月經(jīng)改變對(duì)卵巢功能衰退過程的提示作用

論文編號(hào):HL209 論文字?jǐn)?shù):11786,頁(yè)數(shù):23

論文題目：月經(jīng)改變對(duì)卵巢功能衰退過程的提示作用
摘　要
 研究目的
 探討月經(jīng)參數(shù)(包括LMC、經(jīng)期長(zhǎng)度和經(jīng)量)及其改變對(duì)卵巢功能衰退過程的提示作用。
 研究方法
 符合條件的研究對(duì)象在入組時(shí)完成基線問卷調(diào)查和基線檢查，于12個(gè)月+15天內(nèi)完成隨診問卷調(diào)查和檢查。一般人口學(xué)資料、月經(jīng)史和疾病史、個(gè)人史、家族史；月經(jīng)周期第3．6天的血清FSH和E2水平；月經(jīng)周期第3-9天進(jìn)行經(jīng)陰道盆腔超聲檢查，取卵巢最大平面的橫徑(d)和縱徑(D)徑線，根據(jù)公式：Dxdxrd4計(jì)算卵巢最大截面積；LMC>60天者，在任意天進(jìn)行檢查；有關(guān)基線調(diào)查問卷內(nèi)容的變化情況；血清FSH和E2水平以及盆腔超聲檢查，檢查時(shí)間與基線相同。
 研究結(jié)果
 (1) 研究對(duì)象共記錄3596個(gè)月經(jīng)周期，平均每人記錄11.24.3.9個(gè)。平均LMC(按周期)為(33.09±23.74天，中位數(shù)為28天)；
 (2) 共記錄3919個(gè)經(jīng)期，平均經(jīng)期長(zhǎng)度為4.704±2.09天(中位數(shù)為4天)，平均經(jīng)為28.214±61.73分(中位數(shù)為14分)；月經(jīng)量>40分的有642個(gè)經(jīng)期(16.4％)隨診一年內(nèi)經(jīng)期長(zhǎng)度和經(jīng)量無明顯改變�；�線FSH水平(14.96±15.31IU／L)低于隨診時(shí)(19.78±21.14IU／L，p<0.01)；基線E2水平(73.67±75.83 pg／mL)雖高于隨診時(shí)(68.46±76.29pg／mL)，但無統(tǒng)計(jì)學(xué)差異(p=0.06)；基線右卵巢最大截面積大于隨診時(shí)(基線：3.51±1.19 cm2；隨診：3.30±1.28 cm2，n=279，P<0.01)。
 研究結(jié)論
 月經(jīng)周期長(zhǎng)度(按例)在40-42歲組最短，變化最�。淮撕箅S年齡增長(zhǎng)月經(jīng)周期長(zhǎng)度及其平均SD逐漸增加。經(jīng)期和經(jīng)量的變化沒有顯示出隨年齡變化的趨勢(shì)。不同F(xiàn)SH水平的月經(jīng)周期長(zhǎng)度及其變化不同，經(jīng)期和經(jīng)量則無此差異。月經(jīng)周期長(zhǎng)度及其平均SD可以作為卵巢功能衰退的提示指標(biāo)；經(jīng)期和經(jīng)量雖不能全面反應(yīng)卵巢功能的衰退，但能反應(yīng)卵巢功能衰退的某個(gè)階段。
 
關(guān)鍵詞: 卵巢功能衰退，月經(jīng)周期長(zhǎng)度,平均SD
論文類型：前瞻性隊(duì)列研究
Title: The Study on the Influential Factors and Nursing of BehaviorDisorders of Nephrotic Syndrome Children
ABSTRACT
Objective
 To analyze the relationship between the changes of menstruation(1ength of menstrual cycle and it’s veribility，length of mens and it’s veribility，menstrual blood loss and veribility)and the process of ovary aging．
 1．To describe the changes of menstruation、with age increasing．
 2．To describe the changes of menstruation with FSH increasing．
 3．To choose a veribale of the changes of menstruation that can describe ovary aging used in clinics．
Methods
 We analysis data of the baseline investigation and 1 2 monthsa：1 5 clays follow up．377 women aged 30—54 years who lived Bering community attended our survey by the purposive sample method．We conducted the survey by face-to-face interview with the questionnaire．The items of the queStionnaire are detailed as follow：the basic conditions (such as age，career,education,income，etc)，illness medical history，sex hormone treatment history，menstruation condition．1 2 months-a：1 5 days later these women were investigated again for changes of the above situations and re-measured the indexes below．
 Serum E2：Using the electrochemiluminescenc；
 Serum FSH：Using the electrochemiluminescenc；
 The biggest section proportion of ovary(BSPO).
Results
 (1) Totally recorded menstrual cycles are 3596 with average lengths as 33．09±23．74 days (median 28 days).
 (2) The recorded mens are 391 9 totally，、^ritll average lengths as 4．70±2．09 days(median 4 days)．The percentage of regular menstrual cycle at baseline is 22．6％(73)，and no menstrual cycle longer than 1 80 days．At the 12th month,the percentage of regular menstrual cycle is l 7．3％(56)，and the menstrual cycle of 1 5 women(4．6％)>180 clays，8 women(2．5％)‘s menstrual cycle>365．FSH level at baseline(14．96±1 5．3 1 IU／L，median 8．74 IU／L) iS lower than follow up (19．78±21．14IU／L，median 9．86 IU／L)．E2 at baseline(73．67±75．83 pg／ml，median 52．20 pg／rrd)is higher than follow up(68．46±76．29pg／ml，median 45．90 pg／m1)．The right BSPO at baseline(3．49±1．20 cm2，median 3．34 cm2)is larger than follow up(3．27±1．28cm2，3．07 cm2)．
Conclusion
 The length of menstrual cycle Was shortest in 40-42 years grou pwith lowes variability．The variability of menstrual cycle Was prolonged with the increase of age．The length of menstrual flow and its variability,the amount of menstrual loss and its variability did not show the trends、with age．The length and the variability of menstrual cycle could reflect the different levels of FSH．，nle length and the variability of menstrual cycle are the indicators of ovary aging·．
Key words：Ovary aging，Menstruation，Variability
 

目  錄
 
 摘　要 I
ABSTRACT III
目  錄 IV
1 緒論 2
1.1 背景及意義 2
1.2目的及目標(biāo) 2
1.3關(guān)鍵詞及定義 1
1.3.1卵巢功能衰退 1
1.3.2 月經(jīng)周期長(zhǎng)度 1
1.3.3卵巢最大截面積 1
1.4 文獻(xiàn)回顧 1
1.4.1 女性月經(jīng)周期的臨床意義 1
1.4.2卵巢功能衰退機(jī)制 1
1.4.3 卵巢功能的衰退的研究進(jìn)展 2
2 研究設(shè)計(jì) 4
2.1研究設(shè)計(jì) 4
2.2研究對(duì)象 4
2.3研究工具 4
2.4研究步驟 5
2.5統(tǒng)計(jì)分析 5
3 研究結(jié)果 6
3．1基線及隨診月經(jīng)情況 6
3．2基線和隨診時(shí)FSH、E2水平和卵巢大小的分布情況 7
3.3 不同年齡LMC 8
4 討論 11
4．1研究資料的可靠性分析 11
4．2不同年齡LMC、經(jīng)期長(zhǎng)度和經(jīng)量的特點(diǎn) 11
4．3隨診FSH平均水平的分布 11
4．4小結(jié) 12
5 推論及建議 13
致    謝 14
 參考文獻(xiàn) 15