硒和/或N-乙酰半胱氨酸改善不育男性精液参数的疗效：一项双盲、安慰剂对照的随机研究。

Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study.

作者信息

Safarinejad Mohammad Reza, Safarinejad Shiva

机构信息

Urology and Nephrology Research Center, Shahid Beheshti University, MC, Tehran, Islamic Republic of Iran.

出版信息

J Urol. 2009 Feb;181(2):741-51. doi: 10.1016/j.juro.2008.10.015. Epub 2008 Dec 16.

DOI:10.1016/j.juro.2008.10.015

PMID:19091331

Abstract

PURPOSE

We explored the efficacy of selenium and/or or N-acetyl-cysteine for improving semen parameters in infertile men, and the associations among semen quality and the concentrations of selenium and N-acetyl-cysteine in seminal plasma.

MATERIALS AND METHODS

The study included 468 infertile men with idiopathic oligo-asthenoteratospermia who were randomized to receive 200 microg selenium orally daily (selenium group of 116), 600 mg N-acetyl-cysteine orally daily (N-acetyl-cysteine group of 118), 200 microg selenium plus 600 mg N-acetyl-cysteine orally daily (selenium plus N-acetyl-cysteine group of 116) or similar regimen of placebo (control group of 118) for 26 weeks, followed by a 30-week treatment-free period. These patients provided blood samples for the measurement of serum testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin, inhibin B, selenium and N-acetyl-cysteine. Semen samples were also obtained for routine semen analysis, and the measurement of seminal plasma selenium and N-acetyl-cysteine.

RESULTS

In response to selenium and N-acetyl-cysteine treatment serum follicle-stimulating hormone decreased but serum testosterone and inhibin B increased. All semen parameters significantly improved with selenium and N-acetyl-cysteine treatment. Administering selenium plus N-acetyl-cysteine resulted in additive beneficial effects. A significant positive correlation existed between the seminal plasma concentrations of selenium and N-acetyl-cysteine, and semen parameters. A strong correlation was observed between the sum of the selenium and N-acetyl-cysteine concentrations, and mean sperm concentration (r = 0.67, p = 0.01), sperm motility (r = 0.64, p = 0.01) and percent normal morphology (r = 0.66, p = 0.01).

CONCLUSIONS

These results indicate that supplemental selenium and N-acetyl-cysteine improve semen quality. We advocate their use for male infertility treatment.

摘要

目的

我们探讨了硒和/或N-乙酰半胱氨酸对改善不育男性精液参数的疗效，以及精液质量与精浆中硒和N-乙酰半胱氨酸浓度之间的关联。

材料与方法

该研究纳入了468例特发性少弱畸精子症不育男性，他们被随机分为四组，分别为每日口服200微克硒（硒组，116例）、每日口服600毫克N-乙酰半胱氨酸（N-乙酰半胱氨酸组，118例）、每日口服200微克硒加600毫克N-乙酰半胱氨酸（硒加N-乙酰半胱氨酸组，116例）或服用类似方案的安慰剂（对照组，118例），为期26周，随后为30周的无治疗期。这些患者提供血液样本以测量血清睾酮、雌二醇、促卵泡激素、促黄体生成素、催乳素、抑制素B、硒和N-乙酰半胱氨酸。还采集精液样本进行常规精液分析，并测量精浆中硒和N-乙酰半胱氨酸的含量。

结果

经硒和N-乙酰半胱氨酸治疗后，血清促卵泡激素降低，但血清睾酮和抑制素B升高。经硒和N-乙酰半胱氨酸治疗后，所有精液参数均显著改善。同时给予硒和N-乙酰半胱氨酸产生了累加的有益效果。精浆中硒和N-乙酰半胱氨酸的浓度与精液参数之间存在显著的正相关。观察到硒和N-乙酰半胱氨酸浓度之和与平均精子浓度（r = 0.67，p = 0.01）、精子活力（r = 0.64，p = 0.01）和正常形态百分比（r = 0.66，p = 0.01）之间存在强相关性。