环磷酰胺在月经周期不同时间用药对卵巢抗苗勒管激素的影响

Influence of Cyclophosphamidum Used in Different Time during Menstrual Cycle on Ovary Anti-mullerian Hormone

目的:初步探讨细胞毒性药物环磷酰胺在月经周期不同时间用药对卵巢抗苗勒管激素(AMH)的影响差异。方法:30例使用环磷酰胺治疗肾小球疾病的女性患者[平均年龄为(36±6.39)岁],按月经周期特点将环磷酰胺用药时间分为卵泡期组和分泌期组。卵泡期组:环磷酰胺于月经周期第1~8天内用药;分泌期组:环磷酰胺于月经周期排卵期后用药,约为月经期第14~16天后。每组患者分别于用药前,用药周期1次、3次、6次、10次后测定AMH值。结果:两组患者各周期用药后AMH值差异无统计学意义(P>0.05);与同组用药前相比,卵泡期组和分泌期组患者用药1个月后AMH值显著降低(P<0.05);不同年龄组患者AMH均值差异有统计学意义(P<0.05)。结论:环磷酰胺在月经周期不同时间用药对卵巢的AMH值无显著差异,但患者在使用一次0.8 g小剂量的环磷酰胺后就会出现卵巢功能受损,至少需停药半年以上才能逐步恢复。

Objective： To preliminarily discuss the difference of ovary anti-miillefian hormone （AMH） when cyelophosphamide is used in different time during menstrual cycle. Methods： Totally 30 young female patients with average age of （ 36 ±6.39 ） diagnosed as glomerular disease were treated with cyclophosphamide. According to the medication time, the patients were divided into follicular phase group and secretory phase group based on the property of menstrual cycle. Follicular phase group was treated with cyclophospha- mide during the first day and the eighth clay of menstrual cycle, Secretory phase group was treated with cyelophosphamide after ovulato- ry time, namely the 14th day-the 16th dayof menstrual cycle. AMH was detected before the drug treatment and 1st, 3rd, 6th and 10th cycles after cyclophosphamide treatment in the two groups. Results： AMH in the five periods had no statistic difference between the groups （P 〉0.05）. There was significant difference in AMH before the treatment and after one-month treatment in the same group（P 〈 0.05 ）. AMH in different age groups showed Statistic difference （ P 〈 0.05 ）. Conclusion： There is no significant difference in AMH when eyclophosphamide is administrated in different time of menstrual cycle. However, ovarian function is impaired just by low dose cyclophosphamide （0.8g） with the first administration and will be recovered slowly at least half a year after the drug withdrawal.