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目的探讨促性腺激素释放激素类似物(GnRH-a)对卵巢肿瘤化疗患者卵巢功能的影响。方法选取南通大学附属海安人民医院2012年4月—2014年3月收治的卵巢肿瘤化疗患者110例,采用随机数字表法分为对照组与观察组,各55例。对照组患者予以常规卵巢肿瘤切除术及化疗,观察组患者予以常规卵巢肿瘤切除术并于化疗前及化疗中联合GnRH-a治疗,3周为1个疗程,连续化疗4~5个疗程,并于化疗结束后进行随访,随访至化疗后48周。比较两组患者复发情况、月经恢复时间、基础雌激素(b E2)、抑制素-B(INHB)、抗苗勒氏激素(AMH)、卵泡刺激素(FSH)、基础窦状卵泡数(b AFC)与妊娠结局。结果观察组患者复发率为1.82%,低于对照组的16.36%(P<0.05)。观察组患者月经恢复时间短于对照组(P<0.05)。治疗前,两组患者b E2、INHB、AMH、FSH、b AFC比较,差异无统计学意义(P>0.05);治疗后两组患者b E2水平比较,差异无统计学意义(P>0.05);观察组患者INHB、AMH水平高于对照组,FSH水平低于对照组,b AFC多于对照组(P<0.05)。观察组患者自然妊娠率高于对照组(P<0.05)。结论卵巢肿瘤化疗患者应用GnRH-a可降低复发率,促进月经恢复,保护卵巢功能,提高自然妊娠率。
Objective To investigate the effects of gonadotropin-releasing hormone analogue (GnRH-a) on ovarian function in ovarian cancer patients undergoing chemotherapy. Methods A total of 110 patients with ovarian cancer who received chemotherapy from April 2012 to March 2014 in Hai’an People’s Hospital affiliated to Nantong University were randomly divided into control group and observation group with 55 cases in each group. Patients in the control group were treated with conventional ovarian tumor resection and chemotherapy. Patients in the observation group were treated with conventional ovarian tumor resection and combined with GnRH-a before and after chemotherapy. The course of treatment was 1 course for 3 weeks and 4 to 5 courses for continuous chemotherapy. Follow-up after the chemotherapy, followed up to 48 weeks after chemotherapy. Recurrence, menstruation recovery time, basal estrogen (b E2), INHB, AMH, FSH and b AFC) and pregnancy outcomes. Results The recurrence rate in the observation group was 1.82%, which was lower than 16.36% in the control group (P <0.05). Menstruation recovery time in observation group was shorter than that in control group (P <0.05). Before treatment, there was no significant difference in b E2, INHB, AMH, FSH and b AFC between the two groups (P> 0.05). There was no significant difference in b E2 between the two groups after treatment (P> 0.05) The levels of INHB and AMH in the observation group were higher than those in the control group, FSH level was lower than the control group, b AFC was more than the control group (P <0.05). The pregnancy rate in observation group was higher than that in control group (P <0.05). Conclusion The application of GnRH-a in patients with ovarian cancer chemotherapy can reduce the recurrence rate, promote the recovery of menstruation, protect the ovarian function and improve the rate of natural pregnancy.