心理干预对绝经期后冠心病合并焦虑症患者的影响

目的：探讨心理干预对200例入住心血管内科的绝经后冠心病合并焦虑症状患者的影响。方法：将200例患者随机分为干预组及对照组,各100例,对于预组患者实施了包括心理支持、认知干预和社会支持等一系列的心理干预,对对照组的患者只给予一般的心理支持与常规的护理。结果：按照焦虑自我评定量表（self-rating anxiety scale,SAS）对患者进行评分评价并比较,干预前两组评分差异无统计学意义（P〉0．05）;干预后两组评分差异有统计学意义（P〈0．05）,对照组患者的焦赢程度较实验组高。结论：心理干预能有效降低患者的焦虑程度水平,提高患者及家属对疾病认知能力水平,促进了患者的疾病康复,提高了患者的生活及工作水平。同时也融洽了护患关系。     

绝经后子宫内膜息肉68例临床分析

目的分析绝经后子宫内膜息肉的临床特点,探讨适宜的诊疗方法。方法回顾性分析2007年9月～2009年4月住院治疗的68例绝经后子宫内膜息肉的临床资料,均行B超检查,发现宫内病变63例(92.6%),均经宫腔镜检查并行宫腔镜下子宫内膜息肉切除术。结果子宫内膜良性息肉63例(92.6%),子宫内膜息肉内非典型增生5例(7.4%);61例子宫内膜息肉经宫腔镜治疗后随访12～30个月无复发,7例术后行全子宫切除术(5例子宫内膜息肉内非典型增生,2例因其他病变)。结论①绝经后子宫内膜息肉以良性病变为主,但应警惕癌前病变可能,明确诊断需宫腔镜检查联合病理组织学诊断。②宫腔镜下息肉切除术是治疗绝经后子宫内膜息肉的常规方法 ,若发现癌前病变应尽快行全子宫切除术。     

Bone mineral density, body mass index, postmenopausal period and outcomes of low back pain treatment in Korean postmenopausal women

Women going through menopause experience bone loss and increased musculoskeletal pain, including low back pain. This study explored the relationships between bone mineral density (BMD) and body mass index (BMI), postmenopausal period and outcomes of treatment for low back pain in postmenopausal Korean women. On examining the medical records of 78 postmenopausal women hospitalized for low back pain, investigators found that women with low BMD were older and had been postmenopausal for longer periods than women with normal BMD. Postmenopausal length was positively correlated with pain scores at day 15 and 20 post-admission (P = 0.011 and 0.006) and negatively correlated with T-scores (P = 0.002). BMI was positively correlated with T-scores (r = 0.283, P = 0.022). In conclusion, age, postmenopausal length and BMI correlate with BMD in Korean women suffering from LBP. Larger studies investigating the associations between menopause, BMD, BMI and LBP seem desirable. Moreover, evidence-based therapeutic approaches should be explored for BMD and LBP management.     

更年期女性胆固醇水平调查与影响因素分析

目的研究胆固醇代谢与绝经的关联和可能的影响因素。方法对杭州市拱墅区963例40~60岁女性进行横断面调查,收集其月经史及其他临床资料,填写改良Kupperman更年期症状量表(mKMI),检测血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)水平。收集参与者教育程度、婚姻状态、职业状态、收入、居住地等社会人口资料。研究不同绝经状态女性胆固醇水平及高胆固醇血症、LDL-C升高的发生率,并分析年龄、绝经状态、FSH、E_2、社会人口等因素对血清胆固醇的影响。结果963例参与者平均年龄(51.0±5.6)岁,其中绝经前期302例(31.4%),围绝经期197例(20.5%),绝经后期464例(48.2%),绝经后参与者的平均绝经年龄(49.9±3.8)岁。在所有参与者中,绝经前期mKMI总分(6.36±6.43)显著低于围绝经期(10.30±7.88)和绝经后期(10.35±7.97)(P0.001)。绝经前后平均TC、LDL-C水平呈显著上升趋势,FSH、LH水平呈上升趋势,E_2水平呈下降趋势(P0.001)。所有参与者中高胆固醇血症比例为13.3%,LDL-C升高比例为15.0%,从绝经前期过渡到围绝经期、绝经后期的过程中,高胆固醇血症及LDL-C升高的发生率显著上升(P0.001)。Logistic多元回归分析表明FSH≥40IU/L是发生高胆固醇血症和LDL-C升高的危险因素(OR=2.821,95%CI=1.429~5.569,P=0.003;OR=2.587,95%CI=1.356~4.937,P=0.004),调整FSH水平后,年龄、绝经状态、E_2水平、社会人口因素与发生高胆固醇血症和LDL-C升高均无显著关联(P0.05)。结论相比绝经前期,围绝经期和绝经后女性平均TC、LDL-C上升,胆固醇水平升高的发生率增加,FSH水平升高可能是胆固醇代谢紊乱的内在机制,降低FSH水平可作为绝经激素补充治疗的目标和疗效指标。     

Relationship between alcohol consumption and age at menopause: The Korea National Health and Nutrition Examination Survey

Objective

We used data from the 2011–2014 Korean National Health and Nutrition Examination Surveys (KNHANES) to investigate whether the age at menopause is related to alcohol consumption in South Korean women.

