女性外阴硬化性苔藓发病临床相关高危因素分析

Analysis of clinical risk factors for female vulvar sclerosing lichen

目的探讨女性外阴硬化性苔藓(VLS)的临床发病相关高危因素。方法选取确诊为VLS患者104例和外阴发育正常女性100例,对2组对象年龄、身体质量指数(BMI)、文化程度、生活工作压力、饮食习惯、外阴清洁习惯、初潮年龄、初次性生活年龄、孕产次,是否反复生殖泌尿系感染,是否罹患自身免疫病、高血压、糖尿病,是否有激素替代治疗史、外阴疾病家族史、是否HPV感染等调查进行对比分析,探讨影响VLS发病的高危因素。结果104例VLS患者与100例外阴发育正常女性对比分析结果显示,在BMI、绝经年龄、初次性生活年龄、避孕方式、产次、应用不同内裤洗涤剂、反复生殖泌尿系感染、合并自身免疫病及家族史等方面差异有统计学意义(P<0.05);在年龄、初潮年龄、孕次、吸烟、饮酒、饮食辛辣、喜食发物、外阴清洁频率、内裤材质、文化程度、工作生活压力,是否合并高血压、糖尿病,是否有激素替代治疗史等方面差异无统计学意义(P>0.05);VLS影响因素的logistic回归分析结果显示,绝经年龄、产次、反复生殖泌尿系感染及合并自身免疫病是VLS发病的独立危险因素。结论BMI、初次性生活年龄、避孕方式、应用不同内裤洗涤剂及家族史与VLS发病具有相关性;绝经年龄早、产次多、反复生殖泌尿系感染及合并自身免疫病是VLS的发生独立危险因素。

Objective To investigate the clinical risk factors of female vulvar sclerosing lichen(VLS).Methods 104 VLS patients and 100 non-VLS female patients were selected,and their age,body mass index(BMI),education level,life and work stress,diet habits,vulva cleaning habits,age of menmene,age of first sexual life,time of pregnancy,whether they had recurrent genito-urinary infection,whether they had autoimmune diseases,hypertension and diabetes were investigated.The history of hormone replacement therapy,the family history of vulvar disease and HPV infection were all compared and analyzed.Results There were statistically significant differences in BMI,age of menopause,age of first sexual life,contraceptive method,birth time,application of different underwear detergent,repeated genito-urinary system infection,combined autoimmune disease and family history between the two groups(P<0.05).There were no significant differences in age,age of menarche,pregnancy,smoking,drinking,spicy diet,food and hair,vulva cleaning frequency,underwear material,education level,work and life pressure,hypertension,diabetes,and hormone replacement therapy history between the two groups(P>0.05).Logistic regression analysis of VLS influencing factors showed that age of menopause,birth time,recurrent genitourinary infection and combined autoimmune disease were independent risk factors for VLS.Conclusion BMI,age at first sexual intercourse,contraceptive methods,use of different under wear detergents,and family history are correlated with the onset of VLS;Early menopause,multiple births,recurrent genitourinary infection and autoimmune disease are related to the occurrence of VLS.