系統性紅斑狼瘡患者使用免疫抑制劑后卵巢貯備功能的臨床評估_West China Medical Journal

Authors：

 劉瀟瀟 , 練穎

成都市第一人民醫院血液風濕科（成都 610041）;

Corresponding?author：

Keywords：

系統性紅斑狼瘡; 抗苗勒管激素; 卵巢貯備功能

DOI：

10.7507/1002-0179.20160081

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目的研究抗苗勒管激素（AMH）與系統性紅斑狼瘡（SLE）女性患者使用免疫抑制劑的關系，評估SLE患者卵巢貯備功能。方法選取2009年1月-2013年12月72例年齡在18～40歲，符合美國風濕病學會診斷標準的初診SLE女性患者，使用酶聯免疫吸附測定法對患者用藥前后血清中AMH進行檢測，選取同期20例同年齡段健康女性作為正常對照。比較使用環磷酰胺（CTX）患者（A組，n=41）與未使用CTX患者（B組，n=31）血清AMH的差異，了解AMH水平與CTX累積劑量及年齡之間的關系。結果 72例SLE患者使用免疫抑制劑后血清中AMH水平[（2.39±1.12）ng/mL]較使用前[（3.12±1.38）ng/mL]及正常對照組[（2.95±0.86）ng/mL]低，差異均有統計學意義（P＜0.05）。治療后A組患者血清中AMH水平[（2.24±1.23）ng/mL]低于治療前[（2.97±1.31）ng/mL]，且低于B組患者血清中AMH水平[（2.92±0.82）ng/mL]，差異有統計學意義（P＜0.05）；B組治療前差異無統計學意義（P＞0.05）。AMH水平與使用CTX累積劑量及年齡呈負相關（P＜0.05）。結論 AMH可以作為評價SLE女性患者在使用CTX后造成卵巢損傷的一個指標。

Citation： 劉瀟瀟, 練穎. 系統性紅斑狼瘡患者使用免疫抑制劑后卵巢貯備功能的臨床評估. West China Medical Journal, 2016, 31(2): 306-308. doi: 10.7507/1002-0179.20160081 Copy

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1. Clowse ME, Harward L, Criscione-Schreiber L, et al. Anti-Müllerian hormone:a better marker of ovarian damage from cyclophosphamide[J]. Arthritis Rheum, 2012, 64(5):1305-1310.
2. Sowers MR, Eyvazzadeh AD, McConnell D, et al. Anti-Müllerian hormone and inhibin B in thedefinition of ovarian aging and the menopause transition[J]. J Clin Endoc Metab, 2008, 93(9):3478-3483.
3. Visser JA, de Jong FH, Laven JS, et al. Anti-Müllerian hormone:a new marker for ovarian function[J]. Reproduction, 2006, 131(1):1-9.
4. McDermott EM, Powell RJ. Incidence of ovarian failure in systemic lupus erythematosus after treatment with pulse cyclophosphamide[J]. Ann Rheum Dis, 1996, 55(4):224-229.
5. Warne GL, Fairley KF, Hobbs JB, et al. Cyclophosphamide-induced ovarian failure[J]. N Engl J Med, 1973, 289(22):1159-1162.
6. Petri M. Systemic Lupus International Collaborating Clinic (SLICC):SLICC revision of the ACR classification criteria for SLE[J]. Arthritis Rheum, 2009, 60(Suppl 10):895.
7. Weenen C, Laven JS, von Bergh AR, et al. Anti-Müllerian hormone expression pattern in the human ovary:potential implications forinitial and cyclic follicle recruitment[J]. Mol Hum Reprod, 2004, 10(2):77-83.
8. Pigny P, Jonard S, Robert Y, et al. Serum anti-Mullerian hormone as a surrogate for antral follicle count for definition of the polycystic ovary syndrome[J]. J Clin Endocrinol Metab, 2006, 91(3):941-945.
9. Mok CC, Chan PT, To CH. Anti-Müllerian hormone and ovarian reserve in systemic lupus erythematosus[J]. Arthritis Rheum, 2013, 65(1):206-210.
10. 李艷梅, 趙義, 慈春增, 等. 抗繆勒管激素在女性系統性紅斑狼瘡中的臨床意義及與抗卵巢細胞抗體的關系[J]. 中華風濕病學雜志, 2010, 14(5):305-307.
11. Lawrenz B, Henes JC, Henes M, et al. Impact of systemic lupus erythematosus on ovarian reservein premenopausal women:evaluation by using anti-Müellerian hormone[J]. Lupus, 2011, 20 (11):1193-1197.

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West China Medical Journal

系統性紅斑狼瘡患者使用免疫抑制劑后卵巢貯備功能的臨床評估

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