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[特发性精液质量异常的诊断与治疗]

[Diagnosis and treatment of idiopathic semen quality abnormalities].

作者信息

Lu Jin-chun, Huang Yu-feng

机构信息

Department of Laboratory Science, Nanjing Hospital, Jiangsu Corps, The Armed Police Force, PLA, Nanjing, Jiangsu 210028, China.

出版信息

Zhonghua Nan Ke Xue. 2012 Jan;18(1):3-10.

Abstract

Idiopathic semen quality abnormalities include idiopathic oligozoospermia, asthenospermia, teratospermia, azoospermia and idiopathic abnormal semen liquefaction. The possible causes of idiopathic semen quality abnormality include age, non-inflammatory function changes of subsidiary gonadal organs, infection, genetic abnormalities, sperm mitochondrial changes, effects of environmental pollutants, and subtle hormonal changes. The diagnosis of idiopathic oligozoospermia, asthenospermia, teratospermia and azoospermia require detailed inquiry of the case history, physical examination, semen analysis, determination of reproductive hormones, genetic and immunological examinations, and so on, to exclude possible known causes. The treatment of idiopathic oligozoospermia, asthenospermia, and teratospermia may involve the use of Western medicines, such as clomiphene citrate, tamoxifen, recombinant FSH, Andriol, compound zinc and selenium, L-carnitine, recombinant growth hormone and pentoxifylline, the application of traditional Chinese drugs, or the combination of traditional Chinese and Western medicine. Idiopathic azoospermia can be treated by assisted reproductive technology based on the medication of spermatogenesis-promoting drugs, and idiopathic abnormal semen liquefaction can be managed with traditional Chinese drugs, integrated traditional Chinese and Western medicine, or in vitro semen processing technology. With the development of diagnostic technology, it is expected that more specific therapeutic methods will be established for idiopathic semen quality abnormalities and their incidence will be reduced.

摘要

特发性精液质量异常包括特发性少精子症、弱精子症、畸形精子症、无精子症和特发性精液液化异常。特发性精液质量异常的可能原因包括年龄、附属生殖器官的非炎性功能改变、感染、基因异常、精子线粒体变化、环境污染物的影响以及细微的激素变化。特发性少精子症、弱精子症、畸形精子症和无精子症的诊断需要详细询问病史、体格检查、精液分析、生殖激素测定、基因和免疫学检查等,以排除可能的已知病因。特发性少精子症、弱精子症和畸形精子症的治疗可能涉及使用西药,如枸橼酸氯米芬、他莫昔芬、重组促卵泡生成素、安雄、复方锌硒、左旋肉碱、重组生长激素和己酮可可碱,应用中药,或中西医结合治疗。特发性无精子症可在使用促生精药物的基础上通过辅助生殖技术进行治疗,特发性精液液化异常可采用中药、中西医结合或体外精液处理技术进行处理。随着诊断技术的发展,预计将为特发性精液质量异常建立更具针对性的治疗方法,并降低其发病率。

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