探讨尿毒症患者血液透析前后月经变化及其临床意义

To investigate the menstrual changes and clinical significance of uremic patients before and after hemodialysis

目的探讨尿毒症患者血液透析前后月经变化及其临床意义。方法选取66例尿毒症患者,根据治疗方法不同将其分为对照组与研究组,每组33例。对照组实施常规保守治疗,研究组实施血液透析治疗。另选取同期本院体检的35例健康女性为正常组。检测并比较三组治疗前后性激素水平,并观察对照组与研究组患者月经情况。结果治疗前,研究组与对照组卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))、孕酮(P)及催乳素(PRL)水平比较,差异无统计学意义(P>0.05),研究组FSH、LH、PRL水平均高于正常组,E_(2),P水平低于正常组,差异有统计学意义(P<0.05);治疗后,研究组与对照组FSH水平明显低于治疗前,LH、P、PRL水平均明显高于治疗前,且研究组与对照组FSH、LH、PRL水平均高于正常组,E_(2)、P水平低于正常组,差异有统计学意义(P<0.05)。研究组月经紊乱率27.27%明显低于对照组54.55%,月经正常率63.64%高于对照组36.36%,差异有统计学意义(P<0.05),两组闭经率、闭经后复潮率比较,差异无统计学意义(P>0.05)。结论尿毒症患者采用血液透析治疗对其性激素水平影响较小,但可改善患者月经,同时需结合营养干预,尽可能减少月经紊乱情况发生。

Objective To explore the menstrual changes and clinical significance of uremic patients before and after hemodialysis.Methods 66 uremia patients were divided into control group and research group according to the treatment method,33 cases in each group.The control group was treated with routine conservative treatment,and the study group was treated with hemodialysis.In addition,35 healthy women who underwent physical examination in our hospital in the same period were selected as the normal group.The levels of sex hormones in the three groups before and after treatment were detected and compared,and the menstruation of patients in the control group and the study group were observed.Results Before treatment,there were no significant differences in FSH,LH,Estradiol(E_(2)),progesterone(P)and prolactin(PRL)levels between the study group and the control group(P>0.05).The levels of FSH,LH and PRL in the study group were higher than those in the normal group,while the levels of E_(2)and P were lower than those in the normal group.The difference was statistically significant(P<0.05).After treatment,the levels of FSH in study group and control group were significantly lower than before treatment,while the levels of LH,P and PRL were significantly higher than before treatment.The levels of FSH,LH and PRL in study group and control group were higher than normal group,while the levels of E_(2) and P were lower than normal group,the differences were statistically significant(P<0.05).The menstrual disorder rate of 27.27% in the study group was significantly lower than that in the control group,and the normal rate of 63.64% was significantly higher than that in the control group,36.36%,with statistical significance(P<0.05).There was no statistical significance in the amenorrhea rate and post-amenorrhea retide rate between the two groups(P>0.05).Conclusion Hemodialysis has little eflFect on the level of sex hormone in uremic patients,but it can improve their menstruation.At the same time,it needs to be combined with nutritional intervention to reduce the occurrence of menstrual disorder as much as possible.