影响绝经后女性子宫内膜厚度的因素。
Factors influencing endometrial thickness in postmenopausal women.
作者信息
Hebbar S, Chaya V, Rai L, Ramachandran A
机构信息
Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Udupi District, Karnataka, India.
出版信息
Ann Med Health Sci Res. 2014 Jul;4(4):608-14. doi: 10.4103/2141-9248.139340.
BACKGROUND
Cut-off values for endometrial thickness (ET) in asymptomatic postmenopausal woman have been standardized. However, there are no comprehensive studies to document how various factors can influence the ET after the age of menopause.
AIM
To study the various factors influencing the ET in postmenopausal women.
SUBJECTS AND METHODS
This was a prospective observational study. A total of 110 postmenopausal women underwent detailed history taking, clinical examination, and transvaginal scan for uterine volume and ovarian volume. The volumes were calculated by using ellipsoid formula: Width × thickness × height × 0.523. The variation in ET with respect to the influencing factors such as age, duration of menopause, parity, body mass index (BMI), medical illness like diabetes/hypertension, drugs like tamoxifen, presence of myoma, uterine volume, ovarian volume, and serum estradiol (in selected patients) were measured. Descriptive analysis was performed using SPSS software (version 16, Chicago II, USA) to obtain mean, standard deviation (SD), 95% confidence intervals (CIs) and inter quartile ranges. Comparison of means was carried out using analysis of variance.
RESULTS
The mean (SD) age of the patients was 55.4 (6.91) years (95% CI, 54.1, 56.7). The mean (SD) age at menopause was 47.95 (3.90) years (95% CI, 47.2, 48.7) and the mean (SD) duration of menopause was 7.27 (6.65) years (95% CI, 6.01, 8.53). The mean (SD) ET was 3.8 (2.3) mm (95% CI, 3.36, 4.23). Medical illness like diabetes and hypertension did not alter the ET. ET increased as BMI increased and it was statistically significant. The presence of myoma increased uterine volume significantly and was associated with thick endometrial stripe. Similarly, whenever the ovaries were visualized and as the ovarian volume increased, there was an increase in ET. When ET was > 4 mm (n = 37), they were offered endocel, of which 16 agreed to undergo the procedure. None were found to have endometrial cancer.
CONCLUSION
This study suggests that parity, BMI, presence of myoma, tamoxifen usage, uterine volume, ovarian volume and serum estradiol influence the ET in postmenopausal women.
背景
无症状绝经后女性子宫内膜厚度（ET）的截断值已标准化。然而，尚无全面研究记录绝经后多种因素如何影响ET。
目的
研究影响绝经后女性ET的各种因素。
对象与方法
这是一项前瞻性观察性研究。总共110名绝经后女性接受了详细的病史采集、临床检查以及经阴道超声检查子宫体积和卵巢体积。体积通过椭圆体公式计算：宽度×厚度×高度×0.523。测量ET随年龄、绝经持续时间、产次、体重指数（BMI）、糖尿病/高血压等疾病、他莫昔芬等药物、肌瘤的存在、子宫体积、卵巢体积以及血清雌二醇（部分患者）等影响因素的变化。使用SPSS软件（美国芝加哥II版16.0）进行描述性分析，以获得均值、标准差（SD）、95%置信区间（CI）和四分位数间距。采用方差分析进行均值比较。
结果
患者的平均（SD）年龄为55.4（6.91）岁（95%CI，54.1，56.7）。绝经时的平均（SD）年龄为47.95（3.90）岁（95%CI，47.2，48.7），绝经的平均（SD）持续时间为7.27（6.65）年（95%CI，6.01，8.53）。平均（SD）ET为3.8（2.3）mm（95%CI，3.36，4.23）。糖尿病和高血压等疾病并未改变ET。ET随BMI增加而升高，且具有统计学意义。肌瘤的存在显著增加子宫体积，并与子宫内膜增厚相关。同样，每当观察到卵巢且卵巢体积增加时，ET也会增加。当ET>4mm（n = 37）时，为她们提供了子宫内膜活检，其中16人同意接受该检查。未发现有子宫内膜癌。
结论
本研究表明，产次、BMI、肌瘤的存在、他莫昔芬的使用、子宫体积、卵巢体积和血清雌二醇会影响绝经后女性的ET。
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