阿片类镇痛药体外对精子运动的影响

目的:观察阿片类镇痛药体外对人精子运动功能的影响。方法:试验选取20例精子活力正常的精液标本,每例精液均一式19份,1份为对照,余分别与3种浓度下的6种不同阿片类镇痛药于37℃温箱孵育4 h,分别于15 min(t1)、2 h(t2)、4 h(t3)3个时间点用计算机辅助精液分析系统(CASA)分析精子活力。结果:①1×10-5、2×10-3、0.05 mg/ml芬太尼作用的精子,其3个时间点的(a+b)级精子百分率与对照组相比均显著降低(P<0.05);②1×10-5、2×10-3、0.05 mg/ml阿芬太尼作用的精子,其3个时间点的(a+b)级精子百分率与对照组相比均显著降低(P<0.05);③1×10-5、2×10-3、0.05 mg/ml舒芬太尼作用的精子,其3个时间点的(a+b)级精子百分率与对照组相比均显著降低(P<0.05);④1×10-5 mg/ml布托啡诺作用的精子,其3个时间点的(a+b)级精子百分率与对照组相比均无显著变化(P>0.05),2×10-3、0.05 mg/ml布托啡诺3个时间点的(a+b)级精子百分率与对照组相比均显著降低(P<0.05);⑤1×10-5 mg/ml地佐辛作用的精子,其3个时间点的(a+b)级精子百分率与对照组相比均无显著变化(P>0.05),0.05、0.5 mg/ml地佐辛3个时间点的(a+b)级精子百分率与对照组相比均显著降低(P<0.05);⑥3×10-5、0.05 mg/ml喷他佐辛处理精子,其3个时间点的(a+b)级精子百分率与对照组相比均无显著变化(P>0.05),而0.5 mg/ml喷他佐辛3个时间点的(a+b)级精子百分率与对照组相比均显著增加(P<0.05);⑦0.05 mg/ml布托啡诺作用精子15 min可产生精子活力完全抑制(制动效应),以及2×10-3mg/ml布托啡诺作用精子2 h,0.05、0.5 mg/ml地佐辛作用精子2 h时均产生制动效应;而芬太尼、阿芬太尼、舒芬太尼在0.05 mg/ml作用精子并未发现此效应。⑧0.05 mg/ml舒芬太尼、布托啡诺、地佐辛、芬太尼、阿芬太尼作用精子15 min活力衰减程度:舒芬太尼、布托啡诺、地佐辛与阿芬太尼相比均有显著性的差异(P<0.05),芬太尼与阿芬太尼相比无显著性差别(P>0.05)。结论:不同阿片受体镇痛药在相同作用时间内,低浓度布托啡诺、地佐辛对精子运动无影响,高浓度呈现完全抑制精子活力,而相同低浓度芬太尼、阿芬太尼、舒芬太尼均显著抑制精子活力,所测相同浓度范围内仅部分抑制精子活力。与此相反,高浓度喷他佐辛可促进精子运动。

Effects of opioid analgesics on sperm motility in vitro

Objective: To observe the effects of short-term exposure to opioid analgesics on human sperm motility.Methods: Twenty normal semen samples were collected,each divided into 19 groups,one as the control and the others treated in vitro with six opioid analgesics at three different concentrations,respectively,and sperm motility was assessed by computer-assisted sperm analysis at 15 min,2 h and 4 h.Results: Compared with the control group,fentanyl,alfentanil and sufentanil at 1×10-5,2×10-3 and 0.05 mg/ml significantly decreased the percentage of grade a+b sperm at 15 min,2 h and 4 h(P<0.05),and so did butorphanol at 2×10-3 and 0.05 mg/ml(P<0.05) and dezocine at 0.05 and 0.5 mg/ml(P<0.05),but neither showed any remarkable effect at 1×10-5 mg/ml at the three time points(P>0.05).Pentazocine effected no significant difference at 3×10-5 and 0.05 mg/ml(P>0.05) but a gradual increase in the percentage of grade a+b sperm at 0.5 mg/ml at the three time points(P<0.05).Butorphanol totally inhibited sperm motility at 0.05 mg/ml at 15 min and at 2×10-3mg/ml at 2 h,and so did dezocine at 0.05 and 0.5 mg/ml,but such inhibitory effect was not observed with fentanil,alfentanil and sulfentanil at 0.05 mg/ml.As for the sperm motility decreasing effect at 0.05 mg/ml at 15 min,sufentanil,butorphanol and dezocine exhibited significant differences(P<0.05) while fentanyl displayed none from alfentanil(P>0.05).Conclusion: Given the same length of time of treatment,butorphanol and dezocine totally inhibit sperm motility at a high concentration,but make no significant change at a low concentration.While fentanyl,alfentanil and sufentanil can significantly decrease sperm motility at the same low concentration,and partially inhibit it at all concentrations.On the contrary,a high concentration of pentazocine can promote human sperm motility.