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目的:观察促性腺激素释放激素激动剂(GnRH-a)在女性恶性肿瘤患者术后化疗中对卵巢的保护作用。方法:将85例术后需要化疗的肿瘤患者随机分为两组,对照组40例常规化疗;研究组45例常规化疗同时肌注GnRH-a 3.75 mg,其后每隔28天注射1次,直至化疗结束。在化疗过程中及停药后,对患者的性激素水平及月经情况定期监测。结果:对照组治疗过程中出现闭经31例,出现时间为平均第3个疗程;停药后恢复月经28例(其中12例月经恢复正常,16例月经紊乱),恢复月经时间为停药后30~90天,平均71天。研究组闭经45例,均在第一次使用GnRH-a后出现,停药后恢复月经44例,1例出现月经紊乱,月经恢复时间35~46天,平均39天。两组停药后月经恢复情况及恢复时间比较,差异有统计学意义(P<0.05),停药时,对照组闭经者雌二醇(E2)、促卵泡生成素(FSH)和黄体生成素(LH)高于观察组(P均<0.05),未闭经者的FSH高于治疗前水平(P<0.05),LH也高于治疗前水平,但差异无统计学意义(P均>0.05)。两组月经恢复者FSH、LH、E2水平比较,差异无统计学意义(P均>0.05)。结论:女性恶性肿瘤术后常规化疗可导致患者卵巢功能损害,化疗同时应用GnRH-a可保护患者的卵巢功能。
Objective: To observe the protective effect of gonadotropin-releasing hormone agonist (GnRH-a) on ovarian cancer after chemotherapy in female patients with malignant tumor. Methods: Totally 85 patients with chemotherapy-induced tumors were randomly divided into two groups, 40 patients in the control group received conventional chemotherapy. In the study group, 45 patients received conventional intramuscular GnRH-a 3.75 mg intramuscularly, followed by injection once every 28 days. Until chemotherapy is over. In the course of chemotherapy and withdrawal, the patient’s sex hormone levels and menstrual periodic monitoring. Results: In the control group, there were 31 cases of amenorrhea in the course of treatment, and the average time was the third course of treatment. In the control group, 28 cases (12 menstruation returned to normal and 16 menstrual disorders were recovered) ~ 90 days, an average of 71 days. The study group, 45 cases of amenorrhea, were in the first use of GnRH-a after the withdrawal of menstruation recovery in 44 cases, 1 case of menstrual disorders, menstrual recovery time of 35 to 46 days, an average of 39 days. There was significant difference between the two groups in the recovery of menstruation and the recovery time after stopping the treatment (P <0.05). In the control group, the estradiol (E2), follicle-stimulating hormone (FSH) and luteinizing hormone (P <0.05). The LH of LH group was higher than that of the pretreatment group (P <0.05) . There was no significant difference in FSH, LH and E2 levels between the two groups (P> 0.05). CONCLUSIONS: Conventional chemotherapy of female malignant tumors can lead to ovarian dysfunction in patients. Chemotherapy combined with GnRH-a can protect the ovarian function of patients.