Riley S A, Lecarpentier J, Mani V, Goodman M J, Mandal B K, Turnberg L A
University Department of Medicine, Hope Hospital, Salford.
Gut. 1987 Aug;28(8):1008-12. doi: 10.1136/gut.28.8.1008.
Seminal abnormalities are commonly found during sulphasalazine treatment. Although these changes appear reversible after drug withdrawal this may result in colitis relapse. Animal studies suggest that 5-aminosalicylic acid, the active component of sulphasalazine, does not impair fertility. Sixteen patients with quiescent ulcerative colitis were studied. Each patient produced three samples of semen at weekly intervals. Of the 48 samples analysed 39.6% showed oligospermia, 41.7% showed an increased number of abnormal forms and 91.7% showed impaired motility. Nine patients substituted enteric coated mesalazine (5-aminosalicylic acid) for sulphasalazine for a minimum period of three months. During this time one patient developed a salmonella associated colitis relapse; the others remained well. Improvement in sperm count (p less than 0.02), motility (p less than 0.001) and morphology (p less than 0.02) occurred in all cases. To date, four successful pregnancies have resulted, three in couples complaining of long term infertility. Treatment with enteric-coated mesalazine allows the recovery of seminal abnormalities induced by sulphasalazine in patients with colitis.
柳氮磺胺吡啶治疗期间常发现精液异常。尽管停药后这些变化似乎可逆，但这可能导致结肠炎复发。动物研究表明，柳氮磺胺吡啶的活性成分5-氨基水杨酸不会损害生育能力。对16例静止期溃疡性结肠炎患者进行了研究。每位患者每周采集三次精液样本。在分析的48个样本中，39.6%显示少精子症，41.7%显示异常形态数量增加，91.7%显示活力受损。9例患者用肠溶美沙拉嗪（5-氨基水杨酸）替代柳氮磺胺吡啶至少3个月。在此期间，1例患者出现与沙门氏菌相关的结肠炎复发；其他患者情况良好。所有病例的精子计数（p<0.02）、活力（p<0.001）和形态（p<0.02）均有改善。迄今为止，已成功妊娠4例，其中3例是长期不孕的夫妇。用肠溶美沙拉嗪治疗可使结肠炎患者恢复由柳氮磺胺吡啶引起的精液异常。
