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目的研究促性腺激素释放激素激动剂(GnRH-a)对系统性红斑狼疮(SLE)环磷酰胺(CTX)化疗患者卵巢功能的保护作用。方法选取2010年10月—2013年1月在江西省级医院就诊的门诊和住院女性SLE患者60例,将其随机分为试验组和对照组,各30例。试验组在CTX化疗前1~2周开始使用GnRH-a,对照组单纯接受CTX化疗方案。检测两组患者化疗前后促卵泡生成素(FSH)、雌二醇(E2)水平。结果化疗前两组FSH、E2比较,差异均无统计学意义(P>0.05)。化疗后试验组FSH低于对照组(P<0.05);两组E2比较,差异无统计学意义(P>0.05)。试验组患者有27例(90%)于末次注射GnRH-a后59~81 d恢复月经,仅3例(10%)发生卵巢早衰。对照组患者有21例(70%)恢复月经,9例(30%)发生卵巢早衰。结论 GnRH-a能够降低CTX对SLE患者卵巢功能的损伤,从而保护其卵巢储备功能。
Objective To study the protective effect of gonadotropin-releasing hormone agonist (GnRH-a) on ovarian function in patients with systemic lupus erythematosus (SLE) and cyclophosphamide (CTX) chemotherapy. Methods Sixty female outpatients and inpatients with SLE in our hospital from October 2010 to January 2013 were selected and randomly divided into experimental group and control group, with 30 cases in each group. The experimental group began to use GnRH-a 1 to 2 weeks before CTX chemotherapy, while the control group received CTX chemotherapy alone. The levels of follicle-stimulating hormone (FSH) and estradiol (E2) in both groups before and after chemotherapy were detected. Results Before chemotherapy, FSH and E2 in the two groups showed no significant difference (P> 0.05). The FSH in the experimental group after chemotherapy was lower than that in the control group (P <0.05). There was no significant difference in E2 between the two groups (P> 0.05). Twenty-seven patients (90%) in the experimental group regained menstruation 59 to 81 days after the last GnRH-a injection and only 3 patients (10%) developed premature ovarian failure. In the control group, 21 patients (70%) recovered from menstruation and 9 (30%) developed premature ovarian failure. Conclusion GnRH-a can reduce the damage of ovarian function caused by CTX in patients with SLE and thus protect its ovarian reserve function.