子宫内膜息肉发病相关危险因素临床分析
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摘要
目的分析子宫内膜息肉(EP)发病的相关危险因素。方法选取2016年1月1日～2018年1月1日在我院妇科就诊行宫腔镜检查及病理组织学确诊为子宫内膜息肉患者456例为观察组,病理提示子宫内膜未见明显异常的102例作为对照组,记录两组患者的年龄、体质指数(BMI)、腰围(WC)、异常出血情况、子宫内膜厚度、是否绝经,有无高血压、糖尿病、子宫肌瘤、子宫腺肌症、宫颈息肉、多囊卵巢综合征,用SPSS统计软件进行单因素及多因素Logistic回归分析。结果子宫内膜息肉发病年龄集中在30～49岁,占56.36%,主要临床症状是异常子宫出血,占60.96%,经单因素分析结果发现,与EP发病有关的影响因素包括糖尿病、肥胖、胰岛素抵抗、多囊卵巢综合征、子宫腺肌症及宫颈息肉(P<0.05),而高血压、高脂血症、子宫肌瘤无明显关系(P>0.05)。Logistic回归分析显示绝经、胰岛素抵抗及子宫腺肌症是EP发生的危险因素。结论绝经、子宫腺肌症及胰岛素抵抗是EP发病的危险因素,而对于有异常子宫出血、子宫颈息肉、肥胖、糖尿病、多囊卵巢综合征患者也存在EP高发的可能,在临床中应加强对此类人群的筛查。
Objective To analyze the risk factors associated with the onset of endometrial polyps(EP). Methods From January 1 st, 2016 to January1 st, 20 th, 2016, 456 cases of endometrial polyps diagnosed by hysteroscopy and pathological histology in our hospital were observed. The pathology showed no obvious abnormalities in the endometrium. Of the 102 patients, the age, body mass index(BMI), waist circumference(WC), abnormal bleeding, endometrial thickness, menopause, hypertension, diabetes, uterine fibroids, uterine gland were recorded. Muscular disease, cervical polyps,and polycystic ovary syndrome were analyzed by SPSS statistical software for single factor and multivariate logistic regression analysis. Results The age of endometrial polyps was concentrated in 30-49 years old, accounting for 56.36%. The main clinical symptoms were abnormal uterine bleeding,accounting for 60.96%. The results of single factor analysis showed that the factors related to the incidence of EP included diabetes, obesity and insulin. Resistance, polycystic ovary syndrome, adenomyosis and cervical polyps(P <0.05), but there was no significant relationship between hypertension, hyperlipidemia and uterine fibroids(P>0.05). Logistic regression analysis showed that menopause, insulin resistance and adenomyosis were risk factors for EP.Conclusion Menopause, adenomyosis and insulin resistance are risk factors for EP. For patients with abnormal uterine bleeding, cervical polyps, obesity, diabetes and polycystic ovary syndrome, there is a possibility of high EP, which should be strengthened screening for such people in the clinic.
Objective To analyze the risk factors associated with the onset of endometrial polyps(EP). Methods From January 1 st, 2016 to January1 st, 20 th, 2016, 456 cases of endometrial polyps diagnosed by hysteroscopy and pathological histology in our hospital were observed. The pathology showed no obvious abnormalities in the endometrium. Of the 102 patients, the age, body mass index(BMI), waist circumference(WC), abnormal bleeding, endometrial thickness, menopause, hypertension, diabetes, uterine fibroids, uterine gland were recorded. Muscular disease, cervical polyps,and polycystic ovary syndrome were analyzed by SPSS statistical software for single factor and multivariate logistic regression analysis. Results The age of endometrial polyps was concentrated in 30-49 years old, accounting for 56.36%. The main clinical symptoms were abnormal uterine bleeding,accounting for 60.96%. The results of single factor analysis showed that the factors related to the incidence of EP included diabetes, obesity and insulin. Resistance, polycystic ovary syndrome, adenomyosis and cervical polyps(P <0.05), but there was no significant relationship between hypertension, hyperlipidemia and uterine fibroids(P>0.05). Logistic regression analysis showed that menopause, insulin resistance and adenomyosis were risk factors for EP.Conclusion Menopause, adenomyosis and insulin resistance are risk factors for EP. For patients with abnormal uterine bleeding, cervical polyps, obesity, diabetes and polycystic ovary syndrome, there is a possibility of high EP, which should be strengthened screening for such people in the clinic.
引文
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[13]杨冬梓,赵晓苗.多囊卵巢综合征的多学科干预和长期管理[J].中华妇产科杂志,2015,50(11):810-813.
[2]胡小美.子宫内膜息肉的诊治进展[J].国际妇产科学杂志,2015,42(1):42-44,48.
[3]覃晓.子宫内膜息肉诊治进展[J].广西医科大学学报,2015,32(6):1022-1024.
[4]Matthews DR,Hosker JP,Rudenski AS,et al.Homeostasis model as-sessment:insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man[J].Diabetologia,1985,28(7):412-419.
[5]律欢欢.子宫内膜息肉患者的胰岛素抵抗状态及其发病危险因素分析[D].郑州大学,2017.
[6]中华医学会妇产科学分会内分泌学组及指南专家组.多囊卵巢综合征中国诊疗指南[J].中华妇产科杂志,2018,53(1):2-6.
[7]魻zkan NT,Tokmak A,Güzel A,et al.The association between endometrial polyps and metabolic syndrome:A case-control study[J]. Aust N Z J Obstet Gynaecol,2015,55(3):274-278.
[8]张宁.子宫内膜息肉发病相关高危因素的临床调查分析[J].深圳中西医结合杂志,2016,26(6):103-104.
[9]黄丽华,向梅.子宫内膜息肉研究新进展[J].国际妇产科学杂志,2014,41(1):43-45.
[10]王群,吴步初,龙雯晴.子宫内膜息肉的发病相关高危因素分析[J].现代妇产科进展,2015,7(24):490-492.
[11]Esra S,Ebru C,Selcuk S,et al.Is there a relationship between endometrial polyps and obesity, diabetes mellitus,hypertention[J].Arch Gynecol Obstet,2014,290(5):937-941.
[12]刘子瑜,张洁清,莫哲伦.胰岛素抵抗与子宫内膜癌发生相关性研究[J].中国实用妇科与产科杂志,2014,39(9):706-709.
[13]杨冬梓,赵晓苗.多囊卵巢综合征的多学科干预和长期管理[J].中华妇产科杂志,2015,50(11):810-813.