育龄期妇科肿瘤患者化疗所致卵巢损伤发生率及其影响因素分析

Analysis of the incidence and influencing factors of ovarian injury caused by chemotherapy in gynecological tumor patients of childbearing age

目的调查育龄期妇科肿瘤患者化疗所致卵巢损伤的发生现状,并分析其影响因素。方法收集湖南省妇幼保健院2015年1月至2022年6月就诊的210例育龄期妇科肿瘤化疗患者的临床资料,根据是否发生卵巢损伤分为损伤组(n=64)、未损伤组(n=146)。比较两组临床资料,分析卵巢损伤发生的影响因素,并构建Logistic预测模型。结果化疗所致卵巢损伤发生率为30.48%;年龄、吸烟史、环磷酰胺辅助化疗、化疗周期及匹兹堡睡眠质量指数(PSQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分是育龄期妇科肿瘤患者化疗所致卵巢损伤发生的独立危险因素(P<0.05);基于影响因素构建Logistic预测模型为:Logit(P)=-12.315+0.927×年龄+1.198×PSQI评分+1.633×吸烟史+1.051×SDS评分+1.442×SAS评分+1.802×环磷酰胺辅助化疗+1.705×化疗周期;该模型预测卵巢损伤发生的曲线下面积(AUC)为0.921,预测灵敏度、特异度分别为78.96%、91.23%。结论育龄期妇科肿瘤患者化疗所致卵巢损伤发生率为30.48%,年龄、吸烟史、环磷酰胺辅助化疗、化疗周期及PSQI、SDS、SAS评分均为卵巢损伤发生的影响因素。

Objective To investigate the status of ovarian injury caused by chemotherapy in gynecological tumor patients of childbearing age,and to analyze its influencing factors.Methods Clinical data of 210 gynecological tumor chemotherapy patients of childbearing age were collected from Hunan Maternal and Child Health Care Hospital from January 2015 to June 2022.According to whether ovarian injury occurred,they were divided into injured group(n=64)and uninjured group(n=146).The clinical data of the two groups were compared,the influencing factors of ovarian injury were analyzed,and the Logistic prediction model was constructed.Results The incidence of ovarian injury caused by chemotherapy was 30.48%.Age,smoking history,cyclophosphamide adjuvant chemotherapy,chemotherapy cycle,Pittsburgh sleep quality index(PSQI),self-rating depression scale(SDS)and self-rating anxiety scale(SAS)scores were independent risk factors for ovarian injury caused by chemotherapy in women with gynecological tumors of reproductive age(P 0.05).Based on the influencing factors,the Logistic prediction model is built as follows:Logit(P)=-12.315+0.927×age+1.198×PSQI score+1.633×smoking history+1.051×SDS score+1.442×SAS score+1.802×cyclophosphide adjuvant chemotherapy+1.705×chemotherapy cycle.The area under the curve(AUC)of the model was 0.921,and the sensitivity and specificity were 78.96%and 91.23%.Conclusions The incidence of ovarian injury caused by chemotherapy in gynecological tumor patients of reproductive age was 30.48%.Age,smoking history,cyclophosphamide adjuvant chemotherapy,chemotherapy cycle and PSQI,SDS and SAS scores were all influencing factors.