协和医学杂志

2016, (06)

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

生殖衰老过程中子宫的变化
Change of Uterine size in Ovarian Aging

王亚平;陈蓉;林守清;白敬兰;姜颖;张颖

摘要(Abstract):

目的 了解北京社区女性在生殖衰老过程中子宫大小的变化。方法 对北京市某社区418名年龄30~68岁、符合STRAW+10分期标准的健康女性,前瞻性随访5年。随访期间每天记录月经日记,每年做一次盆腔超声检查以测量子宫大小,并进行血清雌二醇(estradiol,E2)水平测定。结果 基线时,绝经后期早期+1a阶段起子宫各径线和体积开始缩小,+1c阶段继续缩小(P<0.05),绝经后期晚期无明显变化;子宫内膜厚度从绝经后期早期+1a阶段开始变薄(P<0.05),此后并无明显变化;E2在绝经过渡期和绝经后2年内变异度较大,与生育期相比,差异均无统计学意义(P>0.05),从+1c阶段才开始明显下降(P<0.05),绝经后期晚期虽有下降,但与+1c阶段比较差异无统计学意义(P>0.05)。经过5年随访分期未改变者,子宫仅部分径线在绝经后期早期+1c阶段和绝经后期晚期缩小(P<0.05),子宫内膜厚度均无明显变化,E2仅在绝经后期晚期进一步降低(P<0.01),余无明显变化。经过5年随访分期发生改变者,子宫各径线和体积的显著变化发生于从各期转换至绝经后期早期+1a/+1b阶段,或者从绝经过渡期转换至后续各阶段中;内膜厚度的明显变化仅见于从绝经过渡期转换至后续阶段者;E2变化主要见于从绝经过渡期起的后续各阶段转换。子宫肌瘤从生育期转换到绝经过渡期有所增大(P<0.01),从绝经后期开始缩小,但差异无统计学意义(P>0.05)。有子宫肌瘤者子宫体积的缩小主要发生于绝经后期早期,此后无明显变化。结论 子宫大小、子宫内膜厚度及E2的变化并不完全同步。子宫大小从绝经开始逐渐缩小,变化时间较长;子宫内膜厚度变薄主要发生在绝经后的起始阶段;E2在绝经过渡期和绝经2年内变异度较大,直至绝经2年后才明显降低。
Objective  To investigate the change of uterine size in ovarian aging in women living in a Beijing community. Methods A total of 418 healthy women aged 30 to 68 years who could be staged by STRAW+10 staging system were recruited from a Beijing community and prospectively followed up for 5 years. Menstrual dairy was recorded daily by every woman during the research. Transvaginal ultrasonography was performed for measurement of uterine size at baseline and each year during the 5 years. Serum estradiol (E2) was tested as well. Results  At baseline, various diameters and volume of uterus began to shrink significantly since the early post-menopausal stage+1a and shrank further at stage+1c (P<0.05), while not changed much at late post-meno-pausal stage. The thickness of endometrium decreased from stage+1a (P<0.05) and showed no significant change after that (P>0.05). E2 in menopausal transition and the first 2 years after menopause had a large variation that no significant difference was found comparing with reproductive stage (P>0.05). E2 level decreased significantly at stage+1c(P<0.05) and kept at a low level at late postmenopausal stage, with no statistically significant difference compared with stage+1c (P>0.05). For women still at the same STRAW+10 stages after 5-years follow-up, there was only decline in some diameters at early and late postmenopausal stages and no obvious change in endometrial thickness. E2 level only decreased in the late postmenopausal stage(P<0.01). For women with stage progress after 5-years follow-up, each line diameter and volume of the uterus changed significantly during transition to early postmenopausal stage +1a/+1b, or from menopausal transition stage to ensuing stages. Change in endometrial thickness was only found in those transformed since menopausal transition stage. E2 level changed mainly after menopausal transition stage. Uterine fibroids increased significantly during the transition from the reproductive stage to the menopausal transition stage (P<0.01) and began to shrink after menopause but with no statistically significant difference(P>0.05). The decline in uterine volume in women with uterine fibroid was mainly observed at early postmenopausal stage, with no obvious change afterwards. Conclusions Uterine size, endometrial thickness, and E2 level do not change in synchronization. Uterine size shrinks during a rather long time since menopause, endometrial thickness begins to reduce mainly in the early stage after menopause. E2 in menopausal transition and the first 2 years after menopause has a big variation which does not decrease obviously until 2 years after menopause.

关键词(KeyWords): |STRAW+10分期系统|子宫大小|子宫体积|子宫内膜厚度|子宫肌瘤|
|STRAW+10 staging system|uterine size|uterine volume|thickness of endometrium|uterine fibroids|

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王亚平;陈蓉;林守清;白敬兰;姜颖;张颖

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享