环磷酰胺对慢性淋巴细胞白血病患者睾丸功能影响的临床研究

目的:研究抗肿瘤药物环磷酰胺(CP)对睾丸功能的影响,为指导临床用药提供一定的参考。方法:选取分析2014年1月至2016年1月间入院初治的慢性淋巴细胞白血病男性76例,将其随机分为观察组(38例)与对照组(38例)。对照组应用氟达拉滨单药治疗,观察组应用环磷酰胺。两组患者于治疗结束后行精液分析、睾丸活检、并检测睾丸容积与生殖激素水平检测。结果:两组患者治疗精液质量并无显著差异(P0.05)。观察组患者经治疗后精液量减少者增多,精液液化时间延长,精子活力与密度降低,精子畸形率与精液pH值异常者增多,精液质量下降显著(P0.05)。两组患者治疗前睾丸容积与Johnsen评分并无显著差异(P0.05)。观察组患者治疗后睾丸容积为(13.62±3.81)mL,Johnsen评分为(5.58±1.13)分,显著低于对照组与治疗前(P0.05)。两组患者治疗前生殖激素并无显著差异(P0.05)。观察组患者治疗后雌激素、黄体生成素、卵泡刺激素均显著下降(P0.05)。结论:常规剂量长期应用环磷酰胺对睾丸功能与生殖激素的影响较大,并且显著降低精液质量。

Impact of cyclophosphamide on the testicular function of patients with chronic lymphocytic leukemia

Objectives:To study the impact of cyclophosphamide (CP) on testicular function,in order to provide reference for clinical medication.Methods:76 male patients with chronic lymphocytic leukemia from January 2014 to January 2016 were selected and randomly divided into observation group (38 cases) and control group (38 cases).The control group received fludarabine for treatment,while the observation group received cyclophosphamide additionally.All the patients underwent semen analysis,testicular biopsy,testicular volume and reproductive hormone testing at the end of treatment.Results:There was no significant difference in the quality of semen between the two groups (P ＞ 0.05).For patients in the observation group,the amount of semen reduced,semen liquefaction prolonged,sperm motility and density decreased,and patients with abnormal sperm and semen pH value increased and semen quality was significantly decreased (P ＜ 0.05).Difference in testicular volume and Johnsen score was not significant between the two groups before treatment (P ＞ 0.05).The testicular volume and Johnsen score was (13.62 ± 3.81) mL and (5.58 ± 1.13) points respectively,significantly lower than that of the control group and that before treatment (P ＜ 0.05).Difference in reproductive hormones between the two groups before treatment was not significant (P ＞ 0.05).The estrogen,luteinizing hormone and follicle stimulating hormone were significantly decreased in observation group after treatment (P ＜ 0.05).Conclusion:Long-term use of conventional dose of cyclophosphamide has huge impact on testicular function and reproductive hormones,hereby significantly reducing semen quality.