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影响卵巢早衰和提前绝经的绝经前因素
Premenopausal factors influencing premature ovarian failure and early menopause
Chang SH, Kim C-S, Lee K-S  2009/5/27 10:50:39 
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Maturitas, 2007,
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Abstract

Objectives:

We conducted this study to examine premenopausal risk factors associated with premature ovarian failure (POF) and early menopause (EM) among Korean women.

Methods:

A 73% of total women aged 30–69 at four districts in the KMCC (Korean Multi-center Cancer Cohort) was participated in this study during 2002–2003. We selected 137 POF and 281 EM cases who had menopause before age 40 and at age 40–44, respectively, and 1318 normal menopause (NM) controls that experienced menopause at age 45–60, and among them, selected idiopathic POF (n=84) and EM (n=261) after excluding surgical/medical menopause. We collected the information of premenopausal lifestyle and reproductive risk factors. Multivariate and polytomous logistic regression were used to estimate POF and EM risk and to differentiate POF and EM risk using ordinal and nominal scale.

Results:

Cigarette smoking was associated with an increased risk of idiopathic POF (OR=1.82 [1.03–3.23]), whereas oral contraceptive use was associated with a reduced risk of natural EM (OR=0.62 [0.43–0.90]). Idiopathic POF risk by both factors differed from idiopathic EM risk (p-nominal<0.05). Factors related to ovulation, such as later menarche, irregular menstruation and longer breast feeding cumulatively reduced the risk of natural EM and POF (p-ordinal<0.05). In analysis including medical and surgical menopause, lung tuberculosis, hysterectomy, past cancers, and lower number of deliveries before menopause were associated with POF.

Conclusions:

Our findings indicate that etiology in POF development may partly differ from that in EM.
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多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年——长海医院病例

曹晶珠  邹大进

 

解放军第二军医大学附属长海医院内分泌科

 

患者为中年女性，35岁，因“多饮、多尿、全身乏力、闭经1年，体重增加、肝区不适半年”于2008年8月入院。患者2007年感冒后出现多饮、多尿，每日饮水约10,000 ml，未予重视及诊治。2007年出现闭经，在外院妇产科就诊，先后予2次黄体酮肌肉注射，仍未来月经。半年前体重增加25 kg，肝区不适，肝功能示转氨酶升高。患者无便秘腹胀、无皮肤感染、无双下肢水肿，活动后稍感胸闷、气喘，夜尿增多，平均每小时1次。最大体重88.7 kg。既往史无特殊。月经史：初潮14岁，4/28～30，2008年6月。

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