绝经症状与抑郁焦虑情绪相关性研究

目的：探讨不同生殖衰老阶段女性绝经症状与抑郁焦虑情绪的相关性。方法：对门诊妇女进行面对面问卷调查,内容包括一般情况、自评抑郁量表（SDS）、自评焦虑量表（SAS）、改良Kupperman评分表。共372例患者入选。根据STRAW+10分期系统分为生育期晚期组（105例）、围绝经早期组（110例）、围绝经晚期组（84例）和绝经后早期组（73例）。结果：4组患者绝经相关症状严重程度、SDS、SAS、Kupperman评分和抑郁焦虑的发生率比较差异有统计学意义（均P＜0.05）。潮热出汗、心悸症状与抑郁、焦虑情绪有关,性交痛、阴道干涩与焦虑情绪有关。Kupperman评分与SDS、SAS评分呈弱相关（r分别为0.465、0.421,P＜0.001,r2分别为0.22和0.18）。SDS评分与SAS评分呈正相关（r=0.801,P＜0.001,r2=0.64）。结论：40岁后育龄期晚期妇女可出现绝经症状及抑郁焦虑情绪,且随着生殖衰老进展有增加趋势,抑郁和焦虑互相影响。     

围绝经期及绝经期妇女尿脱氧吡啶啉和尿肌酐比值及其与血雌二醇的关系

目的 了解正常围绝经期及绝经期妇女尿脱氧吡啶啉(Deoxy pyridinoline,DPD)和尿肌酐(Creatinine,Cr)比值(DPD/cr)及其与血雌二醇的关系. 方法正常围绝经期及绝经期妇女80例,其中围绝经期妇女42例,按病史是否超过1年分为围绝经期1组(25例,<1年)和围绝经期2组(17例,≥1年),绝经期妇女38例,绝经年限分为<5年组12例、5～15年组17例和>15年组9例;测定其尿DPD、尿肌酐及血雌二醇,尿DPD由化学发光法测定. 结果围绝经期2组DPD/Cr4.80±0.75,高于围绝经期1组3.92±1.05(t=2.961,P=0.005),而血雌二醇(27.8±15.7)ng/L,低于围绝经期1组(60.1±36.5)ng/L(t=3.917,P=0.000),差异均有统计学意义;两组DPD/Cr和雌二醇呈直线负相关关系(r=0.446,P<0.05).绝经期妇女<5年组DPD/Cr高于5～15年组和>15年组,差异有统计学意义(P<0.05),而>15年组血雌二醇水平低于<5年组和5～15年组(P<0.05),其余两组之间比较差异均无统计学意义(P>0.05).本组病例中雌二醇<30 ng/L妇女的DPD/cr高于雌二醇≥30 ng/L的妇女.差异有统计学意义(P<0.005). 结论尿DPD/Cr能敏感、特异地反映体内骨代谢状况,是围绝经期及绝经期妇女最有价值的骨代谢观测指标;围绝经期病史超过1年及绝经<5年妇女骨代谢增强明显,提示该阶段是预防和治疗骨质疏松的有效时机;建议绝经期和围绝经期妇女雌二醇>30 ng/L为雌激素治疗的一项重要观测指标.     

中老年妇女骨转换生化指标和骨密度的变化

目的 探讨中老年妇女骨转换生化指标与骨密度随绝经的变化.方法 408名符合条件40 ～80岁的女性志愿者,同一时间段留取血清和晨尿,统一用酶免方法 测定血清骨碱性磷酸酶(BAP)、骨钙素和尿I型胶原氨基末端肽(uNTX);用舣能X线骨密度仪测定前后位腰椎1-4(L1-4)、左侧股骨颈的骨密度.结果 (1)BAP、骨钙素和uNTX与年龄、孕次、生育次数和绝经年限呈正相关(均P相似文献   

Oxidative status and cardiovascular risk in women: Keeping pink at heart

Although cardiovascular disease (CVD) has always been perceived as a pathology regarding essentially males, incidence and death from cardiovascular events dramatically increase after menopause in women. Obviously, while many aspects of CVD are similar in both sexes, it is now clear that there are significant differences as well. Exploration of these gender-related differences in CVD might provide a basis for the development of new strategies in the management of patients with CVD from a gender point of view. In particular, a growing amount of data suggested the possible major role of oxidative stress in female patients and the possibility to integrate this new biomarker in future study evaluating CVD risk in women.     

Hormone replacement therapy with estrogens may reduce lamotrigine serum concentrations: A matched case–control study

Lamotrigine (LTG) is an antiepileptic drug that is metabolized via glucuronidation. Since the glucuronidizing enzyme is inducible by estrogens, LTG serum concentrations may fall by 50–60% when combined with hormonal contraceptives that contain ethinyl estradiol (EE). Little is known about a possible interaction between estrogens used for hormone replacement therapy (HRT) and LTG, and the few available data are conflicting. Data from serum samples analyzed for LTG were therefore retrieved from a routine therapeutic drug monitoring database. Users of HRT and EE were identified and matched with controls for age and dose. No enzyme‐inducing or enzyme‐inhibiting comedication was allowed. LTG serum concentration‐to‐dose ratios (CDRs) were calculated. Case groups and their respective control groups were compared by the Mann‐Whitney U test. Seventy‐nine HRT users (dose range 1–4 mg/day) and 200 EE users (dose range 20–40 μg/day), as well as 158 and 400 matching controls, respectively, could be included. Both EE users and HRT users had significantly lower mean LTG CDRs than their respective matched controls. These results suggest that HRT with estrogens may reduce serum LTG concentrations.