【摘要】：目的:探討導(dǎo)致早發(fā)性卵巢功能不全(POI)的高危因素及其臨床特點,提高對POI的認(rèn)識,為POI患者的早期診斷和預(yù)防提供理論依據(jù)。方法:調(diào)查收集2014年12月至2016年7月就診于山西醫(yī)科大學(xué)第一醫(yī)院婦科門診的63例POI患者的相關(guān)臨床資料,收集內(nèi)容如下:1、相關(guān)危險因素的相關(guān)結(jié)果,如:染色體核型;甲狀腺功能五項;既往是否患有橋本氏甲狀腺炎、甲狀旁腺功能亢進、系統(tǒng)性紅斑狼瘡、腎上腺皮質(zhì)功能不全等自身免疫性疾病;盆腔手術(shù)史;腮腺炎、結(jié)核、麻疹、水痘等感染史;主被動吸煙史;A型行為調(diào)查問卷等;2、臨床資料:患者的年齡、職業(yè)、閉經(jīng)前月經(jīng)情況或月經(jīng)不調(diào)的年限、孕產(chǎn)史等。分析POI患者的年齡分布情況,各危險因素的所占比例及臨床特點。結(jié)果:1.63例POI患者中:年齡在17歲至40歲之間,平均年齡為26.59±6.29歲,≤30歲的患者49例,占77.78%。30歲的患者14例,占22.22%。2.63例POI患者中:染色體異常者9例占14.29%、自身免疫功能異常者3例占4.76%、醫(yī)源性因素2例占3.17%、感染因素11例占17.46%、不良環(huán)境因素接觸者39例占61.9%、A型行為者38例占60.32%、不明原因者7例占11.11%。3.63例POI患者中:原發(fā)閉經(jīng)者10例占15.87%,月經(jīng)稀發(fā)者15例占23.81%,繼發(fā)閉經(jīng)者38例占60.32%。繼發(fā)閉經(jīng)患者閉經(jīng)前有35例表現(xiàn)為月經(jīng)不調(diào)占55.56%,3例表現(xiàn)為規(guī)律月經(jīng)后突發(fā)閉經(jīng)占4.76%。10例原發(fā)閉經(jīng)者中,染色體異常者6例占60%,不良環(huán)境因素接觸者3例占30%,A型行為者3例占30%。15例月經(jīng)稀發(fā)者中,染色體異常者1例占6.67%,不良環(huán)境因素接觸者12例占80%,A型行為者10例占66.67%。38例繼發(fā)閉經(jīng)者中,染色體異常者2例占5.26%,不良環(huán)境因素接觸者24例占63.16%,A型行為者25例占65.79%。4.63例POI患者中:既往曾妊娠者14例占22.22%,其中12例(85.71%)曾有不同次數(shù)的流產(chǎn)。結(jié)論:1.本研究顯示POI在40歲之前的育齡期女性中平均發(fā)病年齡為26.59±6.29歲。2.POI病因復(fù)雜,臨床上應(yīng)早期進行多因素排查,及時進行干預(yù)并根據(jù)病因采取相應(yīng)治療。3.POI患者中:原發(fā)閉經(jīng)者的主要危險因素是遺傳因素;月經(jīng)稀發(fā)者及繼發(fā)閉經(jīng)者的主要危險因素是不良環(huán)境因素及個人生活行為。4.POI患者多數(shù)在早期出現(xiàn)月經(jīng)異常,僅少數(shù)表現(xiàn)為規(guī)律月經(jīng)后突發(fā)閉經(jīng),在出現(xiàn)月經(jīng)異常時應(yīng)注意評估卵巢功能并進行生育力保存。
[Abstract]:Objective: to explore the high risk factors and clinical characteristics of (POI) leading to early ovarian insufficiency, to improve the understanding of POI, and to provide theoretical basis for early diagnosis and prevention of POI patients. Methods: the clinical data of 63 POI patients in the gynecological clinic of the first Hospital of Shanxi Medical University from December 2014 to July 2016 were investigated and collected as follows: 1. The related results of related risk factors, such as chromosome karyotype; Keywords 5 items of thyroid function, whether or not they suffered from autoimmune diseases such as Hashimoto's thyroiditis, hyperparathyrothyroidism, systemic lupus erythematosus, adrenocortical insufficiency, history of pelvic surgery, etc. History of mumps, tuberculosis, measles, varicella and other infections; history of active and passive smoking; type A behavior questionnaire, etc. 2, clinical data: patient's age, occupation, menstruation before menstruation or menstruation, history of pregnancy and delivery, etc. The age distribution, the proportion of risk factors and clinical characteristics of POI patients were analyzed. Results: 1. Among 63 patients with POI, there were 49 patients (77.78%) aged between 17 and 40 years old, with an average age of 26.59 鹵6.29 years, accounting for 77.78%. 14 patients aged 30 years. Among 2.63 patients with POI, 9 cases (14.29%) had chromosome abnormalities, 3 cases (4.76%) had abnormal autoimmune function, 2 cases (3.17%) had iatrogenic factors, and 11 cases (17.46%) had infection factors. 39 cases (61.9%) were exposed to adverse environmental factors, 38 cases (60.32%) were type A actors, and 7 cases (11.11%) were unexplained. Among 3.63 patients with POI, 10 cases (15.87%) had primary atresia. There were 15 cases (23.81%) with sparse menstruation and 38 cases (60.32%) with secondary menorrhea. Among the patients with secondary atenorrhea, 35 cases showed irregular menstruation (55. 56%), 3 cases showed sudden menorrhea after regular menstruation (4. 76%), and 6 cases (60%) had chromosome abnormalities in 10 cases of primary atresia. 3 cases (30%) were exposed to adverse environmental factors, 3 cases (30%) were type A behavior, 1 case (6.67%) had chromosome abnormality and 12 cases (80%) were exposed to adverse environmental factors. There were 10 cases of type A actors (66.67%), 2 cases of chromosome abnormalities (5.26%) and 24 cases of exposure to adverse environmental factors (63.16%). Type A behavior was 25 cases (65.79%). Among 4.63 patients with POI, 14 cases (22.22%) had previous pregnancy, 12 cases (85.71%) had different miscarriages. Conclusion: 1. This study showed that the average age of onset of POI in women of childbearing age before 40 years old was 26.59 鹵6.29 years old. 2.POI had complex etiology and should be investigated by multiple factors at an early stage. Timely intervention and corresponding treatment according to the etiology. 3. In POI patients, the main risk factor of primary atresia is genetic factor; The main risk factors for patients with rare menstruation and secondary atresia are adverse environmental factors and personal life behavior. 4. Most patients with POI have abnormal menstruation in the early stage, and only a few of them show sudden menorrhea after regular menstruation. In the event of abnormal menstruation, attention should be paid to the evaluation of ovarian function and fertility preservation.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.75

