醋酸戈舍瑞林缓释植入剂对早期宫颈癌和卵巢恶性肿瘤患者化疗所致卵巢功能损伤的预防作用  

Preventive Effect of Goserelin Acetate Sustained-Release Depot on Ovarian Function Damage Caused by Chemotherapy in Patients with Early Cervical Cancer and Early Ovarian Malignant Tumor

作　　者：王东 李慧青 苏引利 段浩然 莫佳娅 雷茜琳 谢娅[1] WANG Dong;LI Huiqing;SU Yinli;DUAN Haoran;MO Jiaya;LEI Qianlin;XIE Ya(Department of Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院妇科,河南郑州450052

出　　处：《河南医学研究》2021年第7期1185-1188,共4页Henan Medical Research

基　　金：河南省科技厅科技攻关项目(192102310070)。

摘　　要：目的探讨醋酸戈舍瑞林缓释植入剂对早期宫颈癌和卵巢恶性肿瘤患者化疗所致卵巢功能损伤的预防作用。方法纳入2018年1月至2019年12月于郑州大学第一附属医院妇科化疗的43例早期宫颈癌和47例早期卵巢恶性肿瘤术后患者(保留卵巢),根据患者是否接受促性腺激素释放激素激动剂(GnRHa)即醋酸戈舍瑞林缓释植入剂治疗分为对照组(45例)和GnRHa组(45例)。给予对照组常规化疗,给予GnRHa组常规化疗联合GnRHa。比较两组化疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E_(2))、抗米勒管激素(AMH)、FSH/LH水平以及化疗后月经恢复情况,采用健康状况调查量表(SF-36)评价两组患者生活质量,采用Kupperman绝经指数(KMI)评价两组患者围绝经期症状。结果与化疗前比较,化疗结束后6个月GnRHa组FSH、FSH/LH上升程度均低于对照组,AMH下降程度低于对照组(P<0.05),GnRHa组E_(2)水平甚至已经恢复至化疗前水平。化疗结束后3、6个月时,GnRHa组FSH、FSH/LH水平均低于对照组,E_(2)、AMH水平均高于对照组(P<0.001)。化疗后,GnRHa组月经恢复时间较对照组短,月经恢复者占比较对照组高,月经稀发者占比较对照组低(P<0.05)。化疗结束后6个月,GnRHa组SF-36评分高于对照组,KMI评分低于对照组(P<0.001)。结论GnRHa可预防早期宫颈癌、卵巢恶性肿瘤患者化疗所致的卵巢功能损伤。Objective To explore the preventive effect of goserelin acetate sustained-release depot on ovarian function damage caused by chemotherapy in patients with early cervical cancer and early ovarian malignant tumor.Methods A total of 43 patients with early cervical cancer and 47 patients with early ovarian malignant tumor with preserved ovaries who underwent postoperative adjuvant chemotherapy in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2019 were included.The patients were divided into control group(45 cases)and GnRHa group(45 cases)according to whether they received goserelin acetate sustained-release depot which was one kind of gonadotropin releasing hormone agonists(GnRHa)or not.Control group was treated with conventional chemotherapy,while GnRHa group was treated with conventional chemotherapy combined with GnRHa.The serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),anti-Müllerian hormone(AMH)and FSH/LH before and after chemotherapy and menstrual recovery after chemotherapy were compared between the two groups.The quality of life and perimenopausal symptoms of the two groups were evaluated by 36-items short form health survey(SF-36)and Kupperman menopausal index(KMI),respectively.Results Compared with before chemotherapy,the levels of FSH and FSH/LH of GnRHa group at 6 months after the completion of chemotherapy rose less than those of control group,and the level of AMH decreased less than that of control group(P<0.05).The level of E_(2) of GnRHa group even returned to the level before chemotherapy.At 3 and 6 months after the completion of chemotherapy,the levels of FSH and FSH/LH of GnRHa group were all lower than those of control group,while the levels of E_(2) and AMH of GnRHa group were all higher than those of control group(P<0.001).After the completion of chemotherapy,the menstrual recovery time of GnRHa group was shorter than that of control group(P<0.05).The proportion of menstruation recovery of GnRHa group was higher th

关 键 词：宫颈癌 卵巢恶性肿瘤 醋酸戈舍瑞林缓释植入剂 促性腺激素释放激素激动剂 化疗 卵巢功能 

分 类 号：R737.34[医药卫生—肿瘤]