中国妇女绝经过渡期特征研究
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摘要
目的了解中国妇女在绝经过渡期的特征。
方法对就诊更年期门诊的妇女进行关于绝经过渡期的问卷调查。建立数据库,应用SPSS13.0软件进行统计分析。
结果1850名妇女完成调查,平均绝经年龄为49.6岁,进入绝经过渡期的平均年龄为46.22岁,出现绝经过渡期症状的平均年龄46.28岁。前5位症状依次为失眠(60%)、潮热出汗(51%)、感觉异常及耳鸣(45%)、骨关节肌肉痛(18%)以及疲乏无力(16%)。症状随年龄增加加重：从事家务工作与离退休妇女症状相对较重,有慢性病或有重大手术史等应激源的妇女症状较重；.激素治疗能有效改善更年期症状。
结论对绝经过渡期女性特征的研究有助于完善绝经过渡期的分期研究；中国妇女绝经过渡期平均约持续3.4年,绝经过渡期开始的年龄与更年期症状开始发生的年龄基本吻合；年龄、月经状况、职业以及有无应急源可能与更年期症状有相关性。激素补充治疗可以有效缓解更年期症状。
Objective:To investigate the characteristics of Chinese women during menopausal transition.
Methods:Investigation was conducted with a questionnaire about menopausal transition composed by general conditions and Kupperman Menopause Index (KMI). All of the parameters were input into a database and analyzed by SPSS.
Results:A total of1850women were interviewed. The average ages of natural menopause, entering menopause transition and on setting of menopausal symptoms were49.60,46.22and46.28years old, respectively. The five most frequent symptoms were insomnia (60%), hot flash or sweating (51%), paraesthesia (45%), aching in muscles and joint s (18%), worn out (16%). x2test revealed the association of aging, menopausal staging, occupation and stress with climacteric syndrome, and hormone treatment could improve climacteric syndrome.
Conclusions:The investigation of the characteristics of women during menopause transition is helpful to improve the study on defining menopause transition. The average duration of menopausal transition is about3.4years. The age of on setting menopausal symptoms is parallel with the age of entering menopausal transition. Climacteric symptoms were common but mild in Chinese women during menopausal transition. Aging, menopausal staging, occupation and stress were related with climacteric syndrome, and hormone treatment could improve climacteric syndrome.
方法对就诊更年期门诊的妇女进行关于绝经过渡期的问卷调查。建立数据库,应用SPSS13.0软件进行统计分析。
结果1850名妇女完成调查,平均绝经年龄为49.6岁,进入绝经过渡期的平均年龄为46.22岁,出现绝经过渡期症状的平均年龄46.28岁。前5位症状依次为失眠(60%)、潮热出汗(51%)、感觉异常及耳鸣(45%)、骨关节肌肉痛(18%)以及疲乏无力(16%)。症状随年龄增加加重：从事家务工作与离退休妇女症状相对较重,有慢性病或有重大手术史等应激源的妇女症状较重；.激素治疗能有效改善更年期症状。
结论对绝经过渡期女性特征的研究有助于完善绝经过渡期的分期研究；中国妇女绝经过渡期平均约持续3.4年,绝经过渡期开始的年龄与更年期症状开始发生的年龄基本吻合；年龄、月经状况、职业以及有无应急源可能与更年期症状有相关性。激素补充治疗可以有效缓解更年期症状。
Objective:To investigate the characteristics of Chinese women during menopausal transition.
Methods:Investigation was conducted with a questionnaire about menopausal transition composed by general conditions and Kupperman Menopause Index (KMI). All of the parameters were input into a database and analyzed by SPSS.
Results:A total of1850women were interviewed. The average ages of natural menopause, entering menopause transition and on setting of menopausal symptoms were49.60,46.22and46.28years old, respectively. The five most frequent symptoms were insomnia (60%), hot flash or sweating (51%), paraesthesia (45%), aching in muscles and joint s (18%), worn out (16%). x2test revealed the association of aging, menopausal staging, occupation and stress with climacteric syndrome, and hormone treatment could improve climacteric syndrome.
Conclusions:The investigation of the characteristics of women during menopause transition is helpful to improve the study on defining menopause transition. The average duration of menopausal transition is about3.4years. The age of on setting menopausal symptoms is parallel with the age of entering menopausal transition. Climacteric symptoms were common but mild in Chinese women during menopausal transition. Aging, menopausal staging, occupation and stress were related with climacteric syndrome, and hormone treatment could improve climacteric syndrome.
引文
1.李颖,郁琦,马良坤,孙正怡.北京市城区围绝经期妇女更年期症状分析.生殖医学杂志,2008,17(5)：329-334.
2..蒋利华,姚珍薇.重庆市绝经期妇女生殖健康状况的现状调查.重庆医学,2005,34(4)：568.
3..田丰莲,詹新林,赵庆国et all广东地区围绝经期综合征患病状况及其影响因素.中国妇幼保健,2004,19：68.
4..沈汝木冈,张凇文,王军华.北京地区围绝经期妇女骨质疏松流行病学调查与分析.中国妇幼保健,2004,19：72.