【參考文獻】

相關(guān)期刊論文 前10條

1 吳潔;陳蓉;;早發(fā)性卵巢功能不全的激素補充治療專家共識[J];中華婦產(chǎn)科雜志;2016年12期

2 陳敏;王遠菊;王彩霞;;腹腔鏡下卵巢子宮內(nèi)膜異位囊腫剝除術(shù)前使用GnRH-a預(yù)處理對卵巢儲備功能的影響[J];現(xiàn)代婦產(chǎn)科進展;2016年10期

3 叢青;李斌;;卵巢早衰的病因與診治進展[J];老年醫(yī)學(xué)與保健;2015年06期

4 張茜劵;秦瑩瑩;陳子江;;卵巢早衰遺傳學(xué)病因研究進展[J];中國實用婦科與產(chǎn)科雜志;2015年08期

5 李婧;呂娟;王宇娟;王贊宏;;腹腔鏡下卵巢子宮內(nèi)膜異位癥囊腫剝除術(shù)不同止血方法對卵巢儲備功能影響的系統(tǒng)評價[J];中國循證醫(yī)學(xué)雜志;2015年07期

6 喬東艷;于紅;任慕蘭;王蓓;;卵巢早衰危險因素的Meta分析[J];生殖與避孕;2013年01期

7 勾麗潔;許士奇;劉旭東;柴葉紅;朱振麗;祝金華;;社會心理因素與腦卒中后抑郁發(fā)病的相關(guān)性研究[J];河北醫(yī)藥;2010年02期

8 王雪梅;張慧敏;戚桂杰;;人工流產(chǎn)術(shù)后閉經(jīng)和月經(jīng)過少原因探討[J];中國婦幼保健;2008年06期

9 龐震苗;梁菁;鄧高丕;;卵巢早衰患者個性特征及心理健康狀況調(diào)查[J];臨床心身疾病雜志;2007年05期

10 孫瑩;張丹;賈海軍;;環(huán)境內(nèi)分泌干擾物與女性生殖健康[J];中華婦幼臨床醫(yī)學(xué)雜志;2007年03期

相關(guān)博士學(xué)位論文 前2條

1 陳默;移植誘導(dǎo)多能干細(xì)胞(iPSCs)修復(fù)化療所致卵巢早衰的實驗研究[D];復(fù)旦大學(xué);2014年

2 趙志藝;卵巢早衰的遺傳學(xué)病因分析和PTEN抑制劑對卵巢的作用及其安全性研究[D];山東大學(xué);2013年

相關(guān)碩士學(xué)位論文 前2條

1 張莉;卵巢早衰發(fā)病因素探討[D];南京中醫(yī)藥大學(xué);2014年

2 閆婭妮;卵巢早衰危險因素的病例對照研究[D];華北煤炭醫(yī)學(xué)院;2010年

，

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