绝经期妇女雌激素水平与常见身心症状的相关性

Correlation between estrogen level and common body and mind symptoms in postmenopausal women

目的:调查唐山地区绝经期妇女常见身心症状严重程度与其绝经年限的关系,并比较不同雌激素水平绝经期妇女身心症状严重程度的差异。方法:选择2001-02/2005-02在唐山市妇幼保健院门诊体检的绝经期妇女267例,年龄42～55岁,平均(53±11)岁;绝经年限1～13年。均自愿接受量表调查测试。绝经年限<3年121例,3～8年67例,>8年79例。高雌二醇组94例(血清雌二醇≥100pmol/L)和低雌二醇组173例(血清雌二醇<100pmol/L);高睾酮组108例(血清睾酮≥30mmol/L)和低睾酮组159例(血清睾酮<30mmol/L);高促卵泡素组163例(血清促卵泡素≥30μg/L)和低促卵泡素组104例(血清促卵泡素<30μg/L);高促黄体生成素组155例(血清促黄体生成素≥40μg/L)和低促黄体生成素组112例(血清促黄体生成素<40μg/L)。①身心症状严重程度调查:采用绝经期妇女常见身心症状调查表该调查表共分14项内容:烦恼;情绪低落;皮肤感觉异常;头晕;注意力不集中;肢体凉;梦多易醒;腰背酸痛;疑病;疲倦乏力;耳鸣;易激动;入睡困难;记忆力减退。每个项目根据无、轻、重评分为0～2分。严重程度总分:14个单项分总和为严重程度总分。严重程度总均分:严重程度总分/14。②实验室指标检测:血清雌二醇、睾酮、促卵泡素和促黄体生成素采用放射免疫分析测定。③组间显著性测定:用t检验完成。结果:绝经期妇女267例均进入结果分析,并完成量表调查。①绝经期妇女267例常见身心症状发生率:最高的为疲倦乏力,占79.8%,情绪低落次之,占78.2%,梦多易醒发生率最低,占24.3%。②绝经年限与常见身心症状程度评分关系:绝经年限<3年组的严重程度平均总分和每项严重程度平均分均明显高于3～8年和>8年组(t=2.210～2.365,P<0.05)。③雌二醇、睾酮浓度与常见身心症状程度评分:低雌二醇组和高睾酮组的严重程度平均总分和每项严重程度平均分明显高于高雌二醇组和低睾酮组(t=2.294～2.879,P<0.05)。④促卵泡素和促黄体生成素浓度与常见身心症状严重程度评分:高促卵泡素组和高促黄体生成素组的严重程度平均总分和每项严重程度平均分均明显高于低促卵泡素组和低促黄体生成素组(t=2.250～2.794,P<0.05)。结论:绝经期妇女身心症状以疲倦乏力最多见;绝经年限短、血清雌二醇浓度低和睾酮、促卵泡素和促黄体生成素浓度高的绝经期妇女身心症状。

AIM： To compare the relation between the severity of common body and mind symptoms and years since menopause in postmenopausal women in Tangshan as well as the severity of body and mind among postmenopausal women with different estrogen levels.METHODS： Totally 267 postmenopausal women, 42-55 years of age, 1-13 years following menopause, who had health examination in the Outpatient of Tangshan Health Center for Women and Children from February 2001 through February 2005, were selected, and participated in the survey voluntarily. Among the 267 women, 121 women had menopause for more than 3 years, 67 for 3-8 years, and 79 for more than $ years.There were 94 cases of high-level estradiol （serum estradiol ≥ 100 pmol/L）,173 of low-level estradiol （serum estradiol 〈 100 pmol/L）; 108 cases of high-level testosteone （serum testosteone ≥30 mmol/L） and 159 of low-level testosteone （serum testosteone 〈 30 mmol/L）; 163 cases of high-level follicle stimulating hormone （serum follicle stimulating hormone ≥30 μg/L）and 104 of low-level follicle stimulating hormone（serum follicle stimulating hormone〈 30 μg/L）; 155 cases of high-level luteinizint hormone （serum luteinizint hormone≥ 40μg/L） and 112 of low-level luteinizint hormone （serum luteinizint hormone 〈 40μg/L）. All the women were evaluated using common body and mind symptoms survey in postmenopausal women for the severity of body and mind symptoms （The scale consists of worry,dejection, abnormal dermal sense, dizzy, inattention, feeling cool in extremities, dreamful and easy to wake, lumbago, hypochondria, tiredness and inertia, tinnitus, easy to excite, difficulty falling asleep, hypomnesia,score 0-2 for none to severe.）, using radioimmunoassay method for measurement of serum estradiol, testosteone, follicle-stimulating hormone and luteinizint hormone, and using t test for inter-group significance.RESULTS： All the 267 women completed the survey, and were involved in the result analysis.① Prevalence of common body and mind symptoms：The most common was tiredness and inertia, accounting for 79.8%; the second was dejection, accounting for 78.2%; the last was dreamful and easy to wake, accounting for 24.3%. ② Years since menopause and scores on common body and mind symptoms： The total average score and each item score were significantly higher in the less than 3 years group than in the 3-8 years group and more than 8 years group （t=2.210-2.365, P 〈 0.05）. ③Levels of estradiol and testosteone and scores on common body and mind symptoms： The total average score and each item score were significantly higher in the low-level estradiol group and high-level testosteone group than in the high-level estradiol group and low-level testosteone group （t =2.294-2.879, P 〈 0.05）.④ Levels of follicle-stimulating hormone and luteinizint hormone and scores on common body and mind symptoms： The total average score and each item score were significantly higher in the high-level follicle-stimulating hormone group and high-level luteinizint hormone group than in the low-level follicle-stimulating hormone group and low-level luteinizint hormone group（t=2.250-2.794, P 〈 0.05）.CONCLUSION： Tiredness and inertia is most common in postmenopausal women, and body and mind symptoms are likely to be more severe in postmenopausal women who have menopause for a short time, low-level estradiol and high-level testosteone, follicle-stimulating hormone and luteinizint hormone.