GnRH类似物对青春期化疗患者卵巢功能的保护作用及机制

Protective effect and its mechanism on ovarian function by gonadotrophin-releasing hormone ana- logue in adolescents under chemotherapy

儿童肿瘤患者的长期生存率正逐年增高，在接受化疗的患者中，性腺功能损害是最常见的内分泌功能障碍。对于青春期化疔患者，用于成人的一些生殖保护的措施多不适用或技术尚未成熟。近年通过动物在体实验和临床研究证实，促性腺激素释放激素类似物（GnRHa）对化疗患者卵巢功能有保护作用，其机制包括阻断化疗期间卵泡刺激素依赖性的卯泡发育，减少子宫、卵巢的血流灌注，直接作用于卵母细胞、颗粒细胞以及可能作用于生殖干细胞的更新。其具有经济易行、不良反应小等优点，可望作为青春期化疗患者卵巢功能保护的首选方法.

It is a striking success of modern medicine that more and more children with cancer can survive long term. Gonadotoxicity is the most common endocrine late effect in pediatric cancer survivors who had received chemotherapy. Many methods of fertility preservation are not suitable or available for adolescents. It has been proved in experimental and clinical observations that combined treatment of gonadotrophinreleasing hormone analogue can help to protect ovarian function. The possible mechanisms involved in blocking FSH dependent follicle development, decreasing local blood infusion, acting on granulosa cells or germline stem cells renewal. Hopefully,it might become the first choice for ovarian function protection in adolescents under chemotherapy.