Clinical Study Of Cyclophosphamide On Ovarian Injury In Women Of Reproductive Age

Objective:To evaluate the risk factors of ovarian injury caused by cyclophosphamide in the women of childbearing age with the change of ovarian reserve function after cyclophosphamide.Methods In this study,40 cases of rheumatic women who had been used or are currently using cyclophosphamide in Weihai municipal hospital rheumatology outpatient and inpatient were selected,age from 19 to 50 years old,and the mean age was 35.03 ± 7.34.These patients suffering from diseases include systemic lupus erythematosus(SLE)29 cases,4 cases of Sjogren's syndrome,sclerosis in 2 cases,myositis in 2 cases,arteritis in 1 case,1 cases of rheumatoid arthritis,system vasculitis in 1 case.Patients were treated with cyclophosphamide and the average age was 32.65±7.68.Intravenous injection mode.For the first time in 40 of the 90% patients,the dose was 0.2g,but the dose was followed by 0.4g.Overview for all cases and in the range of time in this survey,with a total dose of cyclophosphamide in 1.2g~12.6g,mean to 7.54±3.25 g.Patients were divided into tow groups for the group of abnormal menstruation and menstrual normal control group,to investigate the relationship between patients using cyclophosphamide total dose,the first age,and the administration of estradiol,promote follicle stimulating hormone,luteinizing hormone prolactin,hormone,progesterone five estrogen,using Logistic regression analysis were used for statistical analysis.At the same time,compared with the difference of the size of estrogen and ovary in the treatment group,the healthy population and the single use hormone group.Results: The study investigated the relationship between the total dose of cyclophosphamide,the age of the first use of the drug,and the five hormones of estradiol,follicle stimulating hormone,progesterone,prolactin and progesterone.Through the correlation analysis,it is found that the total dose of cyclophosphamide,in follicle stimulation hormone,luteinizing hormone,progesterone out positive correlation,in estradiol,prolactin aspects showed negative correlation,and the use of patients with a total dose of cyclophosphamide and lactation Su was extremely significant negative correlation.Patients with first medication age in luteinizing hormone aspects showed positive correlation,in estradiol,follicle stimulating hormone,prolactin,progesterone angiotensin showed negative correlation,and patients for the first time use age and lactation pigment is significant negative correlation.With prolactin as dependent variable,age,will be the first drug cyclophosphamide cumulative dose as independent variables to implement further multivariate stepwise regression analysis,P > 0.05 as a standard.Analysis results show that: the first medication age(x1),cyclophosphamide cumulative dosage(x2)is main factors of prolactin secretion and the final regression equations is Y?=28.689+13.893 X1+56.765 X2,the regression equation is significant F is 16.934,P < 0.001,coefficient of determination was 0.152,indicating that these two variables can explain lactation hormone secretion 15.2% of the total variation.Patients were negatively correlated with the size of ovary for the first time,and the cumulative dosage of cyclophosphamide showed positive correlation with ovary size.But the correlation between the two and ovary size was not significant at the level of statistics.By cyclophosphamide group,health group,single hormone group in estrogen and ovarian size differences found: cyclophosphamide treatment group estradiol was significantly lower than the other two groups;cyclophosphamide treatment group FSH were significantly higher than that of the healthy group,but no significant difference between the groups;in addition,the three groups in luteinizing hormone,prolactin,estrogen and progesterone in three patients with ovarian size was not significant.Conclusion: Through the study found that in the course of treatment of rheumatism,the use of cyclophosphamide can indeed cause damage to the ovarian function of the patient,the specific manifestations of abnormal menstruation and sex hormones in the regulation.Control of the medication so patients in the use of cyclophosphamide in the treatment of rheumatism,for the first time to pay attention to grasp the age and cyclophosphamide total dose should also take corresponding measures to protect and repair on ovarian function.In addition,the study found that the use of hormone therapy on women's menstruation also has an impact,but the hormone and cyclophosphamide combined with the increase in female menstrual disorders need to be further demonstrated.