Sociodemographic and Clinical Aspects of Climacteric Syndrome of Menopause in the City of Kati in Mali Involving 113 Women

Objective: This paper aims to study the sociodemographic and clinical aspects of menopausal climacteric syndrome in the city of Kati in Mali. Patients and Methods: This was a quantitative descriptive and cross-sectional study, conducted in the city of Kati from February 1 to July 31, 2021. We included 112 menopausal women. Women were selected from a household survey using the sampling step. We were interested in conjugal, family and professional life, self-esteem and the state of health of women in general. Results: More than half of the women in our study were already postmenopausal (52.2%);the mean age was 50.5 years with the extremes ranging from 41 to 62 years. The majority of them were married (69.9%), housewives (43.4%) and Bambara (53.1%). The most common climacteric syndromes were: joint pain (65.5%), hot flashes (62.8%) and night sweats (56.6%). Genital-urinary syndromes (42.5%) were dominated by decreased libido (41.7%), urinary disorder (23%) and vaginal dryness (14.6%). Genitalia-urinary syndromes increased the frequency of disagreements;Pearson’s Chi-square = 33.63;ddl = 1;P = 0.001. There was a statistically significant relationship between night sweat, genital-urinary syndromes, joint pain, and increased disease frequency with, respectively: Pearson’s chi-square = 4.660;ddl = 1;P = 0.031;Fisher’s exact test, P = 0.001, Pearson’s Chi-square = 8.434;ddl = 1;P = 0.004. There was no statistically significant relationship between climacteric syndrome and family life, work life and self-esteem. Changes in the professional relationship between women and their co-workers included, respectively: arguments (50%);disagreements (25%) and disobedience (25%). Conclusion: Menopause deteriorates the quality of life of women who suffer in silence, hence the need to pay special attention to them.

Acupuncture Treatment of Menopausal Syndrome

Case HistoryMs. Li, aged 51 years, a staff member from a certain university in Beijing, paid her first visit on Feb. 17,2003, with the chief complaint of irregular menstrual cycle for more than 2 years. The patient complained that in the recent two years, she had shortened menstrual cycle, sometimes only with a 10-day interval between each two cycles, and each menstrual period lasting 3-10 days. The menstrual blood was profuse and fresh-red in color, accompanied with such symptoms as feverish sensation in the face,uncontrollable irritability and peevishness, poor sleep,excitation, difficulty in falling asleep. She also sometimes had vexation, palpitation, dizziness,forgetfulness, lumbar soreness, dry throat and thirst,dry stool, and yellow urine. She had been diagnosed by western medicine to have menopausal syndrome,and treated with western medicine accordingly with little effect.

CLINICAL ANALYSIS TO 74 CASES OF MENOPAUSAL SYNDROME TREATED WITH SIMPLE FIRE NEEDLE

In this paper,simple fire needle pricking the points of Du（Governor）and Ren（Conception）meridians was employed to treat 74 cases of menopausal syndrome.The result showedthat 41 cases were clinically cured,17 markedly improved,15 improved and 1 ineffective,with thetotal effective rate 87％.With the advantages of extensive materials used,simple manipulation andlarge variety of indications,this method is worthy to be popularized.

Effect of self prescription for nourishing liver and kidney combined with tibolone on hormone levels, lipid metabolism and immune response in women with menopausal syndrome

Objective:To study the effect of self prescription for nourishing liver and kidney combined with tibolone on hormone levels, lipid metabolism and immune response in women with menopausal syndrome.Methods: Patients with menopausal syndrome who were admitted in Hebei Weichang County Hospital between April 2014 and March 2017 were selected as the research subjects and randomly divided into to the combined group who accepted self prescription for nourishing liver and kidney combined with tibolone therapy and the control group who accepted tibolone monotherapy. The serum levels of sex hormones, lipid metabolism and immune cytokines were detected before treatment and3 months after treatment.Results: 3 months after treatment, serum E2, HDL-C, Omentin-1, VaspinC, IL-4 and IL-10 levels of both groups of patients were significantly higher than those before treatment while LH, FSH, TC, TG, LDL-C, Rsistin, IFN-γ and IL-2 levels were significantly lower than those before treatment, E2, LH and FSH levels were not significantly different between the two groups, serum TC, TG, LDL-C, Rsistin, IFN-γ and IL-2 levels of combined group were significantly lower than those of control group while HDL-C, Omentin-1, VaspinC, IL-4 and IL-10 levels were significantly higher than those of control group.Conclusion: Self prescription for nourishing liver and kidney combined with tibolone is equivalent to tibolone monotherapy in regulating the sex hormones, and more significant than tibolone monotherapy in improving the lipid metabolism and immune response in patients with menopausal syndrome.

