目的:探讨抗苗勒管激素用于评价戈舍瑞林对年轻乳腺癌患者卵巢功能抑制的可行性.方法:选取激素受体阳性的术后、化/放疗后年轻乳腺癌患者40例,随机分为戈舍瑞林+他莫昔芬组(简称戈舍瑞林组)20例,他莫昔芬组20例(对照组).戈舍瑞林组在戈舍瑞林注射前1 d及注射戈舍瑞林3、6、12针后测定血清雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)及抗苗勒管激素(AMH)水平.对照组在相应时间段内进行检测.并对比两组不良反应发生率.结果:治疗前两组血清E 2、FSH、LH及AMH水平差异无统计学意义(P均>0.05).治疗后戈舍瑞林组的3个不同时间段血清E 2、FSH、LH及AMH水平均低于对照组水平(P均<0.05).戈舍瑞林组发生不良反应10例(50.0%),对照组6例(30.0%),主要不良反应为恶心、潮热、盗汗、性欲减退、阴道干涩、关节痛、骨质疏松等,均为Ⅰ-Ⅱ级.两组不良反应发生率差异无统计学意义(P>0.05).结论:抗苗勒管激素可以用于评价戈舍瑞林对年轻乳腺癌患者卵巢功能的抑制作用.%Objective:To observe the role of anti-Müllerian hormone (AMH)in evaluation of the ovarian func-tion suppression of goserelin added to tamoxifen in the young breast cancer patients with hormone receptor positive.Methods:Forty patients underwent surgery,chemotherapy and radiotherapy,were randomly divided into two groups.The test group was treated with goserelin + tamoxifen (n = 20),and the control group received tamoxifen alone (n =20).The serum levels of E 2 ,FSH,LH and AMH in test group were measured before and after goserelin in 4 points(0, 3,6,12 needles).Accordingly,the serum was collected as well in control group.The side effects of two groups were e-valuated.Results:There were no significant differences in the serum E 2 ,FSH,LH and AMH levels between the two groups before treatment (P > 0.05).Compared with the control group,the serum E 2 ,FSH,LH and AMH levels of the patients injected with goserelin were decreased significantly (P< 0.05).10 cases of adverse effects occurred in gose-relin group,and 6 cases in control group (P > 0.05).The main Ⅰ-Ⅱ grade adverse effects were nausea,tidal fe-ver,night sweating,hyposexuality,vaginal dryness,joint pain,osteoporosis,and no serious toxicities were observed.Conclusion:The serum AMH level could predict ovarian function suppression of the young breast cancer patients trea-ted with goserelin added to tamoxifen.
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