血液病清髓性化疗后卵巢早衰患者的围绝经期症状研究

发布时间：2018-05-13 02:31

本文选题：医源性卵巢早衰 + 清髓化疗　；参考：《中国妇产科临床杂志》2015年05期

【摘要】：目的了解女性血液病清髓性化疗后卵巢早衰患者性激素治疗(hormone therapy,HT)前后围绝经期症状的发生情况及自我认知。方法 2011年12月至2013年12月,就诊于北京大学人民医院妇科门诊的女性血液病清髓性化疗造血干细胞移植术后符合诊断标准的卵巢早衰患者142例。问卷形式调查其月经情况、性激素水平、围绝经期症状并评估激素治疗后围绝经期症状缓解特点。结果 1 142例患者中103例填写了改良的Kupperman评分表,82例出现了围绝经期症状(79.6%),Kupperman绝经指数评分(KMI)平均为13.50分,96例填写了焦虑/抑郁(HAD)评分量表,6例出现焦虑,平均8.83分,4例出现抑郁,平均8.33分;2 105例接受了激素类药物治疗(94.6%),随访95例接受HT治疗患者中71例有规律撤退性出血。51例诉月经量明显少于移植前月经量,且经血颜色变暗,差异有统计学意义(P=0.00,P0.05);3周期性激素治疗后KMI总分平均为6.7,且下降有统计学意义。结论 1血液疾病清髓性化疗剂量可导致卵巢功能提早衰竭;2性激素治疗也可以缓解清髓化疗后患者出现的围绝经期症状;3血液疾病清髓化疗后卵巢早衰患者对围绝经期症状的认知缺乏。
[Abstract]:Objective to investigate the occurrence of peri-menopausal symptoms before and after hormone therapy and self-cognition in women with premature ovarian failure after antimedullary chemotherapy. Methods from December 2011 to December 2013, 142 patients with ovarian premature failure who met the diagnostic criteria were enrolled in the department of gynecology of Peking University people's Hospital. Questionnaires were used to investigate menstrual status, sex hormone level, symptoms of perimenopausal period and to evaluate the characteristics of remission of menopausal symptoms after hormone therapy. Results among the 1 142 patients, 103 cases filled out the modified Kupperman scale and 82 cases developed peri-menopausal symptoms. The average score of Kupperman menopausal index was 13.50% and 96 cases filled out anxiety / depression scale. 6 cases developed anxiety. An average of 8.83 minutes was found in 4 patients with depression, and an average of 8.33 minutes and 2,105 patients received hormone drugs. Among the 95 patients receiving HT treatment, 71 cases had regular retreating bleeding. 51 cases reported menstrual volume was significantly less than that before transplantation, and the menstrual blood color became dark. The difference was statistically significant (P < 0.05). The average total score of KMI was 6.7, and the decrease was statistically significant. Conclusion (1) the dosage of antimedullary chemotherapeutic therapy in patients with hematologic diseases can lead to premature ovarian failure. It can also relieve the peri-menopausal symptoms of patients with hematological diseases. Lack of awareness of peri-menopausal symptoms.
【作者单位】：北京大学人民医院妇产科;河北医科大学第二医院妇产科;
【基金】：首都特色基金(Z121107001012031)
【分类号】：R711.75

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