子宫内膜息肉患者临床特征及发病相关危险因素分析

Clinical characteristics and risk factors analysis of endometrial polyps in patients

目的分析子宫内膜息肉患者临床特征及发病相关危险因素。方法回顾性选择2018年1月至2023年3月滁州市中西医结合医院收治的120例子宫内膜息肉患者作为观察组,其中绝经前组82例、绝经期组38例;另选同期接受宫腔镜及病理检查的100例非子宫内膜息肉患者作为对照组。比较绝经前组与绝经期组患者的年龄、体重指数、孕次、产次、高血压发生率、糖尿病发生率、异常子宫出血发生率、息肉形态特点(单发、多发)、病理特点。采用单因素及多因素Logistic回归分析分析子宫内膜息肉的相关危险因素。结果绝经期组患者的年龄、体重指数、高血压发生率、糖尿病发生率分别为(60.42±19.53)岁、(25.13±2.46)kg/m^(2)、39.47%、13.16%,均大于绝经前组[(36.08±11.71)岁、(23.87±2.05)kg/m^(2)、4.88%、3.66%],异常子宫出血发生率、多发息肉占比分别为44.74%、44.74%,均小于绝经前组(62.20%、73.17%),差异均有统计学意义(P<0.05)。绝经期组患者的单纯子宫内膜息肉占比为71.05%,低于绝经前组(86.59%),子宫内膜非典型腺肌瘤型息肉占比、伴子宫内膜非典型增生占比分别为5.26%、10.53%,均高于绝经前组(0、1.22%),差异均有统计学意义(P<0.05)。观察组的年龄、高血压发生率、糖尿病发生率、绝经发生率和子宫腺肌症发生率分别为(50.07±15.89)岁、15.83%、6.67%、31.67%、23.33%,均高于对照组[(42.35±13.82)岁、4.00%、2.00%、10.00%、11.00%],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,年龄、子宫腺肌症均是子宫内膜息肉的独立危险因素(P<0.05)。结论绝经前子宫内膜息肉患者易发生异常子宫出血,以多发息肉为主,绝经期子宫内膜息肉以单发为主,患者无明显临床症状,恶性倾向更大,而年龄及子宫腺肌症均是此病的独立危险因素,值得临床予以重视。

Objective To analyze the clinical characteristics and risk factors of endometrial polyps in patients.Methods A total of 120 patients with endometrial polyps admitted to Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to March 2023 were retrospectively selected as the observation group,including 82 cases in premenopausal group and 38 cases in menopausal group.A total of 100 patients with non-endometrial polyps who underwent hysteroscopy and pathological examination during the same period were selected as the control group.The age,body mass index,gestational time,delivery time,incidence of hypertension,diabetes,incidence of abnormal uterine bleeding,morphological characteristics of polyps(single and multiple)and pathological characteristics of the patients with endometrial polyps were compared between the former and the postmenopausal patients.Univariate and multivariate Logistic regression were used to analyze the risk factors related to endometrial polyps.Results The age,body mass index,incidence of hypertension,and incidence of diabetes in the menopausal group were(60.42±19.53)years old,(25.13±2.46)kg/m^(2),39.47%,and 13.16%,respectively,which were higher than those in the premenopausal group[(36.08±11.71)years old,(23.87±2.05)kg/m^(2),4.88%,and 3.66%],and the incidence of abnormal uterine bleeding and multiple polyps were 44.74%,44.74%,respectively,which were lower than those in the premenopausal group(62.20%,73.17%),the differences were statistically significant(P<0.05).The proportion of simple endometrial polyps was 71.05%in the menopausal group,which was lower than that in premenopausal group(86.59%),and the proportion of endometrial atypical adenomyoma polyps and endometrial atypical hyperplasia in menopausal group were 5.26%,10.53%,which were higher than that in the premenopausal group(0,1.22%),the differences were statistically significant(P<0.05).The age,incidence of hypertension,incidence of diabetes,incidence of menopause and incidence of adenomyosis in the observation group were(50.07±15.89)years old,15.83%,6.67%,31.67%and 23.33%,respectively,which were higher than those in the control group[(42.35±13.82)years old,4.00%,2.00%,10.00%and 11.00%],and the differences were statistically significant(P<0.05).Multiple Logistic regression analysis showed that age and adenomyosis were independent risk factors for endometrial polyps(P<0.05).Conclusion Premenopausal patients with endometrial polyps are prone to abnormal uterine bleeding,mainly multiple polyps,while menopausal patients with endometrial polyps are mainly single,no obvious clinical symptoms,more malignant tendency,and age and adenomyosis are independent risk factors of this disease,worthy of clinical attention.