Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts.
Boston Center for Endometriosis, Boston Children's Hospital and Brigham and Women's Hospital, Boston, Massachusetts; Division of Adolescent and Young Adult Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts.
J Adolesc Health. 2018 Dec;63(6):766-772. doi: 10.1016/j.jadohealth.2018.06.027.
While endometriosis is recognized to have a high patient burden for adults, the level of morbidity it causes for adolescents has been understudied, and may be minimized by clinicians. The purpose of this study was to determine whether endometriosis has a significant impact on quality of life (QOL) for adolescents and young adults.
Five hundred and sixty-seven participants (360 cases and 207 controls) aged <25 years old who are enrolled in the Women's Health Study: From Adolescence to Adulthood longitudinal study were included in this analysis. Participants were enrolled from medical clinics and the communities surrounding Boston, MA. Participants completed an expanded World Endometriosis Research Foundation Endometriosis Phenome and Biobanking Harmonization Project standard clinical questionnaire that included the Short Form-36 (SF-36), a widely used measure of health-related QOL. We calculated SF-36 physical component summary and mental component summary scores, as well as eight subscale scores. On the SF-36, lower scores reflect greater impairment.
Adolescents with endometriosis had significantly lower physical component summary (mean [standard deviation]: 43.4 [11.1] vs. 53.8 [7.6], p < .0001) and mental component summary (43.3 [12.3] vs. 46.3 [10.8], p = .008) scores compared to controls, as well as lower scores on all eight subscales. More cases than controls reported mental health diagnoses, pain medication use, and avoidance of exercise during menstruation. Among cases, earlier age at menarche, more severe pelvic pain, and longer duration of diagnostic delay were associated with poorer QOL.
Endometriosis is associated with significantly worse reports of QOL for adolescents and young women with endometriosis compared to unaffected peers. Earlier menarche was associated with poorer physical health-related QOL among cases, whereas severe pelvic pain was associated with both poorer physical and mental health-related QOL among cases. Impairment in QOL is not limited to adults with endometriosis, but affects younger patients as well.
虽然子宫内膜异位症被认为会给成年人带来沉重的负担，但它对青少年造成的发病率尚未得到充分研究，临床医生可能会将其最小化。本研究旨在确定子宫内膜异位症是否会对青少年和年轻女性的生活质量（QOL）产生重大影响。
本分析纳入了参加妇女健康研究：从青春期到成年期纵向研究的 567 名年龄<25 岁的参与者（360 例病例和 207 例对照）。参与者来自马萨诸塞州波士顿附近的医疗诊所和社区。参与者完成了一份扩展的世界子宫内膜异位症研究基金会子宫内膜异位症表型和生物样本库协调项目标准临床问卷，其中包括广泛使用的健康相关 QOL 量表简表 36（SF-36）。我们计算了 SF-36 生理成分综合评分和心理成分综合评分，以及八个子量表评分。在 SF-36 中，较低的分数反映了更大的损伤。
与对照组相比，患有子宫内膜异位症的青少年的生理成分综合评分（均值[标准差]：43.4[11.1] 与 53.8[7.6]，p<0.0001）和心理成分综合评分（43.3[12.3] 与 46.3[10.8]，p=0.008）明显较低，以及所有八个子量表的评分也较低。与对照组相比，更多的病例报告了心理健康诊断、使用止痛药物和在月经期间避免运动。在病例中，月经初潮年龄较早、盆腔疼痛更严重、诊断延迟时间较长与 QOL 较差相关。
与未受影响的同龄人相比，子宫内膜异位症与青少年和年轻女性子宫内膜异位症患者报告的 QOL 显著下降有关。在病例中，月经初潮较早与身体健康相关的 QOL 较差有关，而盆腔疼痛较严重与身体健康和心理健康相关的 QOL 较差有关。生活质量受损不仅限于患有子宫内膜异位症的成年人，也影响年轻患者。