Menopausal Status and Metabolic Syndrome in Women in Climacteric Period Treated at a Clinic in Southern Brazil

Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.

300 CASES OF MENOPAUSAL SYNDROME TREATED BY ACUPUNCTURE

Caused by hypo-ovarianism, menopausal syndrome usually occurs in women aged from 45-55 years. With high incidence and various symptoms, the disease often severely jeopardize the health of the women. The authors had treated 300 cases of menopausal syndrome by acupuncture and obtained a good result.

Management of genitourinary syndrome of menopause in breast cancer survivors:An update

There is increasing attention about managing the adverse effects of adjuvant therapy(Chemotherapy and anti-estrogen treatment)for breast cancer survivors(BCSs).Vulvovaginal atrophy(VVA),caused by decreased levels of circulating estrogen to urogenital receptors,is commonly experienced by this patients.Women receiving antiestrogen therapy,specifically aromatase inhibitors,often suffer from vaginal dryness,itching,irritation,dyspareunia,and dysuria,collectively known as genitourinary syndrome of menopause(GSM),that it can in turn lead to pain,discomfort,impairment of sexual function and negatively impact on multiple domains of quality of life(QoL).The worsening of QoL in these patients due to GSM symptoms can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly.The diagnosis of VVA is confirmed through patient-reported symptoms and gynecological examination of external structures,introitus,and vaginal mucosa.Systemic estrogen treatment is contraindicated in BCSs.In these patients,GSM may be prevented,reduced and managed in most cases but this requires early recognition and appropriate treatment,but it is normally undertreated by oncologists because of fear of cancer recurrence,specifically when considering treatment with vaginal estrogen therapy(VET)because of unknown levels of systemic absorption of estradiol.Lifestyle modifications and nonhormonal treatments(vaginal moisturizers,lubricants,and gels)are the first-line treatment for GSM both in healthy women as BCSs,but when these are not effective for symptom relief,other options can be considered,such as VET,ospemifene,local androgens,intravaginal dehydroepiandrosterone(prasterone),or laser therapy(erbium or CO2 Laser).The present data suggest that these therapies are effective for VVA in BCSs;however,safety remains controversial and a there is a major concern with all of these treatments.We review current evidence for various nonpharmacologic and pharmacologic therapeutic modalities for GSM in BCSs and highlight the substantial gaps in the evidence for safe and effective therapies and the need for future research.We include recommendations for an approach to the management of GSM in women at high risk for breast cancer,women with estrogen-receptor positive breast cancers,women with triplenegative breast cancers,and women with metastatic disease.

Solid State Vaginal Laser for the Treatment of Genitourinary Syndrome of Menopause: A Preliminary Report

Background: Genitourinary syndrome of menopause (GSM) is the new term for vulvovaginal atrophy (VVA). The condition is relevant in more than 50% of women, having an adverse impact on quality of life and sexual relationships. Objective: To assess the efficacy and safety of a new type of non-ablative laser, Solid State Vaginal Laser (SSVL), for vaginal tissue regeneration and rejuvenation. Method: Eighty participants with GSM symptoms were treated with a total of 4 treatments in about two months (every 15 - 20 days) of a non-ablative SSVL (LASEmaR 1500TM-EUFOTON). A cumulative intensity of GSM symptoms using a 10-cm VAS (dryness and/or burning and/or dyspareunia), the vaginal health index (VHI), the Female Sexual Function Index (FSFI) were evaluated. Urinary Incontinence Short Form (ICIQ-UI SF) and vaginal bioptic samples were also collected. Results: Improvement following the SSVL was observed on VHIS, VVA symptoms and sexual female function. This finding was also ratified by the improvement of vaginal histological features. After the SSVL treatment, almost all patients (91%) affected by urinary incontinence obtained the complete remission of symptoms. Conclusion: The objective evaluation of VHIS, FSFI and ICIQ-UI SF scores and the histological results indicates a real favorable effect of SSVL on GSM and on urinary incontinence.

