育龄女性月经稀少发病因素的流行病学调查研究
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摘要
目的:探讨育龄女性月经稀少的危险因素并针对其危险因素提出防治措施。
方法:采用成组病例—对照研究的临床流行病学方法,对297例月经稀少病人和306例对照人群进行回顾性调查。调查受试者的一般情况、月经婚育史、生活方式、职业与生活有害因素、既往史。问卷的分析和统计采用单因素及多因素的非条件Logistic回归分析。
结果:单因素Logistic回归分析结果显示,有18个因素与月经稀少有关联。多因素Logistic回归分析结果显示,11个因素被选入方程,其中OR＞1的有9个,人工流产(OR为52.103)、避孕药(OR为35.752)、减肥(OR为30.247),情志不畅(OR为12.301)、脑力劳动(OR为10.238)、环境污染(OR为5.689)、被动吸烟(OR为5.534)、睡眠质量差(OR为2.493)、幼年胃肠道疾病(OR为2.002);OR＜1的有2个,食豆制品(OR为0.403)、食绿叶蔬菜(OR为0.558)。
结论:人工流产,避孕药,减肥,情志不畅,脑力劳动,环境污染,被动吸烟,睡眠质量差,幼年胃肠道疾病可能是月经稀少发生的危险因素,与本病的发生有一定的联系。食豆制品和绿叶蔬菜可能是本病的保护因素,有利于预防本病的发生。
Objective:To explore the risk factors for infrequent menstruation and provide protective measures for it.
Method:A case-control study was undertaken in 297 infrequent menstruation patients with 306 controls without infrequent menstruation by using questionnaire.Questionnaire includes general information、history of menstruation、marriage and beating、lifestyle、harmful factors of life and profession.Available data were analysed by single and multiple factor Logistic regression analysis.
Result:18 factors were identified to be related to infrequent menstruation when single factor Logistic regression analysis.11 factors in multiple Logistic regression model were:more than 3 times of artificial abortion(OR=52.103),take oral contraceptive(OR=35.752),lose weight(OR=30.247),hard feelings(OR=12.301),mental work(OR=10.238),environmental pollution(OR=5.689),passive smoking(OR=5.534), lack of quality sleep(OR=2.493),disorders of the gastrointestinal tract in young stage(OR=2.002).And eat soybean frequently(OR=0.403),take vegetabl frequently (OR=0.558)
Conclusion:The risk factor include more than 3 times of artificial abortion,take oral contraceptive,lose weight,hard feelings,mental work,smoke pollution,passive smoking,lack of quality sleep,disorders of the gastrointestinal tract in young stage.
方法:采用成组病例—对照研究的临床流行病学方法,对297例月经稀少病人和306例对照人群进行回顾性调查。调查受试者的一般情况、月经婚育史、生活方式、职业与生活有害因素、既往史。问卷的分析和统计采用单因素及多因素的非条件Logistic回归分析。
结果:单因素Logistic回归分析结果显示,有18个因素与月经稀少有关联。多因素Logistic回归分析结果显示,11个因素被选入方程,其中OR＞1的有9个,人工流产(OR为52.103)、避孕药(OR为35.752)、减肥(OR为30.247),情志不畅(OR为12.301)、脑力劳动(OR为10.238)、环境污染(OR为5.689)、被动吸烟(OR为5.534)、睡眠质量差(OR为2.493)、幼年胃肠道疾病(OR为2.002);OR＜1的有2个,食豆制品(OR为0.403)、食绿叶蔬菜(OR为0.558)。
结论:人工流产,避孕药,减肥,情志不畅,脑力劳动,环境污染,被动吸烟,睡眠质量差,幼年胃肠道疾病可能是月经稀少发生的危险因素,与本病的发生有一定的联系。食豆制品和绿叶蔬菜可能是本病的保护因素,有利于预防本病的发生。
Objective:To explore the risk factors for infrequent menstruation and provide protective measures for it.
Method:A case-control study was undertaken in 297 infrequent menstruation patients with 306 controls without infrequent menstruation by using questionnaire.Questionnaire includes general information、history of menstruation、marriage and beating、lifestyle、harmful factors of life and profession.Available data were analysed by single and multiple factor Logistic regression analysis.
Result:18 factors were identified to be related to infrequent menstruation when single factor Logistic regression analysis.11 factors in multiple Logistic regression model were:more than 3 times of artificial abortion(OR=52.103),take oral contraceptive(OR=35.752),lose weight(OR=30.247),hard feelings(OR=12.301),mental work(OR=10.238),environmental pollution(OR=5.689),passive smoking(OR=5.534), lack of quality sleep(OR=2.493),disorders of the gastrointestinal tract in young stage(OR=2.002).And eat soybean frequently(OR=0.403),take vegetabl frequently (OR=0.558)
Conclusion:The risk factor include more than 3 times of artificial abortion,take oral contraceptive,lose weight,hard feelings,mental work,smoke pollution,passive smoking,lack of quality sleep,disorders of the gastrointestinal tract in young stage.
