协和医学杂志

2016, v.7(02) 81-87

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卵巢衰老过程中的月经改变
Menstrual Cyclicity Change in Ovarian Aging

何仲;林守清;陈蓉;陈瑛;高洪莲;乌正赉;
HE Zhong;LIN Shou-qing;CHEN Rong;CHEN Ying;GAO Hong-lian;WU Zheng-lai;Continuing Education College,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University;Central Laboratory of Clinical Medicine,Binzhou Medical College;Department of Epidemiology & Bi

摘要(Abstract):

目的研究卵巢衰老过程中的月经各要素改变。方法对北京市某社区323名30~54岁健康女性前瞻性观察1年,记录月经日记并测量血促卵泡激素(follicle-stimulating hormone,FSH)水平。按年龄、FSH水平及生殖衰老分期分别分组,分析月经周期长度、经期长度和经量的改变。结果年龄影响:平均月经周期长度在40岁后逐渐延长,从48岁以后变化明显,在≥52岁组达最长,为(67.04±36.77)d;平均经期长度随年龄增长变化不明显,但平均经期长度的变异在44岁后逐渐变大,50~51岁组最大;经量在38~47岁间大致相似,在48~49岁组最高,达(45.06±93.54)分,≥52岁组最低,为(15.87±13.81)分。FSH水平影响:月经周期长度随FSH水平的升高而延长;平均经期长度在FSH各水平组间差异无统计学意义,但经期长度的变异在2040 U/L组最低,为(17.38±24.38)分。生殖衰老分期的影响:经期长度和经量在生殖衰老各期的组间差异无统计学意义(P>0.05)。结论在卵巢衰老过程中,月经周期长度变化明显,适于用作生殖衰老分期的标准,但经期长度和经量的改变也有其特征性,从临床角度有提示价值,应予重视。
Objective To observe the alterations of each menstrual factor in ovarian aging. Methods The data were obtained from one-year observation of a prospective cohort involving 323 healthy women in the age of 30- 54 years in a community in Beijing. Menstrual diary was kept and serum level of follicle-stimulating hormone( FSH) was tested. The participants were divided into groups based on age,FSH level,and stages of repro-ductive aging. Alterations of length of menstrual cycle( LMC),length of menstrual period,and menstrual volume were analyzed in each group. Results Age: the mean LMC extended after the age of 40 years,obviously after48,and peaked with( 67. 04 ± 36. 77) days in ≥52-year-old group. The mean length of menstrual period did not vary much with age. However,the variation of mean length of menstrual period gradually increased with age after44 years old,peaked in 50-to 51-year-old group. The menstrual volume scores were approximately stable between38 and 47 years of age,with a peak of( 45. 06 ± 93. 54) in 48- to 49-year-old group and a minimum of( 15. 87 ±13. 81) in ≥52-year-old group. FSH level: LMC increased with elevation of FSH levels. There was no significant difference in the mean length of menstrual period among FSH level groups,but the variation of length of menstrual period was maximum in 20 < FSH≤40 U / L group. The maximum mean menstrual volume score was( 30. 69 ± 31. 84),observed in 10 < FSH≤15 U/L group,while the minimum was( 17. 38 ± 24. 38) in FSH> 40 U / L group. Stages of reproductive aging: the length of menstrual period and menstrual volume scores among each stage showed no statistically significant difference( P > 0. 05). Conclusions The LMC altered significantly in ovarian aging,which could be used as staging criteria of reproductive aging. The length of menstrual period and menstrual volume are also showing some characteristic changes,possibly of some clinical values.

关键词(KeyWords): 卵巢衰老;月经周期长度;月经经期;月经量
ovarian aging;length of menstrual cycle;menstrual period;menstrual volume

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作者(Author): 何仲;林守清;陈蓉;陈瑛;高洪莲;乌正赉;
HE Zhong;LIN Shou-qing;CHEN Rong;CHEN Ying;GAO Hong-lian;WU Zheng-lai;Continuing Education College,Chinese Academy of Medical Sciences & Peking Union Medical College;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University;Central Laboratory of Clinical Medicine,Binzhou Medical College;Department of Epidemiology & Bi

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