormone test. Men with sexual life experience completed the International index of erectile function scale(IIEF-5) and the Premature ejaculation diagnostic tool(PEDT). MPWE completed the Quality of life in epilepsy-1(QOLIE-31). The baseline data, semen quality, sex hormone level and sexual function questionnaire scores of MPWE and healthy controls were compared. In addition, according to the diagnostic criteria of abnormal male reproductive function, MPWE were divided into abnormal group and normal group. Single factor analysis and binary logistic regression analysis were used to preliminarily explore the related risk factors of reproductive function in MPWE. Results Compared with the healthy control group, the proportion of married and childbearing, testosterone level, sperm concentration, sperm survival rate and IIEF-5 score in MPWE were significantly reduced(P<0.05). Compared with the normal group, age, body mass index, seizure frequency and drug type in the abnormal group were significant differences statistically(P<0.05). The total score and energy score of QOLIE-31 in the abnormal group were significantly lower than that in the normal group(P<0.05). Binary Logistic regression analysis indicated that energy score [B=-0.033,OR=0.967, 95%CI(0.937, 0.999)], age [B=0.879, OR=2.408, 95%CI(1.070, 5.416)], seizure frequency [B=1.788, OR=5.976,95% CI(2.031, 17.589)]. Conclusion The reproductive function of MPWE is lower than that in healthy men. The total score, energy score, age, body mass index, seizure frequency and type of drugs will significantly affect the reproductive function of MPWE. Energy score, age and seizure frequency are independent risk factors that affect the reproductive function of MPWE. Abnormal reproductive function of MPWE was positively correlated with age and seizure frequency,but negatively correlated with energy score.