Sleep Disorders in Menopause: Review of the Literature and Occurrence through Menopausal Stages

We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical evaluation. Our data reveal high occurrence of sleep disorders in this group of women if compared to literature data about general population, in the absence of statistically significant differences among the three menopausal stages: we find only a trend toward a higher risk of OSAS (Obstructive Sleep Apnea Syndrome) in PM versus early PM and MT. However, none of women in our survey underwent PSG (polysomnography), essential to confirm the diagnosis of OSAS and none was diagnosed with RLS (Restless Legs Syndrome) (prior to our survey) by the Gynecologist or General Pratictioner: these data reveal the issue of too low attention towards sleep disorders in this contest. Generic “sleep complaints” are clearly associated with depressed mood and worse-quality life along the menopausal process. In our sample, a non-specific definition of insomnia shows a peculiar relationship with a mood disorder: it is only variable not associated with higher BDI and KI scores, in fact. This might suggest that the conditions linked to depression of these women could be more specific sleep disturbances, such as RLS and OSAS.

Body Composition and Metabolic Risk Factors in Postmenopausal Women: Effects of a Dietary Weight Loss Program

Epidemiological studies showed an association between menopause, weight gain and risk factors that identify the metabolic syndrome (MS). We evaluated body composition and metabolic risk factors in postmenopausal women addressed to a center for the assessment of nutritional status to lose weight by hypocaloric balanced diet. 161 postmenopausal women were enrolled. MS diagnosis was made applying IDF (International Diabetes Foundation) criteria. After the prescription of hypocaloric diet all subjects were controlled every 2 months. In patients suffering from MS (MS+) at the first visit, diagnosis of MS was reassessed when 10% weight loss was achieved. 70 women were MS+. Years since menopause, low instruction level, obesity and Visceral Adipose Tissue (VAT) were each associated with MS. Particularly, BMI ≥ 30 Kg/m2 (OR: 2.61;95% CI, 1.76 - 3.46) and VAT > 6.6 cm (OR: 3.49;95% CI, 2.52 - 4.46) resulted independent risk factors. The 30% of the whole sample dropped out, the reminders significantly reduced weight, waist circumference (Wc) and Fat Mass (p 0.01). The 35% of MS+ women achieved the 10% weight loss with significant reduction of VAT, Wc, fasting glucose, tryglicerides, blood pressure and resolution of MS in the 78% of them. The 43.5% of postmenopausal women addressed in one center for the assessment of nutritional status to follow a weight-loss nutritional program had the MS;visceral obesity was the strongest independent risk factor and hypocaloric balanced diet resulted a good strategy to lose weight and treat MS.

Discussion on the mechanism of TCM treatment of climacteric syndrome based on TCM inheritance assistance system and network pharmacology

Background:To explore the law of traditional Chinese medicine in the treatment of climacteric syndrome,and to study the potential mechanism of traditional Chinese medicine therapy.Methods:For the relevant prescriptions collected from Chinese Journal Full-text Database,Wanfang medical network,PubMed and EMBASE were transferred to the traditional Chinese medicine inheritance assistant system(TCMISSV2.5)to conduct the nucleocentric drug group analysis.In this study,we used BATMAN-TCM(http://bionet.ncpsb.org/batman-tcm/)online analysis tool to analyze Therapeutic Target Database disease enrichment and Kyoto Gene and Genome Encyclopedia(KEGG)pathway enrichment,and Cytoscape(3.7.1)software was used to construct disease-target and KEGG pathway-target networks for visualization.Results:Among the 103 prescriptions,3 pairs of core drug combinations and 9 new prescriptions were selected by data mining.In the KEGG pathway of Zhimu(Anemarrhenae rhizoma)and Huangbo(Phellodendri Chinensis cortex),the most potential targets were found in the neural active ligand receptor interaction pathway.Conclusion:The compatibility of Anemarrhenae rhizoma and Phellodendri Chinensis cortex may play a role in the treatment of nervous system symptoms in patients with climacteric syndrome by interfering the neuroactive ligand receptor interaction signaling pathway.

