围绝经期症状及相关因素分析

Analysis for symptoms of perimenopause and related factors

目的对围绝经期及绝经后期妇女的症状进行分析,并探讨围绝经期症状的相关因素。方法2012年3月1日至2012年11月30日,在中南大学湘雅二医院妇产科生殖内分泌门诊就诊的患者中,共纳入120例围绝经期或绝经后患者为研究对象。采用统一的调查表,现场进行问卷调查。采用改良Kupermann评分法评估围绝经期症状,分为Kupermann评分≥17分(A组)与﹤17分(B组)两组。分析研究对象围绝经期症状的具体表现,比较A组与B组的基本情况、症状发生比例、月经史以及治疗情况。采用t检验、χ~2检验、Fisher确切概率法进行统计分析。结果 119例(99.2%,119/120)患者有不同程度症状,发生频率较高的5项症状依次为激动(71.7%)、疲乏无力(68.3%)、失眠(65.8%)、潮热及出汗(64.2%)、以及骨、关节、肌肉痛(62.5%)。Kupermann评分≥17分的A组共53例,﹤17分的B组共67例,两组患者的年龄、居住地、婚姻状况、受教育程度以及高血压、糖尿病、子宫肌瘤病史、卵巢手术史比较,差异均无统计学意义(P值均﹥0.05)。A组各种症状的发生率均高于B组(P值均﹤0.05)。A组初潮年龄、初潮年龄延迟者的比例、育龄期月经不规律者的比例均高于B组(P值均﹤0.05)。初潮年龄与Kupermann评分呈正相关,r=0.244(P=0.007)。120例患者中,39例(32.5%)正接受激素替代治疗(hormone replacement therapy,HRT),A组与B组接受HRT的比例分别为39.6%与26.9%;78例(65.0%)患者听说过HRT,A组与B组分别为56.6%与71.6%,差异均无统计学意义(P值均﹥0.05)。结论初潮年龄延迟或育龄期月经不规律的妇女围绝经期症状更为严重,应引起重视并积极采取治疗措施。长沙地区部分妇女对HRT有一定程度的认识,应继续开展相关的健康教育工作。

Objective To analyze the symptoms of perimenopausal explore the related factors of perimenopausal symptoms. Methods and postmenopausal women, and to From March 1st to November 30th, 2012, among the patients who visited reproductive and endocrine clinic of department of gynaecology ＆ obstetrics in the Second Xiangya Hospital of Central South University, totally 120 cases of perimenopausal or postmenopausal women were included. Uniform questionnaire was used. The patients were divided into two groups according to the evaluation of perimenopausal symptoms by improved Kupermann scoring method, Kupermann score≥ 17 points （group A, 53 cases） and Kupermann score〈17 points （group B, 67 cases）. The perimenopausal symptoms were analyzed. The general information, incidence of symptoms, menstrual history and treatment were compared between group A and group B. Statistical analysis was used by t test, Z2 test and Fisher＇s exact test. Results 119 patients （99.2%, 119/120） showed symptoms of different degrees. The five most common symptoms successively were excitement （71.7%）, fatigue （68.3%）, insomnia （65.8%）, sweat and hot flash （64.2%） and ache of bone, joint and muscle （62.5%）. There was no significant difference on the age, place of residence, marital status , level of education and high blood pressure, diabetes, uterine fibroids and ovarian surgery history between the two groups （all P 〉 0.05）. The incidence of various symptoms in group A were higher than that in group B （all P 〈 0.05）. Moreover, the menarche age, the proportion of delayed rnenarche age and the proportion of irregular menstruation in reproductive stage in group A were higher than that in group B （all P 〈 0.05）. Menarche age and Kupermann scores were positive correlated （r=0.224, P = 0.007）. Among the 120 patients, 39 cases （32.5%） were receiving hormone replacement therapy （HRT）, 39.6% among group A and 26.9% among group B （P 〉 0.05）. 78 cases （65.0%） knowed of HRT, 56.6% among group A and 71.6% among group B （P 〉 0.05）. Conclusions The women with delayed menarche or irregular menstruation period have severe symptoms that should be paid more attention and taken active treatment. Some of the women in Changsha know of HRT, but relevant health education should be carried out.