Yang Xiu-yan, Zhu Xun, Liang Liu-qin, Zhan Zhong-ping, Ye Yu-jin
Department of Rheumatology and Clinical Immunology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2005 Apr 13;85(14):960-2.
To determine the risk factors for ovarian failure after cyclophosphamide therapy in the patients with systemic lupus erythematosus (SLE).
A case-control study was conducted among 138 female SLE patients, aged 16-45, and treated with cyclophosphamide, 46 of which with premature ovarian failure were included in the case group and 92 of which without menopause after completion of induction therapy with cyclophosphamide were included in the control group. A Logistic regression model was established and step-wise selection was used to analyze different factors, such as age of initiation of therapy, marital history, childbearing history, disease activity index, accumulative dosage of cyclophosphamide, accumulative dosage of azathiopurine, and usage of traditional Chinese medicines etc.
Univariate analysis showed that age of initiation of cyclophosphamide treatment (OR = 1.11, 95% CI = 1.06 - 1.17), SLE activity index (OR = 1.11, 95% CI = 1.06 - 1.17), duration of Trypterygium wilfordii treatment (OR = 1.26, 95% CI = 1.05 - 1.51), duration of cyclophosphamide treatment (OR = 0.16, 95% CI = 0.028 - 0.94), and marital situation were associated with ovarian failure; and multivariate analysis showed that age of initiation of cyclophosphamide treatment (OR = 1.24, 95% CI = 1.14 - 1.35), cumulative dosage of cyclophosphamide (OR = 1.13, 95%, CI = 1.05 - 1.23), and duration of treatment of Trypterygium wilfordii agents (OR = 1.36, 95% CI = 1.09 - 1.69)were significantly associated with premature ovarian failure. Only 4 cases in the case group began to receive cyclophosphamide treatment before the age of 20 and their accumulative cyclophosphamide dosage was 28.8 - 32.4 g. The median of cumulative dosage of cyclophosphamide was only 4.8 g for the 11 cases aged 40-45 in the case group.
The risk factors of premature ovarian failure during the induction therapy in SLE patients include age of initiation of cyclophosphamide treatment, cumulative dosage of cyclophosphamide and duration of treatment with leigongteng.
确定系统性红斑狼疮（SLE）患者环磷酰胺治疗后卵巢功能衰竭的危险因素。
对138例年龄在16 - 45岁、接受环磷酰胺治疗的女性SLE患者进行病例对照研究，其中46例发生过早卵巢功能衰竭的患者纳入病例组，92例在完成环磷酰胺诱导治疗后未绝经的患者纳入对照组。建立Logistic回归模型并采用逐步选择法分析不同因素，如治疗开始年龄、婚育史、疾病活动指数、环磷酰胺累积剂量、硫唑嘌呤累积剂量以及中药使用情况等。
单因素分析显示，环磷酰胺治疗开始年龄（OR = 1.11，95%CI = 1.06 - 1.17）、SLE活动指数（OR = 1.11，95%CI = 1.06 - 1.17）、雷公藤治疗时长（OR = 1.26，95%CI = 1.05 - 1.51）、环磷酰胺治疗时长（OR = 0.16，95%CI = 0.028 - 0.94）以及婚姻状况与卵巢功能衰竭有关；多因素分析显示，环磷酰胺治疗开始年龄（OR = 1.24，95%CI = 1.14 - 1.35）、环磷酰胺累积剂量（OR = 1.13，95%，CI = 1.05 - 1.23）以及雷公藤制剂治疗时长（OR = 1.36，95%CI = 1.09 - 1.69）与过早卵巢功能衰竭显著相关。病例组中仅4例在20岁前开始接受环磷酰胺治疗，其环磷酰胺累积剂量为28.8 - 32.4 g。病例组中40 - 45岁的11例患者环磷酰胺累积剂量中位数仅为4.8 g。
SLE患者诱导治疗期间过早卵巢功能衰竭的危险因素包括环磷酰胺治疗开始年龄、环磷酰胺累积剂量以及雷公藤治疗时长。
