血清中邻苯二甲酸酯与子宫内膜异位症的相关性

Correlation between Serum Phthalate Concentration and Endometriosis

[目的]了解育龄女性邻苯二甲酸酯的暴露水平,分析其与子宫内膜异位症的相关性。[方法]176名对照和134名子宫内膜异位症患者的病例对照研究,收集研究对象的调查问卷,气相色谱法检测其血清中邻苯二甲酸酯含量。[结果]310例女性血清中的邻苯二甲酸二乙酯(DEP)、邻苯二甲酸二丁酯(DBP)和邻苯二甲酸二(2-乙基-己基)酯(DEHP)检出率分别为15.5%、95.2%和93.5%,几何均数分别为0.062、0.219和0.178mg/L;病例组血清中DBP检出率高于对照组,差异有统计学意义(98.5%vs.92.6%,P<0.05);病例组血清中DBP、DEHP水平高于对照组,差异有统计学意义。其中,DBP为0.304mg/L vs.0.171mg/L,P<0.05;DEHP为0.200mg/L vs.0.163mg/L,P<0.05。多因素logistic回归分析显示,较高的文化程度、有流产史、避孕药服用史、妇科疾病家族史、较高的血清DBP含量可能是与子宫内膜异位症发病有关的危险因素(OR>1,P<0.05)。[结论]邻苯二甲酸酯类化合物的暴露可能与子宫内膜异位症的发病相关。

[Objective]To assess phthalic acid esters（PAEs） exposure in women of childbearing age and to analyze the correlation of PAEs with endometriosis.[Methods]A case-control study was conducted among 176 controls and 134 endometriosis patients using the information collected from questionnaires and the serum PAEs concentrations measured by gas chromatography.[Results]The positive rates of serum diethyl phthalate（DEP）,di-n-butyl phthalate（DBP） and di-2-ethylhexyl phthalate（DEHP） in 310 women were 15.5%（geometric mean,0.062mg/L）,95.2%（0.219mg/L）,and 93.5%（0.178mg/L）,respectively.The positive rate of serum DBP in the patients was significantly higher than that in the controls（98.5% vs.92.6%,P〈0.05）.The levels of serum DBP and DEHP in the patients were significantly higher than those in the controls（0.304mg/L vs.0.171mg/L,P〈0.05;0.200mg/L vs.0.163mg/L,P0.05,respectively）.The results of multivariate logistic analysis revealed that high education level,abortion history,taking contraceptives,family history of gynecological diseases,and high serum DBP concentration could be potential risk factors of endometriosis（OR〉1,P〈0.05）[.Conclusion]Exposure to PAEs is probably correlated to endometriosis occurrence.