年轻女性子宫内膜增生或癌变的危险因素及临床特征分析#br#

目的　分析40岁以下的年轻女性子宫内膜增生或癌变的危险因素及临床特征，为临床诊疗提供参考。方法　对天津医科大学总医院2017年1月—2019年1月收集的因异常子宫出血、不孕或超声异常行宫腔镜检查或诊刮治疗的243例病例资料进行回顾性分析，其中子宫内膜增生或癌变的患者为病例组（105例），正常子宫内膜的患者为对照组（138例），收集2组患者的临床及超声影像资料并进行比较，分析发生子宫内膜增生或癌变的危险因素和超声影像特征。结果　多因素Logistic回归分析显示，合并肥胖、糖尿病、存在异常子宫出血、异常子宫出血时间≥6个月是影响子宫内膜增生或癌变的独立危险因素（P＜0.05）。病例组患者伴有月经稀发和（或）不规则子宫出血、异常子宫出血≥6个月、子宫内膜呈高回声不具有三线征的比例，以及子宫内膜厚度明显高于对照组（P＜0.01）。结论　合并肥胖、糖尿病、存在异常子宫出血、异常子宫出血时间≥6个月的年轻女性更易患子宫内膜增生或癌变，且具有一定特征性临床表现，在临床诊疗时需加以重视，并注重相关危险因素的控制。

Analysis of risk factors and clinical features of endometrial hyperplasia orcarcinogenesis in young women#br#

Objective　To analyze the risk factors and clinical characteristics of endometrial hyperplasia or carcinoma in young women, and to provide a reference method for clinical diagnosis and treatment. Methods　A retrospective analysis was performed on 243 cases who underwent hysteroscopy and curettage for abnormal uterine bleeding, infertility or ultrasonic abnormalities from January 2017 to January 2019 in the Tianjin Medical University General Hospital. The patients with endometrial hyperplasia or carcinoma were the case group (105 cases), and the patients with normal endometrium were the control group (138 cases). Clinical data of two groups of patients were collected. And ultrasound imaging data were comparedto analyze the risk factors and ultrasound imaging features of endometrial hyperplasia or carcinoma. Results　Multivariate Logistic regression analysis showed that combined diabetes, abnormal uterine bleeding, abnormal uterine bleeding time ≥ 6 months, and obesity were independent risk factors affecting endometrial hyperplasia or carcinoma (P＜0.05). The proportion of patients with thin menstruation and irregular uterine bleeding, endometrial thickening, endometrium hyperechoic and no third-line sign was significantly higher in the case group than that of control group (P＜0.01). Conclusion　This study suggests that young women with obesity, diabetes, abnormal uterine bleeding, and abnormal uterine bleeding time ≥ 6 months are more likely to develop endometrial hyperplasia or carcinoma and have certain characteristic clinical manifestations. In clinical treatment, we should pay attention to the control of related risk factors.