2021 年第 10 期 第 16 卷

二甲双胍对接受化疗乳腺癌患者卵巢功能的保护作用

Protective effect of metformin on ovarian function in breast cancer patients receiving chemotherapy

作者：龚勇杨勇黄汉涛刘家盛

英文作者：Gong Yong Yang Yong Huang Hantao Liu Jiasheng

单位：武警湖北省总队医院二外科，武汉430030

英文单位：Second Department of Surgery Hubei Provincial General Hospital of Armed Police Force Wuhan 430030 China

关键词：乳腺癌；化疗；二甲双胍；卵巢毒性

英文关键词：Breastcancer;Chemotherapy;Metformin;Ovariantoxicit

• 摘要：

• 目的  探讨二甲双胍对接受化疗乳腺癌患者卵巢功能的保护作用。方法 选取2017年1月至2019年6月在武警湖北省总队医院诊断为早期乳腺癌的60例患者，根据随机数字表法分为观察组和对照组，每组30例。对照组接受常规化疗；观察组在常规化疗基础上服用盐酸二甲双胍片（服用至全部化疗周期结束）。比较患者化疗前和化疗1年后的卵巢储备功能，观察月经恢复情况和不良反应发生情况。结果 观察组患者中有2例患者因二甲双胍所致腹泻无法耐受退出试验，1例患者因肝功能损伤无法耐受化疗退出试验，脱失率为10.0%（3/30）；对照组中有2例患者因肝功能损伤无法耐受化疗退出试验，2例因心脏病或脑卒中猝死，脱失率为13.3%（4/30）。化疗1年后观察组卵泡刺激素水平显著低于对照组、雌二醇水平显著高于对照组［（12.3±3.2）IU/L比（17.5±2.9）IU/L、（602±165）pmol/L比（433±170）pmol/L］，差异均有统计学意义（均P<0.05）；抗苗勒管激素和黄体生成素水平差异均无统计学意义（均P>0.05）。化疗1年后观察组月经恢复率高于对照组［77.8%（21/27）比46.2%（12/26）］，差异有统计学意义（P<0.05）。2组患者化疗期间不良反应发生情况比较差异无统计学意义（P>0.05）。结论 二甲双胍能够一定程度上保护乳腺癌化疗患者的卵巢储备功能。

• Objective To explore the protective effect of metformin on ovarian function in breast cancer patients receiving chemotherapy. Methods From January 2017 to June 2019, 60 patients diagnosed as early stage breast cancer in Hubei Provincial General Hospital of Armed Police Force were selected. Patients were randomly divided into observation group and control group, with 30 cases in each group. The control group received conventional chemotherapy and the observation group was treated with metformin hydrochloride tablets on the basis of conventional chemotherapy (until the end of all chemotherapy cycles). Ovarian reserve function was compared before and 1 year after chemotherapy, and menstruation recovery and adverse reactions were observed. Results In the observation group, 2 patients were unable to tolerate the diarrhea caused by metformin and withdrew from the experiment, and 1 patient was unable to tolerate chemotherapy due to liver function injury and withdrew, with a loss rate of 10.0%(3/30). In the control group, 2 patients could not tolerate chemotherapy due to liver function injury and withdrew, and 2 patients died of sudden death due to heart disease or stroke, with a loss rate of 13.3%(4/30). One year after chemotherapy, the follicle stimulating hormone level of the observation group was significantly lower than that of the control group, and the estradiol level of the observation group was significantly higher than that of the control group［(12.3±3.2)IU/L vs (17.5±2.9)IU/L, (602±165)pmol/L vs (433±170)pmol/L］(both P<0.05); there were no significant differences in anti-Müllerian hormone and luteinizing hormone levels between the two groups(both P>0.05). One year after chemotherapy, the menstruation recovery rate of the observation group was higher than that of the control group［77.8%(21/27) vs 46.2%(12/26)］, and the difference was statistically significant(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during chemotherapy(P>0.05). Conclusion Metformin can protect ovarian reserve function in breast cancer patients undergoing chemotherapy to some extent.