引文
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[26]Conway GS,Payne NN,Webb J,et aI.Fragile X premutation screening in women with premature ovarian failure[J].Hum Reprod,1998,13(5):1184-1187.
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[2]Nepomnaschy PA,Welch K,McConnell D,etal.Stress and female reproductive function:a study of daily variations in cortisol,gonadotrpphins,and gonadal steroids in a rural Mayan population.Am J Hum Biol,2004,16:523-532.
[3]Topalski-Fistes N,Bujas M,Maticki-Sekulic M,etal.Hyperprolactinemia and disorders of the menstrual cycle.Med Pregl,1999,52:156-161
[4]林守清.以人为本促进女性一生健康.中国实用妇科与产科杂志,2006,22(1):71-73.
[5]丁曼琳主编,妇产科疾病诊断与鉴别诊断.第二版,人民卫生出版社,2000,357,358.
[6]张玉珍.中医妇科学.中国中医药出版社,2003,72.87.
[7]张文彤.世界优秀统计工具SPSS11.0统计分析教材(高级篇).北京希望电子出版社,2002,92.
[8]王建华.流行病学.普通高等教育“十五”国家级规划教材.人民卫生出版社,2004,77.
[9]朱玲,罗颂平等.卵巢早衰的病因病机及其证治[J].中医药学刊,2003,21(1):143-145.
[10]顾美姣.现代妇产科学[M].北京人民军医出版,2002,1147.
[11]张晓英.三种口服避孕药对女大学生垂体-卵巢轴激素及体重、体脂的影响,中国运动医学杂志.2007,26(5):601-603.
[12]乐杰.妇产科学.人民卫生出版社.2002,427.
[13]曹泽毅.中华妇产科.人民卫生出版社.2005,2379.2146.
[14]Sherman RT,Thompson RA.The female athlete triad.School Nursing.2004;10(4):197-202.
[15]Longitudinal study of the inception of perimenopause in relation to lifetime history of sexual or physical violence Jenifer E Allsworth,Sally Zierler,Kate L Lapane,Nancy Krieger J.EpidemioI.Community Health 2004i58;938-943.
[16]Irene H.Monitor on stress physical load:risk factors,consequence and preventive action,Occup Environ Med.1998,55:73-83.
[17]保毓书.面向21世纪的我国妇女劳动卫生.中华劳动卫生职业病杂志,2001,19:81-82.
[18]陈和利.知识女性月经不调与精神因素关系调查.江西中医学院学报,2007,19(3),86-88.
[19]Matilaine T,Perez GI,Jurisicova A,et al.Aromatic hydrocarbon receptor-driven Bax gene expression is required for premature ovarian an failurecaused by biohazardous environmental chemicals[J].NatGenet,2001.28(4):355-360.
[20]Hoyer PB,Derine PJ,Hu X,et al.Ovarian toxicity of 4-vinylcyclohexene Diepoxide:a menchanistic model[J].Toxicol Pathol.2001,29(1):91-99.
[21]安笑兰主编.环境优生学[M].北京:北京医科大学、中国协和医科大学联合出版社,1995,32:473-481.
[22]Everson RB.Individual transplacental exposure to matemal smoking maybe at increased cancer risking adultlife[J].Lancet,1980,2:123.
[23]Magers T.Cigarette smoke inhalation effects the reproductive system of female hamstens[J].Reprod Toxicol.1995,9:513-525.
[24]WeissmanMM,GreenwaldS,Nio-MurciaG,etaI.The morbidity of insomnia uncomplicated by psychiautdc disorders.Gen Hosp Psych,1997,19:245-250.
[25]Russell P.The clinic pathological features premature ovarian failure[J].VerhDtsch GesPathol,1997,81:197.
[26]Conway GS,Payne NN,Webb J,et aI.Fragile X premutation screening in women with premature ovarian failure[J].Hum Reprod,1998,13(5):1184-1187.
[1]张玉珍.中医妇科学.中国中医药出版社,2002,72.87.
[2]罗元恺主编.中医妇科学.上海科学技术出版社,1990,40.
[3]赵列,高向慧,陈丽萍.王东梅治疗月经过少经验.湖北中医杂志,2004,26(4):15-16.
[4]杨鉴冰,崔晓萍,陈燕萍等.毓宫合剂治疗肾虚型月经稀少50例临床观察.陕西中医学院学报,2002,25(2):23-25.
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