血液病清髓性化疗后卵巢早衰患者的围绝经期症状研究  

The study of perimenopausal symptoms in patients with premature ovarian failure after myeloablative chemotherapy for hematology

作　　者：何小静[1,2] 杨欣[1] 王朝华[1] 王宇[2] 陆美秋 朱晔[1] 李晓冬[2] 

机构地区：[1]北京大学人民医院妇产科,100044 [2]河北医科大学第二医院妇产科

出　　处：《中国妇产科临床杂志》2015年第5期402-405,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：首都特色基金(Z121107001012031)

摘　　要：目的了解女性血液病清髓性化疗后卵巢早衰患者性激素治疗(hormone therapy,HT)前后围绝经期症状的发生情况及自我认知。方法 2011年12月至2013年12月,就诊于北京大学人民医院妇科门诊的女性血液病清髓性化疗造血干细胞移植术后符合诊断标准的卵巢早衰患者142例。问卷形式调查其月经情况、性激素水平、围绝经期症状并评估激素治疗后围绝经期症状缓解特点。结果 1 142例患者中103例填写了改良的Kupperman评分表,82例出现了围绝经期症状(79.6%),Kupperman绝经指数评分(KMI)平均为13.50分,96例填写了焦虑/抑郁(HAD)评分量表,6例出现焦虑,平均8.83分,4例出现抑郁,平均8.33分;2 105例接受了激素类药物治疗(94.6%),随访95例接受HT治疗患者中71例有规律撤退性出血。51例诉月经量明显少于移植前月经量,且经血颜色变暗,差异有统计学意义(P=0.00,P<0.05);3周期性激素治疗后KMI总分平均为6.7,且下降有统计学意义。结论 1血液疾病清髓性化疗剂量可导致卵巢功能提早衰竭;2性激素治疗也可以缓解清髓化疗后患者出现的围绝经期症状;3血液疾病清髓化疗后卵巢早衰患者对围绝经期症状的认知缺乏。Objective To understand the occurrence of perimenopausal symptoms and self-awareness before and after hormone therapy in patients with premature ovarian failure after myeloablative chemotherapy for hematology. Methods Premature ovarian failure patients（142 cases）who received myeloablative chemotherapy and hematopoietic stem cell transplantation for blood disease and consulted to gynecological clinic in Peking University People＇s Hospital from December 2011 to December 2013 meeting the diagnostic criteria. Investigated their menstruation,hormone levels,menopausal symptoms by Questionnaire and assessed perimenopause symptom relief features after hormone therapy. Results （1 ）There were 103 patients who completed the modified Kupperman score questionnaire in 142 cases,of which 82 people showed symptoms of menopause,accounting for 79.6% and Kupperman menopausal index score（KMI）averaged 13.50 points.96 people filled out the anxiety/depression（HAD）scale score,of which 6 people showed anxiety,an average of 8.83 points,while 4 people showed depression,with an average of 8.33 points. （2） 105 cases received hormone therapy（94.6%）,and 71 cases showed regularly withdrawal bleeding in following-up 95 cases. 51 patients complained that their menstrual flow was significantly less than the amount of pre-transplant period,and blood darkened,which was statistically significant. （3） The score of KMI averaged 6.7 after cyclical hormone replacement therapy,with a statistically significant decrease. Conclusions （1） Myeloablative chemotherapy for blood diseases can lead to early failure of ovarian function.（ 2 ）Hormone therapy can relieve perimenopausal symptoms after myeloablativechemotherapy. （3 ）Patients with ovarian premature aging of perimenopausal symptoms were cognitive deficiencies.

关 键 词：医源性卵巢早衰 清髓化疗 围绝经期症状 激素治疗 

分 类 号：R711.75[医药卫生—妇产科学]