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目的探讨克罗米芬对特发性少精子症患者睾丸细胞凋亡的影响。方法采用克罗米芬治疗少精子症患者 30例 ,比较治疗前后血中生殖激素及精液参数变化 ,同时行睾丸穿刺活检 ,电镜检查 ,观察生殖细胞增殖及生殖细胞凋亡变化。结果与正常睾丸相比 ,治疗前患者凋亡指数 (AI)较高 (P <0 .0 1) ,睾丸组织在电镜下存在不同程度的病理改变 ,治疗后病理表现明显改善 ,AI下降 (P <0 .0 1) ,但与正常对照组相比差别仍有显著性意义 (P <0 .0 5 )。治疗后患者主要精液参数及配偶受孕率有明显改善。结论少精子症患者精子减少的主要原因之一是由于生精细胞凋亡增加 ,克罗米芬可纠正生精细胞凋亡的失衡状态 ,改善患者生精功能及生育能力。
Objective To investigate the effect of clomiphene on the apoptosis of testicular cells in patients with idiopathic oligospermia. Methods 30 cases of clomiphene citrate treatment of oligozoospermia patients before and after treatment of blood reproductive hormones and semen parameters were compared at the same time, testicular biopsy and electron microscopy to observe the changes of germ cell proliferation and germ cell apoptosis. Results Compared with normal testis, the apoptotic index (AI) of patients before treatment was higher (P <0.01), and the pathological changes of testis were observed under electron microscope. The pathological changes were obviously improved and the AI was decreased (P <0.01), but the difference was still significant compared with the normal control group (P <0.05). After treatment, the main sperm parameters and spouse pregnancy rate has been significantly improved. Conclusions One of the main reasons for the decrease of spermatozoa in oligozoospermia patients is that clomiphene can correct the imbalance of apoptosis of spermatogenic cells and improve the spermatogenic function and fertility of the patients.