Darrow S L, Vena J E, Batt R E, Zielezny M A, Michalek A M, Selman S
Department of Social and Preventive Medicine, SUNY, Buffalo.
Epidemiology. 1993 Mar;4(2):135-42. doi: 10.1097/00001648-199303000-00009.
The present study utilized a case-control design to assess the relation between menstrual cycle factors and risk of endometriosis in women age 19-45 years. From a gynecologic specialty clinic in Western New York in 1987, we identified 104 laparoscopically confirmed cases of endometriosis. We used two control groups: (1) 100 friend controls (friends of cases), and (2) 98 medical controls (patients from the same medical practice with conditions other than endometriosis). Controls were frequency matched to cases by age. Because crude odds ratios (ORs), stratified by age (< 30 vs > or = 30 years), revealed effect modification by age, we performed all analyses by age group. We used logistic regression to calculate ORs and 95% confidence intervals (CIs), controlling for pregnancy, religion, and body mass index. Among women under age 30, using friend controls, we observed elevated risks for menstrual flow > or = 6 days per month (OR = 2.5, 95% CI = 1.1-5.9), heavy flow (OR = 2.5, 95% CI = 1.1-6.3), severe cramps (OR = 2.5, 95% CI = 1.2-6.0), increasing symptoms (OR = 6.6, 95% CI = 2.6-16.5), and tampon use > or = 14 years (OR = 3.6, 95% CI = 1.04-13.5). Risks were also elevated for women age 30 and over, but not to the same degree as among younger women.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究采用病例对照设计,以评估19至45岁女性月经周期因素与子宫内膜异位症风险之间的关系。1987年,我们从纽约西部的一家妇科专科诊所中,确定了104例经腹腔镜确诊的子宫内膜异位症病例。我们使用了两个对照组:(1)100名朋友对照(病例的朋友),以及(2)98名医疗对照(来自同一医疗机构患有除子宫内膜异位症以外疾病的患者)。对照组按年龄与病例进行频数匹配。由于按年龄(<30岁与≥30岁)分层的粗比值比(OR)显示存在年龄效应修正,我们按年龄组进行了所有分析。我们使用逻辑回归计算OR和95%置信区间(CI),并对怀孕、宗教信仰和体重指数进行了控制。在30岁以下的女性中,使用朋友对照,我们观察到每月月经流量≥6天(OR = 2.5,95% CI = 1.1 - 5.9)、经量多(OR = 2.5,95% CI = 1.1 - 6.3)、严重痛经(OR = 2.5,95% CI = 1.2 - 6.0)、症状加重(OR = 6.6,95% CI = 2.6 - 16.5)以及使用卫生棉条≥14年(OR = 3.6,95% CI = 1.04 - 13.5)的风险升高。30岁及以上女性的风险也有所升高,但程度不及年轻女性。(摘要截于250字)