Matalliotakis Ioannis M, Cakmak Hakan, Fragouli Yvoni G, Goumenou Anastasia G, Mahutte Neal G, Arici Aydin
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA.
Arch Gynecol Obstet. 2008 May;277(5):389-93. doi: 10.1007/s00404-007-0479-1. Epub 2007 Oct 9.
The association between demographic factors, menstrual and reproductive characteristics, and clinical profile for women with endometriosis was analyzed in a retrospective case-control study.
Over a 6-year period, 535 women with endometriosis and 200 infertile women without endometriosis, studied by laparoscopy or laparotomy, were evaluated. Information was then collected in a uniform manner from the patients' medical records. Statistical methods included chi(2) and Mann-Whitney U test.
The factors associated with an increased risk for endometriosis include lower body weight, alcohol use (chi(2) = 8.8; P < 0.003), early menarche (chi(2) = 5.08; P < 0.024), shorter cycle length (chi(2) = 13.06; P < 0.001), and heavier menstrual cycles. Pelvic pain was present in 79.1% of women with endometriosis, dysmenorrhea in 70.2%, and dyspareunia in 49.5%. These symptoms were statistically significantly higher in comparison with the infertile women without endometriosis (P < 0.001). Moreover, we found that women with endometriosis had fewer prior pregnancies, elective abortions and ectopic pregnancies compared to women seeking care for infertility, who did not have endometriosis. Interestingly, women with endometriosis were significantly more likely to report a family history of cancer compared to women in control group (chi(2) = 78.2; P < 0.001).
Body habitus, personal habits and menstrual characteristics are all strongly associated with the development of endometriosis. There may also be an association between family history of cancer and the development of endometriosis.
在一项回顾性病例对照研究中分析子宫内膜异位症女性的人口统计学因素、月经和生殖特征与临床概况之间的关联。
在6年期间，对535例经腹腔镜检查或剖腹手术研究的子宫内膜异位症女性和200例无子宫内膜异位症的不孕女性进行了评估。然后以统一方式从患者病历中收集信息。统计方法包括卡方检验和曼-惠特尼U检验。
与子宫内膜异位症风险增加相关的因素包括体重较低、饮酒（卡方值=8.8；P<0.003）、初潮早（卡方值=5.08；P<0.024）、月经周期较短（卡方值=13.06；P<0.001）以及月经量较多。79.1%的子宫内膜异位症女性存在盆腔疼痛，70.2%有痛经，49.5%有性交困难。与无子宫内膜异位症的不孕女性相比，这些症状在统计学上显著更高（P<0.001）。此外，我们发现与无子宫内膜异位症的不孕女性相比，子宫内膜异位症女性既往怀孕、人工流产和异位妊娠的次数较少。有趣的是，与对照组女性相比，子宫内膜异位症女性报告有癌症家族史的可能性显著更高（卡方值=78.2；P<0.001）。
身体状况、个人习惯和月经特征均与子宫内膜异位症的发生密切相关。癌症家族史与子宫内膜异位症的发生之间可能也存在关联。