坤宝丸治疗更年期综合征临床疗效和安全性Meta分析

目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件对纳入研究进行Meta分析。结果共纳入13项研究,涉及1590例更年期综合征患者,其中观察组803例,对照组787例。按对照组的用药种类进行亚组分析,坤宝丸单用组的临床疗效显著高于氟桂利嗪+谷维素+维生素B1组[RR=1.75,95%CI(1.38,2.22),P<0.00001],坤宝丸联用组临床疗效显著高于戊酸雌二醇+甲羟孕酮组[RR=1.18,95%CI(1.03,1.34),P=0.01]和刺五加组[RR=1.20,95%CI(1.08,1.33),P=0.0007];坤宝丸单用组对更年期临床症状调查表(Kupperman)评分显著低于替勃龙组[MD=-6.00,95%CI(-7.72,-4.28),P<0.00001];坤宝丸联用组卵泡刺激素(FSH)显著低于刺五加组[MD=-25.70,95%CI(-33.22,-18.18),P<0.00001];坤宝丸联用组促黄体素(LH)显著低于刺五加组[MD=-11.20,95%CI(-12.05,-10.35),P<0.00001];坤宝丸单用组雌二醇(E2)显著高于替勃龙组[MD=-7.00,95%CI(-11.44,-2.56),P=0.002]。药品不良反应主要为腹胀、便秘、头晕、阴道出血、体质量增加等,患者均能耐受。结论坤宝丸对更年期综合征患者的临床疗效、Kupperman评分、激素指标等的改善效果与激素类药物相当,甚至更优。但由于纳入研究的质量不高,尚需更严格、高质量的临床研究进一步证实。

绝经综合征焦虑状态中西医治疗研究进展

绝经综合征焦虑状态是围绝经期妇女常见的症状之一,是指妇女在绝经前后出现除烘热汗出、倦怠乏力等生理症状以外的心理精神症状,表现为焦虑烦躁、抑郁寡欢、记忆力减退等,严重影响女性的身心健康。治疗上,目前对绝经综合征焦虑状态的西医治疗多为激素补充疗法和抗焦虑药物治疗,但激素类药物长期服用的不良作用争议大,存在发生乳腺癌、肝肾功能损伤、血栓的风险,抗焦虑药物会引起神情淡漠、神经麻痹等副作用。中医治疗方法多样,以整体观念及辨证论治等思想为准则,灵活运用中药及中医传统疗法治疗,安全且疗效稳定。

正念减压疗法对改善女性更年期综合征生活质量及负性情绪的效果

目的研究分析正念减压疗法对改善女性更年期综合征生活质量及负性情绪的效果。方法选择2020年1月—2022年6月在梅州市第三人民医院接受治疗的100例女性更年期综合征伴负性情绪患者为研究对象,并按照随机数字表法分为对照组(n=50)与观察组(n=50)。两组均接受抗抑郁药治疗,观察组在此基础上给予正念减压疗法。比较两组干预前后负性情绪、激素水平、女性绝经期自测量表评分及生活质量。结果干预后,观察组焦虑自评量表及汉密尔顿抑郁量表评分均低于对照组,组间差异有统计学意义(P<0.05);干预后,观察组5-羟色胺、雌二醇水平高于对照组,女性绝经期自测量表评分低于对照组,组间差异有统计学意义(P<0.05);观察组干预后生活质量评分高于对照组,组间差异有统计学意义(P<0.05)。结论正念减压疗法可改善女性更年期综合征负性情绪及激素水平,缓解患者临床症状,提高生活质量。

Assessment of the Clinical Effect of Chinese Medicine Therapy Combined with Psychological Intervention for Treatment of Patients of Peri-menopausal Syndrome Complicated with Hyperlipidemia

