原发性闭经的病因：泰国295例病例报告
Causes of primary amenorrhea: a report of 295 cases in Thailand.
作者信息
Tanmahasamut Prasong, Rattanachaiyanont Manee, Dangrat Chongdee, Indhavivadhana Suchada, Angsuwattana Surasak, Techatraisak Kitirat
机构信息
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
J Obstet Gynaecol Res. 2012 Jan;38(1):297-301. doi: 10.1111/j.1447-0756.2011.01677.x. Epub 2011 Nov 9.
AIMS
The aim of this study was to determine the prevalence of etiologic causes of primary amenorrhea in Thailand.
METHODS
A retrospective study was performed using 295 complete medical records of women with primary amenorrhea who attended the Gynecologic Endocrinology Clinic, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand from September 1992 to February 2009.
RESULTS
The three most common causes of primary amenorrhea were Müllerian agenesis (39.7%), gonadal dysgenesis (35.3%), and hypogonadotropic hypogonadism (9.2%). Amongst 88 cases of gonadal dysgenesis, 59 cases (67.0%) incurred abnormal karyotype including 45X (n=21), mosaic (n=31), and others (n=7).
CONCLUSIONS
The present study has currently been the largest case series of primary amenorrhea. Müllerian agenesis is the most prevalent cause in our study, while gonadal dysgenesis is the most common cause in the largest-scale study in the USA. Hence, racial, genetic and environmental factors could play roles in the cause of primary amenorrhea.
目的
本研究旨在确定泰国原发性闭经的病因患病率。
方法
采用回顾性研究方法，分析了1992年9月至2009年2月期间在泰国玛希隆大学诗里拉吉医院妇产科妇科内分泌门诊就诊的295例原发性闭经女性的完整病历。
结果
原发性闭经最常见的三个原因是苗勒管发育不全（39.7%）、性腺发育不全（35.3%）和低促性腺激素性性腺功能减退（9.2%）。在88例性腺发育不全病例中，59例（67.0%）存在染色体核型异常，包括45,X（n = 21）、嵌合体（n = 31）和其他类型（n = 7）。
结论
本研究是目前关于原发性闭经最大的病例系列研究。苗勒管发育不全是我们研究中最常见的病因，而性腺发育不全是美国规模最大的研究中最常见的病因。因此，种族、遗传和环境因素可能在原发性闭经的病因中起作用。
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