Hafizi Leili, Mirfeizi Zahra, Razmjoo Nastaran, Keshvari Maliheh, Jabbari Atefeh, Ashraf Hami, Yousefi Fatemeh
Department of Obstetrics and Gynecology, Women Health Research Center, Imam Reza Hospital, Faculty of Medicine.
Department of Rheumatology, Women Health Research Center, Imam Reza Hospital, Faculty of Medicine.
J Pak Med Assoc. 2013 Sep;63(9):1152-6.
To determine whether joint hypermobility is associated with pelvic organ prolapse.
The case-control study was conducted from January to April 2011 and comprised 30 women with pelvic organ prolapse, stage > or = II and 30 controls with stages 0 and I with similar age and parity. They were recruited from the gynaecology clinic at Imam Reza Hospital in Mashhad, Iran. The condition was evaluated by a quantification system and, for the purposes of this study, pelvic organ prolapse was defined as stage > or = II. All the subjects were examined in the dorsal lithotomic position with an empty bladder. A separate investigator evaluated each subject for joint hypermobility by using Beighton score which was calculated by doing five simple manoeuvres. SPSS 11.5 was used for data analysis.
The mean age of the 30 cases was 35.40 +/- 6.39 years, while for the controls it was 35.36 +/- 5.9 years. Overall clinical joint hypermobility was found in 24 of the 60 (40%) subjects. There were no significant difference in the prevalence of joint hypermobility between the two groups. The prevalence of hypermobility in the cases was 36.7% (n = 11) versus 43.3% (n=13) in the controls (p = 0.59). The prevalence of cystocele in subjects with joint hypermobility was 41.7% (n = 10) versus 38.9% (n=14), (p < 0.83); rectocele 33.3% (n = 8) versus 41.7% ( n =15), (p < 0.73) women with normal joint mobility. No Significant differences were found between the groups with regard to other markers of connective tissue weakness such as the presence of varicose veins (p < 0.37), easy bruising ( p < 0.43) and observed striae ( p < 0.42).
Joint hypermobility was not associated with pelvic organ prolapse in the study population. Further studies involving more patients with pelvic organ prolapse are recommended.
确定关节活动过度是否与盆腔器官脱垂相关。
病例对照研究于2011年1月至4月进行，包括30例盆腔器官脱垂（分期≥II期）的女性和30例年龄及产次相似的0期和I期对照者。她们来自伊朗马什哈德伊玛目礼萨医院的妇科门诊。通过量化系统对病情进行评估，在本研究中，盆腔器官脱垂定义为分期≥II期。所有受试者均在膀胱排空的情况下取膀胱截石位接受检查。由一名独立的研究者使用Beighton评分对每位受试者的关节活动过度情况进行评估，该评分通过五项简单动作计算得出。使用SPSS 11.5进行数据分析。
30例病例的平均年龄为35.40±6.39岁，而对照组的平均年龄为35.36±5.9岁。60名受试者中有24名（40%）存在总体临床关节活动过度。两组之间关节活动过度的患病率无显著差异。病例组关节活动过度的患病率为36.7%（n = 11），对照组为43.3%（n = 13）（p = 0.59）。关节活动过度的受试者中膀胱膨出的患病率为41.7%（n = 10），而关节活动正常的女性中为38.9%（n = 14），（p < 0.83）；直肠膨出分别为33.3%（n = 8）和41.7%（n = 15），（p < 0.73）。在两组之间，关于其他结缔组织薄弱指标，如是否存在静脉曲张（p < 0.37）、易出现瘀斑（p < 0.43）和观察到的萎缩纹（p < 0.42），未发现显著差异。
在本研究人群中，关节活动过度与盆腔器官脱垂无关。建议开展涉及更多盆腔器官脱垂患者的进一步研究。
