原发性抗磷脂综合征：形态功能阴茎异常，精子分析正常。

Primary antiphospholipid syndrome: morphofunctional penile abnormalities with normal sperm analysis.

机构信息

Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Brazil.

出版信息

Lupus. 2012 Mar;21(3):251-6. doi: 10.1177/0961203311422715. Epub 2011 Oct 17.

DOI:10.1177/0961203311422715

PMID:22004973

Abstract

OBJECTIVE

To perform a global gonadal and sexual functions assessment in primary antiphospholipid syndrome (PAPS) patients.

METHODS

A cross-sectional study was conducted in 12 male PAPS patients and 20 healthy controls. They were assessed by demographic data, clinical features, systematic urological examination, sexual function, testicular ultrasound, seminal parameters according to the World Health Organization (WHO), seminal sperm antibodies, and hormone profile, including follicle stimulating hormone (FSH), luteinizing hormone (LH), morning total testosterone, and thyroid hormones.

RESULTS

The median of current age and age of spermarche were similar in PAPS patients and controls (37.5 vs. 32.4 years, p = 0.270, and 13.1 vs. 12.85 years, p = 0.224, respectively), with a higher frequency of erectile dysfunction in the former group (25% vs. 0%, p = 0.044). Further analysis of PAPS patients with and without previous arterial thrombosis demonstrated that the median penis circumference was significantly lower in PAPS with arterial thrombosis than in PAPS without this complication (8.1 [6-10] vs. 10.2 [10-11] cm, p = 0.007). In addition, the median penis circumference was significantly lower in PAPS patients with erectile dysfunction than in patients without this complication (7.5 [6-9.5] vs. 9.5 [7.5-11] cm, p = 0.039). Regarding seminal analysis, the median sperm concentration, sperm motility, and normal sperm forms by WHO guidelines were comparable in PAPS patients and controls (141.5 [33-575] vs. 120.06 [34.5-329] × 10(6)/ml, p = 0.65; 61.29 [25-80] vs. 65.42 [43-82]%, p = 0.4; 21.12 [10-42.5] vs. 23.95 [10-45]%, p = 0.45, respectively), and none of them had oligo/azoospermia. No differences were observed between PAPS patients and controls regarding the frequency of antisperm antibodies, testicular volume by ultrasound, or hormone profile (FSH, LH, morning total testosterone, and thyroid hormone) (p > 0.05).

CONCLUSIONS

Normal testicular function has been identified in PAPS patients, in spite of morphofunctional penile abnormalities. Previous arterial thrombosis may underlie penile anthropometry alteration.

摘要

目的

对原发性抗磷脂综合征（PAPS）患者进行全面的性腺和性功能评估。

方法

对 12 例男性 PAPS 患者和 20 名健康对照者进行横断面研究。通过人口统计学数据、临床特征、系统泌尿科检查、性功能、睾丸超声、精液参数（根据世界卫生组织[WHO]）、精液抗体和激素谱（包括卵泡刺激素[FSH]、促黄体生成素[LH]、早晨总睾酮和甲状腺激素）进行评估。

结果

PAPS 患者和对照组的当前年龄和首次遗精年龄中位数相似（37.5 岁与 32.4 岁，p=0.270；13.1 岁与 12.85 岁，p=0.224），前者勃起功能障碍的频率更高（25%比 0%，p=0.044）。对有和无既往动脉血栓形成的 PAPS 患者进一步分析表明，与无此并发症的 PAPS 患者相比，有动脉血栓形成的 PAPS 患者阴茎周长明显较低（8.1[6-10]cm 与 10.2[10-11]cm，p=0.007）。此外，勃起功能障碍的 PAPS 患者的阴茎周长明显低于无此并发症的患者（7.5[6-9.5]cm 与 9.5[7.5-11]cm，p=0.039）。关于精液分析，PAPS 患者和对照组的精子浓度、精子活力和 WHO 指南规定的正常精子形态中位数相当（141.5[33-575]比 120.06[34.5-329]×10(6)/ml，p=0.65；61.29[25-80]比 65.42[43-82]%，p=0.4；21.12[10-42.5]比 23.95[10-45]%，p=0.45），且两者均无少精/无精症。PAPS 患者和对照组之间抗精子抗体的频率、睾丸超声体积或激素谱（FSH、LH、早晨总睾酮和甲状腺激素）无差异（p＞0.05）。