围绝经期综合征患者胃肠道动力紊乱的临床症状及影响因素

Clinical symptoms of gastrointestinal motility disorder in patients with perimenopausal syndrome and influencing factors

目的 探究围绝经期综合征患者胃肠道动力紊乱(gastrointestinal motility disorders, GMD)的临床症状及影响因素。方法 选取2020年8月-2023年8月台州市第一人民医院收治的150例女性GMD患者作为研究对象,按照是否合并围绝经期综合征分为GMD合并围绝经期综合征组(58例)及GMD组(92例)。对比两组患者基线资料、雌激素水平、相关量表[汉密尔顿焦虑量表(hamilton anxiety scale, HAMA)、汉密尔顿抑郁量表(hamilton depression scale, HAMD)、胃肠道症状分级评分量表(gastrointestinal symptom rating scale, GSRS)]评分,采用logistic回归分析影响因素,同时比较两组患者临床症状发生的差异。结果 两组患者基础疾病、饮食习惯、营养不良及睡眠时间比较,差异均有统计学意义(均P<0.05);GMD合并围绝经期综合征组患者雌二醇水平(82.10±13.06)pmol/L低于GMD组(101.57±22.60)pmol/L,差异有统计学意义(t=5.959,P<0.05);与GMD组相比,GMD合并围绝经期综合征组患者HAMA评分(15.20±3.26)分、HAMD评分(19.23±4.11)分及GSRS评分(54.15±12.54)分均升高,差异均有统计学意义(t_(HAMA)=4.240,t_(HAMD)=5.196,t_(GSRS)=10.940,均P<0.05);饮食习惯(OR=3.549)、营养不良(OR=3.008)、睡眠时间(OR=3.226)、雌二醇(OR=3.020)、HAMA评分(OR=2.277)及GSRS评分(OR=3.264)是围绝经期综合征合并GMD的危险因素(P<0.05);两组患者腹泻、恶心呕吐、嗳气、便秘临床症状比较,差异均无统计学意义(均P>0.05);与GMD组相比,GMD合并围绝经期综合征组患者的腹痛(84.48%)、腹胀(70.69%)的发生概率更高,差异均有统计学意义(χ^(2)_(腹痛)=23.621,χ^(2)_(腹胀)=15.171,均P<0.05)。结论 饮食不良、睡眠时间、营养不良、雌二醇、焦虑及胃肠道症状是围绝经期综合征合并GMD的影响因素,且与单纯GMD患者相比,围绝经期综合征合并GMD患者临床腹痛、腹胀的发生概率更高。

Objective To explore the clinical symptoms and influencing factors of gastrointestinal motility disorders(GMD)in patients with perimenopausal syndrome.Methods A total of 150 female patients with GMD admitted to the First People's Hospital of Taizhou from August 2020 to August 2023 were selected as the research objects.According to whether they were combined with perimenopausal syndrome,they were divided into GMD combined with perimenopausal syndrome group(58 cases)and GMD group(92 cases).Baseline data,estro-gen levels,and related scales[Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),gastrointestinal symptom rating scale(GSRS)]scores were compared between the two groups.logistic regression analysis was used to analyze the influencing factors,and the differences in clinical symptoms between the two groups were compared.Results There were significant differences in basic diseases,eating habits,malnutrition and sleep time between the two groups(all P<0.05).The level of estradiol in GMD combined with perimenopa-usal syndrome group(82.10±13.06)pmol/L was lower than that in GMD group(101.57±22.60)pmol/L,and the difference was statis-tically significant(t=5.959,P<0.05).Compared with the GMD group,the HAMA score(15.20±3.26),HAMD score(19.23±4.11)and GSRS score(54.15±12.54)in the GMD combined with perimenopausal syndrome group were increased,and the differences were statis-tically significant(tHAMA=4.240,tHAMD=5.196,tGSRS=10.940,all P<0.05).Eating habits(OR=3.549),malnutrition(OR=3.008),sleep time(OR=3.226),estradiol(OR=3.020),HAMA score(OR=2.277)and GSRS score(OR=3.264)were risk factors for perimenopausal syndrome with GMD(P<0.05).There were no significant differences in the clinical symptoms of diarrhea,nausea and vomiting,belching and constipation between the two groups(all P>0.05).Compared with the GMD group,the incidence of abdominal pain(84.48%)and abdominal distension(70.69%)in the GMD combined with perimenopausal syndrome group was higher,and the differ-ence was statistically significant(x^(2)=23.621,x2=15.171,all P<0.05).Conclusion Poor diet,sleep time,malnutrition,estradiol,anxiety and gastrointestinal symptoms are the influencing factors of perimenopausal syndrome with GMD.Compared with patients with simple GMD,the incidence of clinical abdominal pain and abdominal distension in patients with perimenopausal syndrome with GMD is higher.