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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。
Objective: To observe the effect of opioid analgesics on human sperm motor function in vitro. Methods: Twenty semen samples with normal sperm motility were selected and tested, with 19 semen samples in each sample and 1 control sample. After incubation with 6 different opioid analgesics at 37 ℃ for 4 h . Sperm motility was analyzed by computer assisted semen analysis system (CASA) at 15 min (t1), 2 h (t2) and 4 h (t3) respectively. Results: (1) The percentage of (a + b) spermatozoa of 1 × 10-5, 2 × 10-3 and 0.05 mg / ml fentanyl groups were significantly lower than that of the control group at 3 time points (P < 0.05). ② The percentage of (a + b) spermatozoa of spermatozoa treated with 1 × 10-5, 2 × 10-3 and 0.05 mg / ml alfentanil was significantly lower than that of the control group P <0.05). (3) The percentage of (a + b) spermatozoa in the three time points was significantly higher in the sperms treated with 1 × 10-5, 2 × 10-3 and 0.05 mg / ml sufentanil (P <0.05); ④ The percentage of (a + b) spermatozoa at the time of 1 × 10-5 mg / ml butorphanol did not change significantly compared with the control group (P> 0.05 ), The percentage of (a + b) spermatozoa at 2 time points of 2 × 10-3,0.05 mg / ml butorphanol was significantly lower than that of the control group (P <0.05); ⑤1 × 10-5 mg / ml dezocine, there was no significant difference in the percentage of (a + b) spermatozoa between the two groups at 3 time points (P> 0.05), at 3 time points of 0.05 and 0.5 mg / ml dezocine (A + b) spermatozoa were significantly decreased compared with the control group (P <0.05); ⑥3 × 10-5, 0.05 mg / ml pentazocine treatment of sperm, the three time points ) Grade sperm (P> 0.05), while the percentage of (a + b) sperm at the 0.5 mg / ml pentazocine time point was significantly higher than that of the control group (P < 0.05). ⑦0.05 mg / ml butorphanol-induced spermatozoa could completely inhibit the sperm motility (braking effect) and 2 × 10-3 mg / ml butorphanol-induced sperm 2 h, 0.05 and 0.5 mg / ml dezocine induced spermatozoa at 2 h had a braking effect; and fentanyl, alfentanil, sufentanil at 0.05 mg / ml role of sperm did not find this effect. ⑧ 0.05 mg / ml sufentanil, butorphanol, dezocine, fentanyl, alfentanil role of sperm 15 min activity decay: sufentanil, butorphanol, dezocine and There was significant difference between alfentanil and fentanyl (P <0.05). There was no significant difference between fentanyl and alfentanil (P> 0.05). CONCLUSIONS: Different concentrations of opioid receptor analgesics had no effect on sperm motility at low concentrations of butorphanol and dezocine for the same duration of action, with high concentrations exhibiting complete inhibition of sperm motility, while the same low concentrations of fentanyl, alfentanil Niu Sufentanil significantly inhibited sperm motility, measured within the same concentration range only partially inhibited sperm motility. In contrast, pentazocine at high concentrations promotes sperm motility.