使用环磷酰胺是狼疮患者出现卵巢…
使用环磷酰胺是狼疮患者出现卵巢早衰的主要危险因素
作者：Mayorga J, et al.
翻译：北医三院张警丰
发布：孙琳
审核：姚中强
目的：评估系统性红斑狼疮（SLE）发生卵巢早衰（POF）的相关危险因素及其流行性病学特点。
方法：本研究为横断面研究，纳入于风湿科就诊的＜60岁的SLE女性患者。进行面对面访视获取人口学资料、妇科资料及狼疮资料。进一步的风湿病学资料及内分泌学资料由患者的就诊记录获得。分析研究样本的POF发生率，并对＜40岁的亚组进行进一步分析。应用logistic分析判断POF与所选择的多变量之间的关系。
结果：共纳入961例患者，卵巢早衰、不明原因的继发性闭经、绝经以及子宫切除的发生率分别为5.4%、0.8%、7.8%和4.4%。674例（70%）未暴露于环磷酰胺的患者POF的发生率为0.6%。疾病活动持续时间(OR 1.4 (CI 95%
1.0-1.8, p < 0.05))以及环磷酰胺治疗(OR 5.9 (CI 95% 1.8-18.8, p < 0.01))与发生率增加相关。卵巢早衰与内分泌系统自身免疫疾病未发现相关性。
结论：未接受环磷酰胺治疗的狼疮患者卵巢早衰的发生率与普通人群无差异。大部分狼疮患者未发现卵巢的自身免疫反应。
附原文：
OBJECTIVE:To estimate the prevalence of premature ovarian failure (POF) and its associated factors in patients with systemic lupus erythematosus (SLE). METHODS: Cross-sectional study including consecutive SLE women <60 years of age attending a rheumatology clinic. A face-to-face interview was undertaken to obtain demographic, gynaecological and lupus characteristics. Additional rheumatologic and endocrine data were retrieved from patients' medical records.
POF prevalence was estimated in the study sample and in a subgroup of patients aged <40 years at interview. Associations between POF
and selected variables were assessed by logistic regression analyses.RESULTS:A total of 961 patients were analysed. Prevalence of POF, secondary amenorrhea of known cause, menopause and hysterectomy were 5.4%, 0.8%, 7.8% and 4.4%, respectively. In 674 (70%) patients who had not been exposed to cyclophosphamide (CYC) the prevalence of POF was 0.6%. Disease activity over time (OR 1.4 (CI 95% 1.0-1.8, p < 0.05)) and CYC treatment (OR 5.9 (CI 95% 1.8-18.8, p < 0.01)) were associated with higher prevalence. Association between POF and endocrine autoimmune diseases was not found.CONCLUSIONS:In the absence of CYC treatment, the prevalence of POF in lupus patients is consistent with that reported in the general population. The existence of autoimmune processes at the ovary seems
unlikely in most lupus patients.
引自：
Mayorga J, Alpízar-Rodríguez D, Prieto-Padilla J, et al. Prevalence of premature ovarian failure in patients with systemic lupus erythematosus.Lupus. 2016 Jun;25(7):675-83.
作者：Mayorga J, et al.
翻译：北医三院张警丰
发布：孙琳
审核：姚中强
目的：评估系统性红斑狼疮（SLE）发生卵巢早衰（POF）的相关危险因素及其流行性病学特点。
方法：本研究为横断面研究，纳入于风湿科就诊的＜60岁的SLE女性患者。进行面对面访视获取人口学资料、妇科资料及狼疮资料。进一步的风湿病学资料及内分泌学资料由患者的就诊记录获得。分析研究样本的POF发生率，并对＜40岁的亚组进行进一步分析。应用logistic分析判断POF与所选择的多变量之间的关系。
结果：共纳入961例患者，卵巢早衰、不明原因的继发性闭经、绝经以及子宫切除的发生率分别为5.4%、0.8%、7.8%和4.4%。674例（70%）未暴露于环磷酰胺的患者POF的发生率为0.6%。疾病活动持续时间(OR 1.4 (CI 95%
1.0-1.8, p < 0.05))以及环磷酰胺治疗(OR 5.9 (CI 95% 1.8-18.8, p < 0.01))与发生率增加相关。卵巢早衰与内分泌系统自身免疫疾病未发现相关性。
结论：未接受环磷酰胺治疗的狼疮患者卵巢早衰的发生率与普通人群无差异。大部分狼疮患者未发现卵巢的自身免疫反应。
附原文：
OBJECTIVE:To estimate the prevalence of premature ovarian failure (POF) and its associated factors in patients with systemic lupus erythematosus (SLE). METHODS: Cross-sectional study including consecutive SLE women <60 years of age attending a rheumatology clinic. A face-to-face interview was undertaken to obtain demographic, gynaecological and lupus characteristics. Additional rheumatologic and endocrine data were retrieved from patients' medical records.
POF prevalence was estimated in the study sample and in a subgroup of patients aged <40 years at interview. Associations between POF
and selected variables were assessed by logistic regression analyses.RESULTS:A total of 961 patients were analysed. Prevalence of POF, secondary amenorrhea of known cause, menopause and hysterectomy were 5.4%, 0.8%, 7.8% and 4.4%, respectively. In 674 (70%) patients who had not been exposed to cyclophosphamide (CYC) the prevalence of POF was 0.6%. Disease activity over time (OR 1.4 (CI 95% 1.0-1.8, p < 0.05)) and CYC treatment (OR 5.9 (CI 95% 1.8-18.8, p < 0.01)) were associated with higher prevalence. Association between POF and endocrine autoimmune diseases was not found.CONCLUSIONS:In the absence of CYC treatment, the prevalence of POF in lupus patients is consistent with that reported in the general population. The existence of autoimmune processes at the ovary seems
unlikely in most lupus patients.
引自：
Mayorga J, Alpízar-Rodríguez D, Prieto-Padilla J, et al. Prevalence of premature ovarian failure in patients with systemic lupus erythematosus.Lupus. 2016 Jun;25(7):675-83.
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