腹腔巨淋巴结增生症1例

病例：患者女,55岁,因“月经失调5个月,B超检查发现右附件占位性病变1d”入院。患者既往无慢性妇科疾病史．生育史1-0．1．1。平素月经规则,5-6d／30d,量少,无痛经史。2008年4月行经,经量稍多。末次月经（LMP）2008年7月6日．无腹痛．无异常阴道流出液。2008年9月9日于我院行B超检查示有附件-37mm×43mm×48mm的不均质性占位,部分呈低回声。入院查体：一般情况可,心肺无异常。腹平软．无压痛、反跳痛、肌卫,未触及明显包块。     

Polycystic Ovarian Syndrome in Women with Epilepsy: A Review

Summary: Polycystic ovarian syndrome (PCOS) remains a controversial issue in women with epilepsy. The syndrome is characterized by clinical signs of endocrine dysfunction, such as irregular menstruation, hirsutism, and infertility, but its pathogenesis and presentation are heterogeneous. There are few data on the relationship between epilepsy and PCOS. Studies by a Finnish group have raised the issue of an association between valproate (VPA) and PCOS in young women with epilepsy. These studies, however, were retrospective, laid emphasis on polycystic ovary morphology rather than on clinical endocrine dysfunction, and were undertaken in selected populations. Further studies, both in Italy and Germany, failed to replicate the findings of the Finnish group. Future research should ideally be prospective and include baseline data in untreated women. No compelling data lead to a specific contraindication of the use of VPA in young women, and the drug remains a first-line treatment option.     

Treatment of Reduced Bone Mineral Density in Athletic Amenorrhea: A Pilot Study

There is considerable concern about the adverse effects on the skeleton of loss of menstrual function as a result of athletic activity, as well as uncertainty as to how it should be managed clinically. In a pilot intervention study 34 elite middle and long-distance runners, aged 18–35 years, with menstrual irregularity due to their athletic activity were randomized to three groups: (A) to receive hormone replacement therapy (HRT) and 1000 mg calcium per day (n= 10), (B) to receive 1000 mg calcium per day (n = 14), (C) a control group who received no treatment (n= 10). Bone mineral density (BMD) was measured in the left hip and lumbar spine (L2–4) using dual-energy X-ray absorptiometry. Results were first analyzed according to whether menstruation returned, either naturally or secondary to HRT (EU), and compared with those from subjects who remained amenorrheic (AM). During the first year BMD increased in the EU group in Ward’s triangle (3.8%) and the lumbar spine (4.1%; both P<0.05). BMD fell in the AM group in all regions and the between-group differences were 5.6% (p<0.02) in Ward’s triangle, 5.8% (p<0.02) in L2–4 and 3.9% in the trochanter (p<0.05). An ‘intention to treat’ analysis was then performed. It was found that the mean relative improvement at 1 year in spinal BMD was only 1.5%, due to return of menses in some of the controls and withdrawals from treatment in the treatment group. In consequence, a trial designed to show, with 80% power and 5% significance, a measurable benefit in lumbar spine BMD resulting from allocation to HRT treatment would require about 1150 athletes with amenorrhea or oligomenorrhea. These numbers could be reduced substantially to 380 subjects by confining the trial to completely amenorrheic athletes, who in this study were less likely to regain menses. For these and other logistical reasons, an HRT trial in amenorrheic athletes could only be successfully organized through international collaboration. This study illustrates the major effects of treatment withdrawals and instability of menstrual status on the design of longitudinal studies on the bony effects of menstrual dysfunction prior to menopause. Received: 5 August 1998 / Accepted: 11 March 1999     

田径训练对女大学生运动员月经的影响

目的了解田径训练对女大学生运动员月经的影响，为制定训练计划提供科学依据。方法采用问卷调查法，对参加田径比赛的女大学生的月经情况进行调查。结果多数运动员在月经期都不同程度地参加了训练。参加训练后月经失调发生率明显高于训练前；开始训练初期及假期集中训练初期月经失调发生率明显高于训练适应期，参加耐力性项目训练的运动员月经周期紊乱的发生率（100．0％）明显高于速度力量性项目（72．4％），参加速度力量性项目训练的运动员经血过多的发生率（51．7％）明显高于耐力性项目（15．8％）。结论多数女大学生运动员月经期可以安排一定量的运动训练，但在训练初期及耐力性项目应合理控制运动负荷，经期训练应减少疾跑、跳跃及力量性练习。     

宫内节育器导致月经改变的子宫内膜病理变化分析

目的:了解IUD伴月经改变的子宫内膜变化。方法:选取168例IUD伴月经改变的患者在取环的同时刮取子宫内膜病理检查,分析IUD伴月经改变的子宫内膜变化类型及放置IUD后月经改变开始时间和持续时间与子宫内膜变化的关系。结果:放置IUD后月经改变者子宫内膜50%发生变化。放置IUD后半年内开始月经改变的子宫内膜变化以子宫内膜炎为主,月经改变持续半年以上者子宫内膜病变的发生率明显增加,增生期与分泌期并存的子宫内膜与放置IUD后月经改变开始时间和持续时间无明显关系。结论:IUD伴月经改变者子宫内膜变化呈多样性,可能与内分泌改变有关,随着月经改变持续时间的延长子宫内膜病变有增加趋势,建议对IUD伴月经改变者要注意子宫内膜的病理检查。     

