不同免疫抑制剂对肾移植患者精子参数的影响

目的:研究不同免疫抑制剂对肾移植患者精子运动功能的影响。方法:20例肾移植患者应用以普乐可复(FK506+霉酚酸酯+泼尼松)、17例应用环孢素(CsA+硫唑嘌呤+泼尼松)为主的免疫抑制治疗方案,15例正常男性为对照组。采用计算机辅助的精子分析系统分别检测精子活率、运动参数(前向运动百分率、直线速度VSL、曲线速度VCL、平均路径速度VAP)和精子形态。结果:3组精子活率(81.7±5.7)%、(79.4±6.8)%、(83.8±6.0)%]、VCL(24.1±8.6)%、(23.9±4.4)%、(24.8±4.2)%]和VAP(19.7±6.6)%、(18.6±2.9)%、(21.0±4.0)%]差异均无显著性(P>0.05);FK506组的精子前向性运动百分率(46.4±8.1)%]和VSL(15.4±4.6)%]均显著高于CsA组(33.3±6.4)%、(10.2±2.4)%],畸形率(67.8±5.7)%]显著低于CsA组(80.1±5.6%](P<0.05)。结论:FK506和霉酚酸酯的联合应用,有助于肾移植患者精子运动功能及形态的恢复。

Effects of Different Immunodepressants on the Sperm Parameters of Kidney Transplant Recipients

OBJECTIVE: To study the effects of different immunodepressants on the sperm parameters of kidney transplant recipients. METHODS: In 15 healthy fertile men and 37 kidney transplant recipients, ejaculates were aseptically obtained by masturbation. Thirty-seven patients were divided into two groups, 20 patients were treated with Prograf (FK506) combination with mycophenolate mofetil (MMF) and prednisone; 17 patients were treated with cyclosporine (CsA) combination with azathioprine with prednisone. The sperm viability, mobility parameters such as prorsad percentage motility, straight line velocity (VSL), curve line velocity (VCL), velocity of average path (VAP) and morph were estimated with a computer-assisted sperm analyzer (CASA) provided with a multiple-exposure photography system. RESULTS: There were no significant difference in sperm viability rate (81.7 +/- 5.7)%, (79.4 +/- 6.8)% and (83.8 +/- 6.0)%], VCL (24.1 +/- 8.6)%, (23.9 +/- 4.4)%, (24.8 +/- 4.2)% ] and VAP (19.7 +/- 6.6)%, (18.6 +/- 2.9)%, (21.0 +/- 4.0)%] among groups of FK506, CsA and control, respectively (P > 0.05). The rate of anomaly (67.8 +/- 5.7)%], the prorsad percentage motility (46.4 +/- 8.1)%] and VSL (15.4 +/- 4.6)%] in the group of FK506 were respectively significantly lower and higher than those in the group of CsA (80.1 +/- 5.6%, (33.3 +/- 6.4)%, (10.2 +/- 2.4)%] (P < 0.05). CONCLUSION: The application of FK506 combined with MMF could help recover the mobility and morphology of the sperm in kidney transplantation recipients.