Marana R, Muzii L, Caruana P, Dell'Acqua S, Mancuso S
Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy.
Acta Eur Fertil. 1991 Jul-Aug;22(4):209-12.
Two-hundred-and-six patients newly diagnosed to have endometriosis at laparoscopy were evaluated in order to see if endometriosis-associated symptoms are proportional to the extent of the disease, as assessed using the Revised American Fertility Society Classification, and if the extent worsens with age. At hospital admission 81% of the patients complained of dysmenorrhea, 54% of chronic pelvic pain and 27% of dyspareunia. At laparoscopy, 39% of the patients had stage I endometriosis, 13% stage II, 35% stage III and 13% stage IV. At statistical analysis, no significant differences were found in total endometriosis scores, in active scores or in adhesion scores in different age groups. Although a difference in prevalence rate for dysmenorrhea and dyspareunia stage I versus III was found, a trend of increasing severity of symptoms with more widespread disease was not evident. There was not a significant difference in prevalence rate of symptoms for different aspects of endometriosis (implants, cysts or adhesions). Our data show that the American Fertility Society classification does not reflect the intensity of endometriosis-associated symptoms, probably underestimating the most active forms of this disease, and does not allow to follow a possible natural progression of the disease.
对206例经腹腔镜检查新诊断为子宫内膜异位症的患者进行了评估，以确定子宫内膜异位症相关症状是否与疾病程度成正比（采用修订后的美国生育协会分类法评估），以及疾病程度是否随年龄增长而加重。入院时，81%的患者主诉痛经，54%主诉慢性盆腔疼痛，27%主诉性交困难。腹腔镜检查时，39%的患者为Ⅰ期子宫内膜异位症，13%为Ⅱ期，35%为Ⅲ期，13%为Ⅳ期。经统计学分析，不同年龄组在子宫内膜异位症总分、活动评分或粘连评分方面未发现显著差异。虽然发现Ⅰ期与Ⅲ期痛经和性交困难的患病率存在差异，但随着疾病范围扩大症状严重程度增加的趋势并不明显。子宫内膜异位症不同方面（植入物、囊肿或粘连）的症状患病率没有显著差异。我们的数据表明，美国生育协会分类法不能反映子宫内膜异位症相关症状的强度，可能低估了该疾病最活跃的形式，也无法追踪疾病可能的自然进展情况。
