Farquhar C M, Lethaby A, Sowter M, Verry J, Baranyai J
Department of Obstetrics and Gynecology, School of Medicine, University of Auckland, New Zealand.
Am J Obstet Gynecol. 1999 Sep;181(3):525-9. doi: 10.1016/s0002-9378(99)70487-4.
We sought to determine the clinical risk factors for endometrial hyperplasia in premenopausal women with abnormal bleeding.
A laboratory database was searched to identify all endometrial samples taken in 1033 premenopausal women over a 30-month period from January 1995 to July 1997. Clinical data were extracted from the patients' clinical records retrospectively, and univariate and multivariate analyses were performed. The setting was the gynecologic service of a large teaching hospital.
There were 46 cases of endometrial hyperplasia and 5 cases of endometrial cancer diagnosed. The following factors were independently associated with increased risk of endometrial hyperplasia or the presence of carcinoma: age >/=45 years (odds ratio, 3.1; 95% confidence interval, 1.5-6.1), weight >/=90 kg (odds ratio, 5.5; 95% confidence interval, 2.9-10.6), history of infertility (odds ratio, 3.6; 95% confidence interval, 1.3-9.9), family history of colonic carcinoma (odds ratio, 5.0; 95% confidence interval, 1.3-19.1), and nulliparity (odds ratio, 2.8; 95% confidence interval, 1.1-7.2). There was no increased association of endometrial hyperplasia on the basis of irregularity of menstrual cycle or duration of menstrual bleeding.
The following are risk factors for endometrial hyperplasia in premenopausal women with abnormal menstrual bleeding: body weight >/=90 kg, age >/=45 years, infertility, family history of colonic carcinoma, and nulliparity. Current guidelines may need to be reconsidered.
我们试图确定绝经前异常子宫出血女性发生子宫内膜增生的临床危险因素。
检索实验室数据库，以识别1995年1月至1997年7月这30个月期间1033名绝经前女性所采集的所有子宫内膜样本。回顾性地从患者临床记录中提取临床数据，并进行单因素和多因素分析。研究地点为一家大型教学医院的妇科门诊。
诊断出46例子宫内膜增生和5例子宫内膜癌。以下因素与子宫内膜增生或癌的风险增加独立相关：年龄≥45岁（比值比，3.1；95%置信区间，1.5 - 6.1），体重≥90千克（比值比，5.5；95%置信区间，2.9 - 10.6），不孕史（比值比，3.6；95%置信区间，1.3 - 9.9），结肠癌家族史（比值比，5.0；95%置信区间，1.3 - 19.1），以及未生育（比值比，2.8；95%置信区间，1.1 - 7.2）。基于月经周期不规律或月经出血持续时间，子宫内膜增生的相关性并未增加。
绝经前月经异常出血女性发生子宫内膜增生的危险因素如下：体重≥90千克、年龄≥45岁、不孕、结肠癌家族史以及未生育。可能需要重新考虑当前的指南。
