环磷酰胺治疗难治性肾病综合征导致卵巢早衰的影响因素研究

Risk factors of premature ovarian failure in the patients with refractory nephrotic syndrome receiving cyclophosphamide therapy

目的探讨环磷酰胺冲击治疗难治性肾病综合征导致卵巢早衰的影响因素。方法将73例接受环磷酰胺治疗的育龄期女性患者根据是否出现卵巢早衰分为两组,卵巢早衰组17例,卵巢功能正常组56例,收集患者的临床和生化指标,对数据进行单因素分析和多因素Logistic回归分析。结果单因素分析显示,卵巢早衰的影响因素包括:开始用环磷酰胺的年龄、孕次、产次环磷酰胺的累计用量、使用环磷酰胺后的白细胞下降值和霉酚酸酯累计用量。多因素分析则显示,导致卵巢早衰的危险因素包括:环磷酰胺的累计用量(OR=2.575)和使用环磷酰胺后白细胞的下降值(OR=2.195)。结论环磷酰胺的累计用量及白细胞下降值是环磷酰胺导致卵巢早衰的危险因素。

Objective To determine the influential factors for premature ovarian failure （POF） after cyclophos- phamide therapy in the patients with refractory nephrotic syndrome （RNS）. Methods 73 reproductive femal patients with RNS whom were treated with cyclophosphamide were included for this study. They were divided into two groups：POF group （n = 17 ）, patients with POF after CTX therapy, non-POF group（ n = 56） , patients with normal ovarian function after CTX therapy. The independent t test and the logistic regression were used to analyze different factors. Results Univariate anal- ysis showed that age of initiation of eyc!ophosphamide treatment, duration of cyelophosphamide treatment, the decrease of WBC and childbearing history were associated with POF; and multivariate analysis showed that cumulative dosage of cyelo- phosphamide（ OR = 2. 575 ）, and the decrease of WBC （OR = 2. 195 ） were significantly associated with premature ovarian failure. The olded age, the less dosage of cyclophosphamide that lead to POF. Conclusions The risk factors of premature ovarian failure during the induction therapy in RNS patients include cumulative dosage of cyclophosphamide and the de- crease of WBC after cyclophosphamide therapy.