来曲唑与他莫昔芬治疗特发性少精子症的疗效对比

 目的 探讨来曲唑(letrozole)治疗特发性少精子症患者的临床效果。方法 选取150例特发性少精子症患者,按照随机数字法分为A、B、C 3组各50例,A组采用来曲唑片治疗,B组采用枸橼酸他莫昔芬治疗,C组给予安慰剂治疗,疗程均为3个月,比较各组治疗前后性激素水平(E₂、T、FSH、LSH、PRL、T/E₂、INHB)、精液常规参数、睾丸体积和BMI。结果 治疗后A组临床总有效率为96.0%,显著高于B组的84.0%、C组的28.0%,差异有统计学意义(P<0.05);治疗后A组血清FSH、LH、T、INH-B水平、T/E₂比值明显高于B组、C组,血清E₂水平低于B组、C组,差异均有统计学意义(P<0.05);治疗后A组精子浓度、精子总数、精子正常形态比例明显提高(P<0.05);A组有效精子数显著高于B组、C组,差异有统计学意义(P<0.05)。结论 采用来曲唑治疗特发性少精子症能显著提高T、FSH水平、T/E₂比值及精液质量。

Clinical efficacy of letrozole and tamoxifen in the treatment of patients with idiopathic oligozoospermia

Objective To investigate the clinical effect of letrozole in the treatment of patients with idiopathic oligozoospermia.Methods A total of 150 patients with idiopathic oligozoospermia admitted to our hospital between April 2015 and January 2018 were divided into group A (n=50, letrozole tablets), group B (n=50, tamoxifen citrate) and group C (n=50, placebo) using random number table method. After 3 months of treatment, the sex hormone levels (E₂, T, FSH, LSH, PRL, T/E₂, INHB), general parameters of semen, testicular volume and BMI before and after treatment were compared.Results After treatment, the total effective rate of group A was significantly higher than that of group B and group C (96.0% vs 84.0% vs 28.0%, P<0.05). After treatment, the serum levels of FSH, LH, T, INH-B and T/E₂ ratios in group A were significantly higher than those in group B and group C, but the serum E₂ level was lower (P<0.05). After treatment, the sperm concentration, sperm count and normal sperm morphology in group A were significantly increased (P<0.05). The average effective sperm count increase in group A was significantly higher than that of group B and group C (P<0.05).Conclusions The use of letrozole in the treatment of idiopathic oligozoospermia can significantly improve the T and FSH levels, T/E₂ ratios as well as semen quality, which has a good clinical effect.