Objective：To observe the effect of Chinese medicine therapy combined with psychological intervention（combined therapy） on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia.Methods：With the use of a randomizing digital table method,185 patients that fit the registration standard were randomly assigned to three groups.The 59 cases in Group A were treated with two Chinese patents,Kunbao Pill（坤宝丸） and Modified Xiaoyao Pill（加味逍遥丸）;the 63 in Group B received psychological intervention alone;and the 63 in Group C were treated with both（the combined therapy）,with the treatment course for all six months.The items of observation included： （1） scoring by SCL-90 on eight factors and seven symptoms;（2） scoring on Chinese medicine symptoms by Kupermann scale,including anxiety and bad temper,scorching sense ation with sweating,dizziness,tinnitus, soreness and weakness of the loin and knees,palpitation,insomnia,lassitude,weakness,and hyposexuality; （3） blood contents of total cholesterol（TC）,triglyceride（TG）,high-density lipoprotein cholesterol（HDL-C）, low-density lipoprotein cholesterol（LDL-C）,apoprotein Al（ApoAl） and B（ApoB）;（4） levels of sex hormones, including estradiol（E_2）,progesterone（P）,pituitary prolactin（PRL）,follicular stimulating hormone（FSH）,and luteinzing hormone（LH） in some randomly selected patients;（5） adverse reaction;and（6） one-year follow-up study on long-term effect.Results：A total of 21 patients（6,8,and 7 cases in Groups A,B,and C,respectively） dropped out;the drop-out rate was insignificant among groups.（1） The markedly effective rates in Group A, B,and C were 26.42%（14/53）,18.18%（10/55）,and 53.57%（30/56）,respectively,and the total effective rates in them were 64.15%（34/53）,50.91%（28/55）,and 87.50%（49/56）,respectively,suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B（P〈0.01）.（2） SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C（P〈0.01）,but remained unchanged in Groups A and B（P〉0.05）.（3） Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms,except that menstrual disorder and amenorrhea were unchanged in all three groups（P〉0.05）.（4） Levels of HDL-C,ApoAl,and E_2 increased and those of TG,TC,LDL-C,ApoB,FSH,and LH decreased after treatment in Group C,reaching near normal levels;similar trends of blood lipids were shown in Group A,but the level of sex hormones was unchanged.In Group B all the above-mentioned indices were unchanged（P〉0.05）.（5） A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively（P〈0.01）.（6） No adverse reaction was found.Conclusion：Chinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms,but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.

全国名中医尤昭玲基于“以胞宫为中心的五脏一体观”诊治绝经前后诸证

绝经前后诸证对应西医学围绝经期综合征,或多种因素致卵巢功能衰竭而出现围绝经期综合征临床表现的患者。全国名中医尤昭玲基于《黄帝内经》“五脏一体观”,提出“以胞宫为中心的五脏一体观”,认为“五脏失调”为绝经前后诸证的主要病机,以“调和五脏”为治则,创制经验方更年方。以胞宫为中心,顺应胞宫藏泻有序的特点,绝经前分经期、排卵前、排卵后辨证施以耳穴辅助治疗,绝经后顺应胞宫藏而不泻的生理特性,辅以耳穴静养阴阳。分年龄配合药膳养巢煲或养生安神煲,临证中收获佳效。

中医药治疗围绝经期综合征文献可视化分析

目的基于文献计量学方法对中医药治围绝经期综合征(MPS)相关文献进行分析,探索中医药治疗MPS的研究现状、前沿热点与发展趋势。方法以中国知网(CNKI)为文献数据来源,检索2000-2020年中医药治疗围绝经期综合征的相关文献,利用CiteSpace6.1.R3软件,对发文量、作者、机构、关键词等绘制相关知识图谱并分析。结果最终纳入文献1623篇,共有618位作者,以李瑛、傅萍、卢苏等为代表;研究机构共计550家,以南京中医药大学、北京中医药大学、山东中医药大学等为代表;关键词共计429个,高频关键词有中医疗法、二仙汤、辨证论治,聚类图谱显示研究主要包括围绝经期综合征中医药治疗与临床疗效研究,突现词分析可知研究焦点集中于临床疗效、研究进展。结论中医药在治疗MPS的领域上逐步地发展与完善,失眠症、抑郁症与性激素是其研究热点,辨证论治与针灸是其研究趋势,还需加强作者、团队之间合作联系,以形成广泛联系的合作网络。

郭志强教授基于“脾肾互赞”理论论治绝经综合征经验

中医妇科学者普遍认为绝经综合征核心病机在于肾阴虚,而郭志强教授总结临床经验后发现患者肾阴阳俱虚者多见,且脾胃不足者亦不少。故提出临证须注重脾肾同治,以“脾肾互赞”为理论依托,着重健补脾胃,发挥脾肾相赞功能,在补益精血、温补阳气、安神定志等重要治疗方向上发挥疗效。本文总结了郭志强教授基于“脾肾互赞”理论论治绝经综合征的经验。

