绝经后妇女子宫内膜病变的特点及高危因素

Characteristics and high risk factors of endometrial lesions among postmenopausal women in Hebi

目的：探讨鹤壁市妇女绝经后子宫内膜病变患者的临床特点及高危因素。方法：对2013年1月~2014年12月体检患者进行妇科检查,对所有体检患者进行阴道彩色多普勒超声检查,观察子宫内膜回声及声晕、厚度与宫壁间的关系。并且采用Logistic多因素回归模型分析绝经后子宫内膜病变患者的高危因素。结果：在健康体检患者中共检出子宫内膜病变患者567例,占总检查数的57.86%。其中无临床症状者38.45%,有出血等症状者61.55%。单因素分析结果显示,孕次、产次、糖尿病、高血压、年龄≥60岁、BMI≥25 kg/m2、恶性肿瘤家族史是子宫内膜病变的高危因素。多因素分析结果显示,孕次、产次、年龄≥60岁、BMI≥25 kg/m2、恶性肿瘤家族史为子宫内膜病变的独立高危因素。结论：妇女随着绝经时间的增加,部分子宫和子宫内膜会出现萎缩性改变。制定绝经后无症状子宫内膜病变患者的筛查策略时,需进一步研究针对高危因素人群的筛查方法。

Objective： To explore the clinical characteristics and high risk factors of endometrial lesions among postmenopausal women in Hebi. Methods： Gynecological examination and transvaginal color Doppler ultrasound examination were performed among the patients receiving physical examination from January 2013 to December 2014; the relationship between endometrial echo,echo halo,thickness and uterine wall was observed. Multivariate Logistic regression model was used to analyze the high risk factors of endometrial lesions among postmenopausal women. Results： A total of 567 patients were diagnosed as endometrial lesions,accounting for 57. 86%,38. 45% of them had no clinical symptoms and 61. 55% of them had hemorrhage symptom. Univariate analysis showed that gravidity,parity,diabetes,hypertension,age≥60 years,BMI≥25 kg / m2 and family history of malignant tumors were high risk factors of endometrial lesions. Multivariate analysis showed that gravidity,parity,age≥60 years,BMI≥25 kg / m2 and family history of malignant tumors were independent high risk factors of endometrial lesions. Conclusion： With the extension of menopausal time,atrophic changes can be found in partial uteri and endometrium tissues. When formulating screening strategies for asymptomatic postmenopausal patients with endometrial lesions,screening methods targeting to high risk factors of population should be further researched.