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目的:探讨促性腺释放激素类似物(GnRHa)曲普瑞林联合环磷酰胺(CTX)治疗系统性红斑狼疮(SLE)对SLE患者的卵巢储备功能的短期保护作用,初步评价GnRHa作为CTX治疗SLE的卵巢保护剂的有效性。方法:选取2013年3月至2015年3月在北京大学深圳医院风湿免疫科确诊为SLE的育龄女性27例,患者初次使用CTX且治疗周期为6个月。根据患者是否使用GnRHa分为CTX+GnRHa组(12例)和CTX组(15例)。ELISA法测定AMH值。比较两组SLE患者治疗前后AMH变化及两组间AMH差异。结果:CTX+GnRHa组、CTX组患者的治疗前AMH值分别为2.42±0.85和2.39±0.88,差异无统计学意义(P=0.935);治疗后AMH值分别为1.99±0.56和1.31±0.48,差异有统计学意义(P=0.002)。CTX+GnRHa组的治疗前后AMH值比较,差异无统计学意义(P=0.162)。CTX组的治疗前后AMH值比较,差异有统计学意义(P<0.000)。结论:GnRHa辅助CTX治疗SLE对患者卵巢储备功能有一定保护作用。
Objective: To investigate the short-term protective effect of GnRHa and paclitaxel combined with cyclophosphamide (CTX) on ovarian reserve in patients with systemic lupus erythematosus (SLE). To evaluate the short-term protection of GnRHa as CTX in the treatment of SLE The effectiveness of ovarian protectants. Methods: Twenty-seven women of childbearing age who were diagnosed as SLE by Department of Rheumatology, Peking University Shenzhen Hospital from March 2013 to March 2015 were selected. The patients were treated with CTX for the first time and the treatment period was 6 months. Patients were divided into CTX + GnRHa group (n = 12) and CTX group (n = 15) according to whether they were using GnRHa. AMH value was measured by ELISA. The changes of AMH before and after treatment in two groups of SLE patients and the difference of AMH between the two groups were compared. Results: The values of AMH before treatment in CTX + GnRHa group and CTX group were 2.42 ± 0.85 and 2.39 ± 0.88, respectively, with no significant difference (P = 0.935). After treatment, AMH values were 1.99 ± 0.56 and 1.31 ± 0.48, respectively, The difference was statistically significant (P = 0.002). There was no significant difference in AMH between CTX + GnRHa group before and after treatment (P = 0.162). The difference of AMH between CTX group before and after treatment was statistically significant (P <0.000). Conclusion: GnRHa-assisted CTX treatment of SLE has some protective effect on ovarian reserve.