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目的:观察雷米芬太尼和纳洛酮联合应用对体外人精子运动功能的影响并探讨其机制。方法:实验选取20例a+b级精子百分率正常的精液标本,每例精液均一式13份,分别经过不同浓度雷米芬太尼或联合不同浓度纳洛酮处理35 min,在计算机辅助的精子分析下观察精子5、10、15、20、35 min时的运动情况。结果:①与对照组相比,0.1～100μg/L雷米芬太尼作用精子5、10 min时a+b级精子百分率降低,并呈浓度依赖性降低,而作用精子15、30 min时a+b级精子百分率无显著性差异;②与对照组相比,0.004～0.04 mg/L纳洛酮作用精子5～35 min时,a+b级精子百分率无显著性差异;0.4～4 mg/L纳洛酮作用精子5～20 min时a+b级精子百分率无显著性差异,而作用精子35 min时a+b级精子百分率显著增加;③与同浓度雷米芬太尼组相比,0.004、0.04、0.4、4 mg/L纳洛酮依次联合0.1、1、10、100μg/L雷米芬太尼共同作用精子5、10 min时a+b级精子百分率显著提高,而作用15、35 min时无显著性差异。结论:雷米芬太尼对精子运动的抑制作用起效和消失快,其抑制作用可被纳洛酮所拮抗,推测可能与μ受体有关。
Objective: To observe the effect of remifentanil combined with naloxone on the motility of human sperm in vitro and its mechanism. Methods: Twenty semen samples with normal percentage of a + b grade spermatozoa were selected in the experiment. Thirty semen samples of each type were homogenized, each sample was treated with remifentanil at different concentrations or naloxone with different concentrations for 35 min. Analysis under the observation of sperm motility 5,10,15,20,35 min. Results: ① Compared with the control group, the percentage of a + b sperm in the sperm of 0.1 ~ 100μg / L remifentanil decreased at 5,10 min and decreased in a concentration-dependent manner, + b grade sperm percentage was no significant difference; ② compared with the control group, 0.004 ~ 0.04 mg / L naloxone sperm 5 ~ 35 min, a + b grade sperm percentage was no significant difference; 0.4 ~ 4 mg / L, there was no significant difference in the percentage of a + b sperm between 5 and 20 min when the naloxone acted on spermatozoa, while the percentage of a + b sperm at sperm 35 min increased significantly. ③ Compared with the same concentration of remifentanil, 0.004,0.04,0.4,4 mg / L naloxone followed by 0.1,1,10,100μg / L remifentanil co-acting sperm 5,10 min a + b grade sperm percentage increased significantly, and the role of 15, No significant difference at 35 min. CONCLUSION: The inhibitory effect of remifentanil on sperm motility is rapid and disappears rapidly. Its inhibitory effect can be antagonized by naloxone, suggesting that remifentanil may be related to μ receptor.