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等待肾移植患者的生育动态

Dynamics of fertility in patients on waiting list for kidney transplantation.

作者信息

Zachoval R, Jarabak J, Slatinska J, Burgelova M, Sobotka V, Vranova J, Krhut J

出版信息

Bratisl Lek Listy. 2013;114(12):711-5. doi: 10.4149/bll_2013_150.

Abstract

OBJECTIVES

To evaluate the presence of hormonal abnormalities and fertility disorders in patients with chronic kidney disease (CKD) awaiting renal transplantation.

METHODS

From September 2009 to April 2011 all male patients with CKD awaiting kidney transplantation were investigated. The following tests were performed: semen analysis, serum concentration of testosterone, SHBG, LH, FSH and prolactin. Differences in hormone levels and sperm count parameters were statistically evaluated between the control group and the patient group.

RESULTS

The group of patients consisted of 74 and the control group of 41 men. Average testosterone levels were lower in patients compared to control group. In patients significantly higher levels of SHBG, LH, FSH and PRL were found, and statistically significantly lower ejaculate volume, total sperm count, sperm concentration, total and progressive sperm motility and sperm morphology than in the control group. Within the group of patients a negative correlation between testosterone and PRL was found and a positive correlation between testosterone and total sperm motility and morphology. A negative correlation was detected between the duration of haemodialysis and testosterone, sperm concentration, total and progressive motility and sperm morphology.

CONCLUSION

Significant changes in hormone levels and impaired fertility are found in haemodialyzed patients on a waiting list for kidney transplantation. The dynamics of these changes are dependent on the duration of haemodialysis (Tab. 4, Fig. 2, Ref. 15). Text in PDF www.elis.sk.

摘要

目的

评估等待肾移植的慢性肾脏病(CKD)患者中激素异常和生育障碍的情况。

方法

对2009年9月至2011年4月期间所有等待肾移植的男性CKD患者进行调查。进行了以下检查:精液分析、血清睾酮、性激素结合球蛋白(SHBG)、促黄体生成素(LH)、促卵泡生成素(FSH)和催乳素浓度检测。对对照组和患者组之间的激素水平和精子计数参数差异进行统计学评估。

结果

患者组有74名男性,对照组有41名男性。与对照组相比,患者的平均睾酮水平较低。患者的SHBG、LH、FSH和催乳素水平显著更高,且射精量、总精子计数、精子浓度、总精子活力和渐进性精子活力以及精子形态在统计学上显著低于对照组。在患者组中,发现睾酮与催乳素呈负相关,睾酮与总精子活力和形态呈正相关。血液透析时间与睾酮、精子浓度、总精子活力和渐进性精子活力以及精子形态之间呈负相关。

结论

在等待肾移植的血液透析患者中发现激素水平有显著变化且生育能力受损。这些变化的动态取决于血液透析时间(表4,图2,参考文献15)。PDF文本www.elis.sk

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