原因不明不孕症妇女月经周期与解脲脲原体感染关系的探讨

本文检查了７４例不明原因的不孕症妇女生殖道解脲脲原体感染的情况，其中３９例阳性，正常组５１例１４例阳性，两组比较有显著性差异。同时观察到解脲脲有原体检出率的高低与月经周期有关，排卵前７天至排卵后８天不孕症组的阳性率为６３％，明显高于卵泡早期２３％和黄体晚期２８．５７％。     

苯及其同系物对职业女工生殖机能的影响

目的 :研究苯及其同系物对职业接触者月经及生殖机能的影响。方法 :对化工行业 2 6 8名苯作业女工月经及生殖机能进行回顾性调查 ,探讨职业接触对女工的影响。结果 :月经周期延长、经量增多、经期腰痛明显高于对照组 (χ2 =9.90 ,P<0 .0 0 5 ) ,且妊娠后自然流产、早产、胎儿失天缺陷等均高于对照组。结论 :苯职业接触可引起女工月经及生殖机能障碍。     

未婚女青年性别认同与月经障碍的相关分析

目的探讨未婚女青年性别认同与月经障碍的关系,为促进青少年性/生殖健康提供依据.方法分层随机抽取昆明地区4所高校17～24岁未婚女生580名,用性别认同及月经状况的问卷进行调查及描述;并以月经态度将其分为厌恶组和悦纳组,作性别认同与月经障碍(MD)的相关分析.结果在性别认同上,高达90.34%的女生认为男性较女性更具有成功的机会,有37.85%的女生认为"为人妻/母的社会角色会影响事业的发展",认同自身性别者仅占抽样人群的54.13%.尽管有62.41%的女生肯定母性和母爱的伟大,但仍有64.83%的女生讨厌月经,22.93%的人对女性的生殖节育任务感到恐惧,甚至有30.00%的人希望改变目前的性别.讨厌月经、恐惧生育、性别认同不良与MD/PMS(经前综合征)高度相关(r=0.75,0.50,0.77～0.47,P值均＜0.01).厌恶月经的女生发生痛经、月经过多、经期抑郁和虚弱多病者分别高达68.09%,28.72%,49.47%和42.29%,显著高于悦纳组的34.31%,9.31%,23.04%,25.00%(OR值分别为4.08,3.92,3.27和2.2,P＜0.01).结论性别认同与月经障碍密切相关.     

Menstrual cycle lengths and bone mineral density: a cross-sectional, population-based study in rural Chinese women ages 30–49 years

Introduction The menstrual cycle involves periodic fluctuations in estrogen and progesterone levels. Longer cycles have been associated with longer follicular phase, delayed estrogen peak and a lower mean oestradiol level of the entire cycle. Methods We hypothesized that prolonged menstrual cycle length is associated with decreased bone mineral density (BMD) in a population of pre- and perimenopausal women. This population-based cross-sectional study was conducted in rural Anhui province, China. It includes 4,771 women, aged 30 to 49 years, who did not smoke or drink alcohol, and did not use oral contraceptives or breastfeed during the previous year. Dual-energy X-ray absorptionometry (DEXA) BMD measurements were taken at four skeletal sites: whole body, total hip, femoral neck and lumbar spine. Menstrual cycle characteristics (polymenorrhea, short normal, long normal, oligomenorrhea, 90-day amenorrhea, irregular cycle) in the prior year were assessed by questionnaire. Results Prolonged menstrual cycle was consistently associated with decreased BMD at whole body, total hip, and femoral neck in both age 30–39, and age 40–49 stratum (p_trend<0.05). Prolonged menstrual cycle was also associated with decreased lumbar spine BMD for women aged 40–49 (p_trend<0.05). Among women with normal cycles aged 30–39, menstrual cycle length in the previous year was inversely associated with whole-body BMD (p<0.05). Women with 90-day amenorrhea had significantly lower mean total hip and femoral neck BMD relative to women with short normal cycles in the 30–39 age group; and had significantly lower whole body and total hip BMD relative to short normal cycles in the 40–49 age group. BMD in poylmenorrheic women did not differ from BMD in women with short normal cycles at any of the skeletal sites. Conclusions We conclude that prolonged menstrual cycle length is associated with decreased BMD in pre- and perimenopausal women in this population.     

苯系混合物对女性生殖机能影响的研究

对接触苯系混合物的女工１９９人和对照组女工２０５人的月经状况、妊娠经过及妊娠结局进行了调查，应用回顾性队列研究方法分析，结果表明，接触苯系混合物女工的月经周期异常、经期异常、经量过多、痛经、自然流产、妊娠剧吐、妊高征、早产等的发生率均高于对照组（Ｐ＜０．０５）。