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目的探讨环磷酰胺冲击治疗难治性肾病综合征导致卵巢早衰的影响因素。方法将73例接受环磷酰胺治疗的育龄期女性患者根据是否出现卵巢早衰分为两组,卵巢早衰组17例,卵巢功能正常组56例,收集患者的临床和生化指标,对数据进行单因素分析和多因素Logistic回归分析。结果单因素分析显示,卵巢早衰的影响因素包括:开始用环磷酰胺的年龄、孕次、产次环磷酰胺的累计用量、使用环磷酰胺后的白细胞下降值和霉酚酸酯累计用量。多因素分析则显示,导致卵巢早衰的危险因素包括:环磷酰胺的累计用量(OR=2.575)和使用环磷酰胺后白细胞的下降值(OR=2.195)。结论环磷酰胺的累计用量及白细胞下降值是环磷酰胺导致卵巢早衰的危险因素。
Objective To investigate the influencing factors of cyclophosphamide in the treatment of refractory nephrotic syndrome caused by premature ovarian failure. Methods A total of 73 women of childbearing age who received cyclophosphamide were divided into two groups according to whether they had premature ovarian failure, 17 cases of premature ovarian failure and 56 cases of normal ovarian function. The clinical and biochemical indexes of patients were collected. Analysis and multivariate logistic regression analysis. Results Univariate analysis showed that the influencing factors of premature ovarian failure include: the initial age of using cyclophosphamide, gestational age, the cumulative dose of cyclophosphamide, the leukopenia after using cyclophosphamide and the cumulative amount of mycophenolate. Multivariate analysis showed that the risk factors for premature ovarian failure included the cumulative dose of cyclophosphamide (OR = 2.575) and the decline of white blood cells after cyclophosphamide (OR = 2.195). Conclusion The cumulative dose of cyclophosphamide and leukopenia is a risk factor for cyclophosphamide-induced premature ovarian failure.