月经改变对卵巢功能衰退过程的提示作用

论文编号:HL209 论文字数:11786,页数:23

论文题目：月经改变对卵巢功能衰退过程的提示作用
摘　要
 研究目的
 探讨月经参数(包括LMC、经期长度和经量)及其改变对卵巢功能衰退过程的提示作用。
 研究方法
 符合条件的研究对象在入组时完成基线问卷调查和基线检查，于12个月+15天内完成随诊问卷调查和检查。一般人口学资料、月经史和疾病史、个人史、家族史；月经周期第3．6天的血清FSH和E2水平；月经周期第3-9天进行经阴道盆腔超声检查，取卵巢最大平面的横径(d)和纵径(D)径线，根据公式：Dxdxrd4计算卵巢最大截面积；LMC>60天者，在任意天进行检查；有关基线调查问卷内容的变化情况；血清FSH和E2水平以及盆腔超声检查，检查时间与基线相同。
 研究结果
 (1) 研究对象共记录3596个月经周期，平均每人记录11.24.3.9个。平均LMC(按周期)为(33.09±23.74天，中位数为28天)；
 (2) 共记录3919个经期，平均经期长度为4.704±2.09天(中位数为4天)，平均经为28.214±61.73分(中位数为14分)；月经量>40分的有642个经期(16.4％)随诊一年内经期长度和经量无明显改变。基线FSH水平(14.96±15.31IU／L)低于随诊时(19.78±21.14IU／L，p<0.01)；基线E2水平(73.67±75.83 pg／mL)虽高于随诊时(68.46±76.29pg／mL)，但无统计学差异(p=0.06)；基线右卵巢最大截面积大于随诊时(基线：3.51±1.19 cm2；随诊：3.30±1.28 cm2，n=279，P<0.01)。
 研究结论
 月经周期长度(按例)在40-42岁组最短，变化最小；此后随年龄增长月经周期长度及其平均SD逐渐增加。经期和经量的变化没有显示出随年龄变化的趋势。不同FSH水平的月经周期长度及其变化不同，经期和经量则无此差异。月经周期长度及其平均SD可以作为卵巢功能衰退的提示指标；经期和经量虽不能全面反应卵巢功能的衰退，但能反应卵巢功能衰退的某个阶段。
 
关键词: 卵巢功能衰退，月经周期长度,平均SD
论文类型：前瞻性队列研究
Title: The Study on the Influential Factors and Nursing of BehaviorDisorders of Nephrotic Syndrome Children
ABSTRACT
Objective
 To analyze the relationship between the changes of menstruation(1ength of menstrual cycle and it’s veribility，length of mens and it’s veribility，menstrual blood loss and veribility)and the process of ovary aging．
 1．To describe the changes of menstruation、with age increasing．
 2．To describe the changes of menstruation with FSH increasing．
 3．To choose a veribale of the changes of menstruation that can describe ovary aging used in clinics．
Methods
 We analysis data of the baseline investigation and 1 2 monthsa：1 5 clays follow up．377 women aged 30—54 years who lived Bering community attended our survey by the purposive sample method．We conducted the survey by face-to-face interview with the questionnaire．The items of the queStionnaire are detailed as follow：the basic conditions (such as age，career,education,income，etc)，illness medical history，sex hormone treatment history，menstruation condition．1 2 months-a：1 5 days later these women were investigated again for changes of the above situations and re-measured the indexes below．
 Serum E2：Using the electrochemiluminescenc；
 Serum FSH：Using the electrochemiluminescenc；
 The biggest section proportion of ovary(BSPO).
Results
 (1) Totally recorded menstrual cycles are 3596 with average lengths as 33．09±23．74 days (median 28 days).
 (2) The recorded mens are 391 9 totally，、^ritll average lengths as 4．70±2．09 days(median 4 days)．The percentage of regular menstrual cycle at baseline is 22．6％(73)，and no menstrual cycle longer than 1 80 days．At the 12th month,the percentage of regular menstrual cycle is l 7．3％(56)，and the menstrual cycle of 1 5 women(4．6％)>180 clays，8 women(2．5％)‘s menstrual cycle>365．FSH level at baseline(14．96±1 5．3 1 IU／L，median 8．74 IU／L) iS lower than follow up (19．78±21．14IU／L，median 9．86 IU／L)．E2 at baseline(73．67±75．83 pg／ml，median 52．20 pg／rrd)is higher than follow up(68．46±76．29pg／ml，median 45．90 pg／m1)．The right BSPO at baseline(3．49±1．20 cm2，median 3．34 cm2)is larger than follow up(3．27±1．28cm2，3．07 cm2)．
Conclusion
 The length of menstrual cycle Was shortest in 40-42 years grou pwith lowes variability．The variability of menstrual cycle Was prolonged with the increase of age．The length of menstrual flow and its variability,the amount of menstrual loss and its variability did not show the trends、with age．The length and the variability of menstrual cycle could reflect the different levels of FSH．，nle length and the variability of menstrual cycle are the indicators of ovary aging·．
Key words：Ovary aging，Menstruation，Variability
 

目  录
 
 摘　要 I
ABSTRACT III
目  录 IV
1 绪论 2
1.1 背景及意义 2
1.2目的及目标 2
1.3关键词及定义 1
1.3.1卵巢功能衰退 1
1.3.2 月经周期长度 1
1.3.3卵巢最大截面积 1
1.4 文献回顾 1
1.4.1 女性月经周期的临床意义 1
1.4.2卵巢功能衰退机制 1
1.4.3 卵巢功能的衰退的研究进展 2
2 研究设计 4
2.1研究设计 4
2.2研究对象 4
2.3研究工具 4
2.4研究步骤 5
2.5统计分析 5
3 研究结果 6
3．1基线及随诊月经情况 6
3．2基线和随诊时FSH、E2水平和卵巢大小的分布情况 7
3.3 不同年龄LMC 8
4 讨论 11
4．1研究资料的可靠性分析 11
4．2不同年龄LMC、经期长度和经量的特点 11
4．3随诊FSH平均水平的分布 11
4．4小结 12
5 推论及建议 13
致    谢 14
 参考文献 15