来曲唑与他莫昔芬治疗特发性少精子症的疗效对比

Clinical efficacy of letrozole and tamoxifen in the treatment of patients with idiopathic oli-gozoospermia

目的探讨来曲唑(letrozole)治疗特发性少精子症患者的临床效果。方法选取150例特发性少精子症患者,按照随机数字法分为A、B、C 3组各50例,A组采用来曲唑片治疗,B组采用枸橼酸他莫昔芬治疗,C组给予安慰剂治疗,疗程均为3个月,比较各组治疗前后性激素水平(E2、T、FSH、LSH、PRL、T/E2、INHB)、精液常规参数、睾丸体积和BMI。结果治疗后A组临床总有效率为96. 0%,显著高于B组的84. 0%、C组的28. 0%,差异有统计学意义(P <0. 05);治疗后A组血清FSH、LH、T、INH-B水平、T/E2比值明显高于B组、C组,血清E2水平低于B组、C组,差异均有统计学意义(P <0. 05);治疗后A组精子浓度、精子总数、精子正常形态比例明显提高(P <0. 05);A组有效精子数显著高于B组、C组,差异有统计学意义(P <0. 05)。结论采用来曲唑治疗特发性少精子症能显著提高T、FSH水平、T/E2比值及精液质量。

Objective To investigate the clinical effect of letrozole in the treatment of patients with idiopathic oligozoospermia.Methods A total of 150 patients with idiopathic oligozoospermia admitted to our hospital between April 2015 and January 2018 were divided into group A(n=50,letrozole tablets),group B(n=50,tamoxifen citrate)and group C(n=50,placebo)using random number table method.After 3 months of treatment,the sex hormone levels(E2,T,FSH,LSH,PRL,T/E2,INHB),general parameters of semen,testicular volume and BMI before and after treatment were compared.Results After treatment,the total effective rate of group A was significantly higher than that of group B and group C(96.0%vs 84.0%vs 28.0%,P<0.05).After treatment,the serum levels of FSH,LH,T,INH-B and T/E2 ratios in group A were significantly higher than those in group B and group C,but the serum E2 level was lower(P<0.05).After treatment,the sperm concentration,sperm count and normal sperm morphology in group A were significantly increased(P<0.05).The average effective sperm count increase in group A was significantly higher than that of group B and group C(P<0.05).Conclusions The use of letrozole in the treatment of idiopathic oligozoospermia can significantly improve the T and FSH levels,T/E2 ratios as well as semen quality,which has a good clinical effect.