绝经后子宫内膜增厚与子宫内膜病变的相关性研究

Study on the correlation between endometrial thickening and endometrial lesions in postmenopausal women

目的分析绝经后子宫内膜增厚与子宫内膜病变的相关性,探讨发生子宫内膜病变的高危因素。方法将122例绝经后且子宫内膜厚度超过5mm的患者按有、无阴道出血(PMB)分成PMB组及无PMB组,对两组患者进行全面检查,包括子宫内膜活检与病理检查,对其各项资料、子宫内膜厚度及病理结果展开相关性分析。结果PMB组AH/EC例数占比高于无PMB组,但子宫内膜息肉例数占比低于无PMB组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果表明,PMB组发生子宫内膜恶性病变的独立危险因素为高血压及子宫内膜厚度10~15mm、≥15mm,无PMB组发生子宫内膜恶性病变的独立危险因素为子宫内膜厚度10~15mm、≥15mm。结论子宫内膜厚度≥10mm及高血压会大大提高AH/EC的患病风险,子宫内膜增厚且有PMB患者应及时展开全面检查排查病变,无PMB、子宫内膜增厚<10mm者且未合并其他高危因素时可行随访观察。

Objective To analyze the correlation between endometrial thickening and endometrial lesions in postmenopausal women,and to explore the risk factors of endometrial disease.Methods According to the presence or absence of postmenopausal bleeding(PMB),122 postmenopausal patients with endometrial thickness of more than 5 mm were divided into a PMB group and a non-PMB group.The two groups of patients were comprehensively examined,including endometrial biopsy and pathological examination,and the correlation analysis was carried out on various data,endometrial thickness and pathological results.Results The proportion of AH/EC cases in PMB group was higher than that in non-PMB group,but the proportion of endometrial polyps was lower than that in non-PMB group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the independent risk factors for endometrial malignant lesions in PMB group were hypertension and endometrial thickness of 10~15 mm and≥15 mm,while the independent risk factors for endometrial malignant lesions in non-PMB group were endometrial thickness of 10~15 mm and≥15 mm.Conclusion Endometrial thickness≥10 mm and hypertension can greatly increase the risk of AH/EC.Patients with endometrial thickening and PMB should conduct comprehensive examination and investigation in time.Patients without PMB,endometrial thickening<10 mm and no other high risk factors can be followed up.