化疗对卵巢癌患者内分泌功能影响的临床研究

目的 探讨化疗对卵巢癌患者保守性手术治疗后卵巢功能的临床影响.方法 选择2006年1月～2010年12月湖北省襄阳市中心医院妇科收治的33例卵巢癌患者,其中,18例患者采用BEP方案,15例患者采用TP方案.观察两种方案治疗患者的停经时间及化疗前后血清中促卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）水平及Kupperman评分的变化.结果 33例患者中,月经异常者25例,占75.75％,其中,发生停经20例,占80％,月经减少5例,占20％.对于停经患者,在化疗结束后3个月左右月经可恢复正常.患者停经后2d,其血清中FSH[（8.6±3.4） mU/mL]及LH[（6.7±2.6）mU/mL]水平明显降低,而E2[（158.2±58.6）mU/mL]水平明显升高,与停经前2d比较,差异有统计学意义（P＜0.05）.停经时间与患者的化疗时间具有明显的正相关（r=0.625,P=0.022）.化疗前后患者血清Kupperman评分比较差异无统计学意义（P＞0.05）,而化疗后卵巢Kupperman评分明显高于化疗前,差异有统计学意义（P＜0.05）.结论 对于行保守手术治疗的卵巢癌患者而言,术后给予化疗对其卵巢功能具有一定的损害作用,能够明显升高促性腺激素,降低雌激素水平,导致患者出现停经或月经减少等表现.

Effect of chemotherapy on endocrine function in patients with ovarian cancer

Objective To determine the clinical effect of chemotherapy on ovarian endocrine function in patients with ovarian cancer after conservative surgery treatment.Methods 33 cases of patients with ovarian cancer from January 2006 to December 2010 in Department of Gynecology and Obstetrics,the Center Hospital of Xiangyang City were selected.All patients underwent chemotherapy,18 cases were adopted BEP scheme,15 cases were adopted TP scheme.Menelipsis time of the patients and serum luteinizing hormone （LH）,follicle-stimulating hormone （FSH）,estradiol （E2）levels and Kupperman score before and after the chemotherapy were observed.Results Among 33 cases,abnormal menstruation occurred in 25 cases （75.75％）,including 80％ of amenorrhea （25 cases） and 20％ of oligomenstruate （5 cases）,who could return to normal 3 months after chemotherapy.Compared with 2 days before menelipsis,2 days after menelipsis,serum LH [（6.7±2.6） mU/mL],FSH [（8.6±3.4） mU/mL] levels decreased significantly,and E2 level [（158.2±58.6） mU/mL] increased significantly,the differences were statistically significant （P ＜ 0.05）.There was significant positive correlation between menopause time and patients with chemotherapy （r=0.625,P=0.022）.Before and after chemotherapy,serum Kupperman score of patients was compared,the difference was not statistically significant （P ＞0.05）.The ovary Kupperman score of patients after chemotherapy was higher than before chemotherapy,the difference was statistically significant （P ＜ 0.05）.Conclusion For patients with ovarian cancer who were given conservative surgical treatment,chemotherapy postoperatively has certain damage effect for ovarian function,can significantly elevated gonadotropins,lower estrogen levels,lead to menopause or reduce menstruation.