女性不明原因的肿胀症状（特发性水肿）是常见多症状综合征的一个组成部分。

Dunnigan M G, Henderson J B, Hole D, Pelosi A J

University Department of Human Nutrition, Glasgow Royal Infirmary, UK.

QJM. 2004 Nov;97(11):755-64. doi: 10.1093/qjmed/hch126.

BACKGROUND

Non-menstrually-related swelling symptoms (idiopathic oedema) are common in women. The community prevalence of such symptoms, their association with other symptoms, and their underlying aetiology, are uncertain.

AIM

To determine the community prevalence of swelling symptoms and the independent contributions of major risk factors.

DESIGN

Comparison of major risk factors in women with and without swelling symptoms.

METHODS

We assessed 196 women attending a menopause clinic, 201 women attending a fracture clinic and 201 women attending their general practitioner. Each documented family histories of swelling symptoms and diabetes mellitus, age, height and current weight. Women attending the menopause and fracture clinics also completed Visual Analogue Symptom (VAS) scales documenting the perceived severity of swelling symptoms, and of 20 affective, somatic and functional autonomic symptoms. The independent contributions of risk factors to swelling symptom risk were estimated by logistic regression analysis.

RESULTS

Of those attending a fracture clinic or their general practitioner, 28% and 33%, respectively, experienced non-menstrually-related swelling symptoms in the month before interview. Severe (RR 43, 95%CI 16-112, p < 0.001) and moderate (RR 7.8, 95%CI 4-15, p < 0.001) affective symptoms, a family history of swelling symptoms (RR 4.5, 95%CI 2.3-8.8, p < 0.001) and a body mass index (BMI) >or=25 kg/m(2) (RR 4.8, 95%CI 2.5-8.9, p < 0.001) were significantly associated with the presence of mild to severe swelling symptoms (VAS 1-9). The prevalence of swelling symptoms increased from 8% in women with no risk factors to 100% in women with three risk factors, which included severe affective symptoms.

DISCUSSION

Affective symptom severity provides the principal independent contribution to swelling symptom risk. BMI >or=25 and a family history of swelling symptoms provide smaller independent contributions. The nature of the mechanisms underlying these associations remains uncertain.

背景

与月经无关的肿胀症状（特发性水肿）在女性中很常见。此类症状在社区中的患病率、与其他症状的关联及其潜在病因尚不确定。

目的

确定社区中肿胀症状的患病率以及主要危险因素的独立影响。

设计

比较有和没有肿胀症状的女性的主要危险因素。

方法

我们评估了196名前往更年期诊所就诊的女性、201名前往骨折诊所就诊的女性以及201名前往全科医生处就诊的女性。每位女性都记录了肿胀症状和糖尿病的家族史、年龄、身高和当前体重。前往更年期和骨折诊所就诊的女性还完成了视觉模拟症状（VAS）量表，记录肿胀症状以及20种情感、躯体和功能性自主神经症状的感知严重程度。通过逻辑回归分析估计危险因素对肿胀症状风险的独立影响。

结果

在前往骨折诊所或全科医生处就诊的女性中，分别有28%和33%在访谈前一个月出现了与月经无关的肿胀症状。严重（相对风险43，95%置信区间16 - 112，p < 0.001）和中度（相对风险7.8，95%置信区间4 - 15，p < 0.001）情感症状、肿胀症状家族史（相对风险4.5，95%置信区间2.3 - 8.8，p < 0.001）以及体重指数（BMI）≥25 kg/m²（相对风险4.8，95%置信区间2.5 - 8.9，p < 0.001）与轻度至重度肿胀症状（VAS 1 - 9）的存在显著相关。肿胀症状的患病率从无危险因素的女性中的8%增加到有包括严重情感症状在内的三个危险因素的女性中的100%。