单核细胞计数/高密度脂蛋白胆固醇及促甲状腺激素对绝经期女性急性冠脉综合征患者预测价值及与冠状动脉病变相关性研究

背景既往研究发现单核细胞计数、高密度脂蛋白胆固醇(HDL-C)、促甲状腺激素(TSH)与急性冠脉综合征(ACS)相关,然而单核细胞计数/高密度脂蛋白胆固醇(MHR)与ACS发病的相关性研究较少,绝经期女性MHR、TSH与ACS发病是否存在关联仍不明确。目的探讨MHR、TSH对绝经期女性ACS患者发病的预测价值,并研究上述指标与患者冠状动脉狭窄程度的相关性。方法选择2020—2021年在苏北人民医院心血管内科住院诊治并行冠状动脉造影的325例绝经期女性作为研究对象。通过电子病历系统收集患者一般资料,研究对象入院后采集静脉血检测单核细胞计数、总胆固醇(TC)、三酰甘油(TG)、HDL-C、低密度脂蛋白胆固醇(LDL-C)、TSH等。以双平面Simpson法测量左心室射血分数(LVEF),通过冠状动脉造影术观察冠状动脉病变情况。采用Gensini评分标准统一衡量冠状动脉病变情况。符合ACS诊断标准的患者为ACS组(n=184),非ACS者为对照组(n=141)。同时依据Gensini评分三分位数将ACS组进行分组:≤36.5分为低危亚组(n=59),36.6~66.5分为中危亚组(n=64),>66.5分为高危亚组(n=61)。采用单因素及多因素Logistic回归分析探究ACS的影响因素。绘制受试者工作特征(ROC)曲线评估TSH、MHR及联合检测对ACS的诊断价值并计算ROC曲线下面积(AUC)。采用Spearman秩相关分析探究TSH、MHR及联合检测指标与Gensini积分的相关性。结果ACS组与对照组患者基线资料结果示,ACS组BMI、吸烟比例、高血压、糖尿病、LDL-C、单核细胞计数、TSH、MHR高于对照组,LVEF、HDL-C低于对照组(P<0.05)。多因素Logistic回归分析结果示,吸烟、高血压、BMI≥24.0 kg/m^(2)、LDL-C≥3.30 mmol/L、TSH≥2.1m U/L、MHR≥0.25是绝经期女性发生ACS的危险因素,HDL-C≥1.2 mmol/L为保护因素(P<0.05)。ROC曲线结果显示,MHR、TSH及联合预测指标诊断绝经期女性ACS的AUC分别为0.777(95%CI=0.725~0.830,P<0.001)、0.747(95%CI=0.694~0.800,P<0.001)、0.810(95%CI=0.764~0.857,P<0.001)。中危亚组、高危亚组MHR、TSH均高于低危亚组,高危亚组MHR、TSH高于中危亚组(P<0.05)。Spearman秩相关分析结果示,ACS组患者MHR(r_(s)=0.497,P<0.01)、TSH(r_(s)=0.498,P<0.01)及联合预测指标与Gensini评分均呈正相关(r_(s)=0.600,P<0.001)。结论TSH及MHR升高是绝经期女性发生ACS的独立危险因素,两指标及联合对病情预测具有较高的灵敏度和特异度,并与患者冠状动脉病变程度相关,对绝经期女性ACS的早期识别及风险评估具有一定的临床应用价值。

维生素E对围绝经期和绝经后妇女健康的影响

随着年龄的增长,卵巢功能由旺盛期到逐渐减退,直至衰竭,女性也将从生殖期逐渐进入老年期。这不仅会对月经周期和生育能力有影响,还会伴随着一系列身体和心理上的变化,严重时会影响生活和工作。研究发现卵巢卵泡的发育以及绝经前后出现的泌尿生殖功能异常、骨质疏松、神经认知功能障碍及心血管病变等疾病的发生发展可能与氧化应激反应有着密不可分的关系。维生素E具有抗氧化特性和稳定细胞的能力,已经被证实可在代谢综合征、骨质疏松、心脑血管、神经系统等疾病的预防和治疗方面发挥着重要作用,并且发现维生素E在一定程度上还具有模拟雌激素的作用。因此,补充维生素E对围绝经期和绝经后妇女的健康具有潜在的益处。综述维生素E对围绝经期卵巢卵泡发育、雌激素的影响和绝经综合征的预防和治疗作用,为维生素E作为改善围绝经期和绝经后妇女身心健康的辅助或替代治疗方案提供参考依据。