5. Ying L et al. Prevalence of depression and anxiety symptoms and their influence factors during menopausal transition and postmenopause in Beijing city. Maturits, 2008,61,238-242.
6.王晓明,修新红,袁丽,万爱华.青岛市围绝经期妇女健康状况调查.中国妇幼保健,2007,22：2703.
7. Jokinen K et al. Experience of climacteric symptoms among 42-46 and 52-56 years old women. Maturitas,2003,46 (3):199-205.
8. Gold EB et al. Relation of demographic and lifestyle factors to symptoms in a multiracial ethnic population of women 40-55 years of age. Am J Epidemiol, 2000,152(5):463-473.
9. Sievert LL et al. Vasomotor symptoms among J apanese2American and European American women living in Hilo, Hawaii. Menopause,2007,14 (2):261-269.
10. Karasam Z, Seker SE. Factors associated wit h menopausal symptoms and t heir relationship with the quality of life among Turkish women. Maturitas,2007,58 (1):75-82.
11. Chedraui P et al. Assessing menopausal symptoms among healt hy middle aged women with the Menopause Rating Scale. Maturitas,2007,57 (3):271-278.
12. Lu J, Liu J, Eden J. The experience of menopausal symptoms by Arabic women in Sydney. Climacteric,2007,10(1):72-79.
13.徐苓,赵衍,葛秦生.围绝经期的流行病学调查.生殖医学杂志,1993,2 (1)：23-27.
14.邓小虹,张淞文.北京地区围绝经期妇女健康现状的流行病学调查.北京医学,2002,24(2)：235-238.
1.Clarisa R et al.Defining menopause status.creation of a new definition to identify the early changes of the menopausal transition Menopause:The Journal of the North American Menopause Society,2005,12(2); 128-135.
2.曹泽毅。中华妇产科学。人民卫生出版社,2004,11.
3.Henry M et al. Williams Textbook of endocrinology.2008,11th ed.
4.费安兴,肖新立,游爱平.围绝经期妇女性激素水平的变化.中国妇幼保健,2003,18(7)：406-407.
5. Sowers MR et al. Follicle stimulating hormone and its rate of change in defining menopause transition stage. J Clin Endocrinol Metab,2008 Oct,93(10):3958-3964.
6.Muttukrishna S et al. Serum concentrations of dimeric inhibins, activin A, gonadotrophins and ovarian steroids during the menstrual cycle in older women. Hum Reprod,2000,15(3):549-556.
7.Katz. Comprehensie Gynecologu.2007,5th ed.
8.葛秦生.临床生殖内分泌学女性与男性.科学技术文献出版社,2001,11.
9. Burger HG et al. Cycle and hormone change during perimenopause:the key role of ovarian function. Menopause,2008,15(4 Pt 1):603-612.
lO.Davison SL et al. Androgen levels in adult females:changes with age, menopause, and oophorectomy. J Clin Endocinol Metab,2005,90(7):3847-3853.
11.Longcope C. Adrenal and gonadal androgen secretion in normal females. Clin Endocrinol Metab,1986,15(2):21-228.
12.Stanford JL et al. Factors influencing the age at natural menopause. J Chronic Dis,1987,40(1):995-1002.
13.Gold EB, Bromberger J, Crawford S, et al. Factors associated wit h age at natural menopause in a multiet hnic sample ofmidlife women. Am J Epidermiol, 2001,153(9):865-874.
14.Porter M, Penney G, Russell E, et al.A population based survey of woman's experience of the menopause.Br J Obstet Gynaecol,1996, 103:1025.
15.Kowalcek I et al. Retrospectively experiencing the menopause in Germany and in Papua New Guinea:a comparative report.Zentralbl Gynakol,2003,125(11):467
16.邓小虹,张松文.北京地区围绝经期妇女健康状况的流行病学调查.北京医学,2002,24(4)：235—238
17.陆洪波,杨晓钊,黄永兴等.南宁市妇女围围绝经期综合征流行病学调查研究.广西医科大学学报,2001,18(5)：761—763
18.Pedro AO, Pinto-Neto AM, Costa-Paiva LH, et al.Climacteric syndrome:a population-based study in Brazil.Rev Saude Publica,2003,37(6):735.
19.Yahya S, Rehan N. Age, pattern and symptoms of menopause among rural women of lahore.J Ayub Med Coll Abbottabad,2002,14(3):9.
20.Versi E et al.Urogenital prolapse and atrophy at menopause:a prevalence study.Int Urogynecol J Pelvic Floor Dysfunct,2001,12(2):107.
21.Nadkar MY et al.NE.Relationship between osteoarthritis of knee and menopause. J Assoc Physicians India,1999,47(12):1161.
22.娄友群,江虹.激素替代疗法与药物选择[J].首都医药.1999,8：21—22.
23.乐杰主编.妇产科学[M].人民卫生出版社,1980年(第一版),382—384.
