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询问患者的青少年病史可以识别与深部浸润性内异症相关的标志物。

Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis.

机构信息

Faculté de Médecine, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Universitaire Ouest, Centre Hospitalier, Paris, France.

出版信息

Fertil Steril. 2011 Mar 1;95(3):877-81. doi: 10.1016/j.fertnstert.2010.10.027. Epub 2010 Nov 11.

Abstract

OBJECTIVE

To investigate whether the clinical history, particularly of the adolescence period, contains markers of deeply infiltrating endometriosis (DIE).

DESIGN

Cross-sectional study.

SETTING

Universitary tertiary referral center.

PATIENT(S): Two hundred twenty-nine patients operated on for endometriosis. Endometriotic lesions were histologically confirmed as non-DIE (superficial peritoneal endometriosis and/or ovarian endometriomas) (n = 131) or DIE (n = 98).

INTERVENTION(S): Surgical excision of endometriotic lesions with pathological analysis of each specimens.

MAIN OUTCOME MEASURE(S): Epidemiological data, pelvic pain scores, family history of endometriosis, absenteeism from school during menstruation, oral contraceptive (OC) pill use.

RESULT(S): Patients with DIE had significantly more positive family history of endometriosis (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2-8.8) and more absenteeism from school during menstruation (OR = 1.7; 95% CI: 1-3). The OC pill use for treating severe primary dysmenorrhea was more frequent in patients with DIE (OR = 4.5; 95% CI: 1.9-10.4). Duration of OC pill use for severe primary dysmenorrhea was longer in patients with DIE (8.4 ± 4.7 years vs. 5.1 ± 3.8 years). There was a higher incidence of OC pill use for severe primary dysmenorrhea before 18 years of age in patients with DIE (OR = 4.2; 95% CI: 1.8-10.0).

CONCLUSION(S): The knowledge of adolescent period history can identify markers that are associated with DIE in patients undergoing surgery for endometriosis.

摘要

目的

探讨临床病史,特别是青春期病史,是否包含深部浸润性子宫内膜异位症(DIE)的标志物。

设计

横断面研究。

地点

大学附属医院。

患者

229 例因子宫内膜异位症而行手术治疗的患者。通过组织病理学分析,将子宫内膜异位症病灶分为非 DIE(腹膜表面子宫内膜异位症和/或卵巢子宫内膜异位囊肿)(n=131)或 DIE(n=98)。

干预

切除子宫内膜异位症病灶,并对每个标本进行病理分析。

主要观察指标

流行病学数据、盆腔疼痛评分、子宫内膜异位症家族史、经期缺课、口服避孕药(OC)使用情况。

结果

DIE 患者的子宫内膜异位症家族史阳性率显著更高(比值比[OR] = 3.2;95%置信区间[CI]:1.2-8.8),经期缺课率也更高(OR = 1.7;95% CI:1-3)。为治疗严重原发性痛经而使用 OC 避孕药的患者中,DIE 患者更为常见(OR = 4.5;95% CI:1.9-10.4)。DIE 患者因严重原发性痛经而使用 OC 避孕药的时间更长(8.4±4.7 年 vs. 5.1±3.8 年)。在 18 岁之前,为治疗严重原发性痛经而使用 OC 避孕药的患者中,DIE 患者的发生率更高(OR = 4.2;95% CI:1.8-10.0)。

结论

了解青春期病史可以识别出与行子宫内膜异位症手术的患者的 DIE 相关的标志物。

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