24.林守清,林萍,姜玉新,等.绝经后卵巢和子宫萎缩及血雌二醇降低的观察.中华妇产科杂志,1997,32(9)：524—527.
25.闰琳丽.围绝经期卵巢功能及老化机制的研究.国外医学妇产科学分册,1996,23(5)：262—265.
26.Rannevik G et al.Effects of synthetic luteinizing hormone--releasing hormone on Plasma luteinzing hormone follicle.stimnlating hormone in amenorrheric women.Fertil Steril,1994,25:547-550.
27.梁文郁.中西医结合防治更年期综合征.中国中医基础医学杂志,1999,5(3)：57—59.
28.步世忠,孙梅,张沅,等.更年健上调老年雌性大鼠下丘脑雌激素受体mRNA表达对P物质和β-内啡肽的影响.中国中西医结合杂志,1998,18(1)：28—30.
29.Stefano GB et al.Auto immunomodulation, age-related opioid differences in vertebrate and invertebrate immune systems. Ann.N.Y.Acad.Sci,1992,663:396.
30.Hirikawa K et al. Aging and immunity. Acta Pathol Jpn,1992,42(8):537.
31.王文君,俞瑾,李大金等.雌性大鼠老化过程中脾细胞雌激素受体含量及白细胞介素-2、肿瘤坏死因子活性的变化.中华内分泌代谢杂志,1999,15(4)：225—228.
32.李大金,李超荆,俞瑾,等.中药复方对更年期综合征妇女生殖内分泌-免疫功能的调节.上海免疫学杂志,1995,15(5)：257—259.
33.黄晨,崔致贤.氧自由基在冠心病研究中的现状与展望.心血管病学进展,1994,15(3)：129—131
34.肖炜,邓虹珠,马云,陈育尧,杨俊.益妇宁软胶囊对去势大鼠血清性激素、自由基及NO水平的影响.中药材,2003,26(10)：740—743.
35.方玉荣,王立金,周昕.围绝经期妇女血清性激素水平与自由基、血脂含量的变化.实用妇产科杂志,2004,20(3)：151一152.
36. Mackness MI et al. Alloenzymes os paraoxonase and effectiveness of highdensity lipoproteins in protecting low density lipoprotein against lipid peroxidation.Lancet,1997,349(9055):851.
37.Vallance P et al. Biology and clinical relevance of nitric oxide. BMJ,1994,309: 453.
38.Yang D, Buren GA, Clark KE. Effect of calcitonin gene-related pelide on the uterine vasculafare of the nonpregeant ewe.AmJ Obster Gynecol,1992, 167(1):178-184.
39.Carrasco G A, Van de Kar L D. Neuroendocrine pharmacology of stress.Eur J Pharmacol,2003,463(1-3):235-272
40.Binfa L et al. Influence of paychosocial factors on climacteric symptoms. Maturitas,2004,48(4):425-431.
41.王晓萍.更年期忧郁症的心理治疗.浙江预防医学,1998,(9)：575.
42.赵更力,王临虹,渠川琰,等.妇女个性特征与更年期综合征初探.中国心理卫生杂志,1998,12(3)：136—137.
2..蒋利华,姚珍薇.重庆市绝经期妇女生殖健康状况的现状调查.重庆医学,2005,34(4)：568.
3..田丰莲,詹新林,赵庆国et all广东地区围绝经期综合征患病状况及其影响因素.中国妇幼保健,2004,19：68.
4..沈汝木冈,张凇文,王军华.北京地区围绝经期妇女骨质疏松流行病学调查与分析.中国妇幼保健,2004,19：72.
5. Ying L et al. Prevalence of depression and anxiety symptoms and their influence factors during menopausal transition and postmenopause in Beijing city. Maturits, 2008,61,238-242.
6.王晓明,修新红,袁丽,万爱华.青岛市围绝经期妇女健康状况调查.中国妇幼保健,2007,22：2703.
7. Jokinen K et al. Experience of climacteric symptoms among 42-46 and 52-56 years old women. Maturitas,2003,46 (3):199-205.
8. Gold EB et al. Relation of demographic and lifestyle factors to symptoms in a multiracial ethnic population of women 40-55 years of age. Am J Epidemiol, 2000,152(5):463-473.
9. Sievert LL et al. Vasomotor symptoms among J apanese2American and European American women living in Hilo, Hawaii. Menopause,2007,14 (2):261-269.
10. Karasam Z, Seker SE. Factors associated wit h menopausal symptoms and t heir relationship with the quality of life among Turkish women. Maturitas,2007,58 (1):75-82.
11. Chedraui P et al. Assessing menopausal symptoms among healt hy middle aged women with the Menopause Rating Scale. Maturitas,2007,57 (3):271-278.
12. Lu J, Liu J, Eden J. The experience of menopausal symptoms by Arabic women in Sydney. Climacteric,2007,10(1):72-79.
13.徐苓,赵衍,葛秦生.围绝经期的流行病学调查.生殖医学杂志,1993,2 (1)：23-27.
14.邓小虹,张淞文.北京地区围绝经期妇女健康现状的流行病学调查.北京医学,2002,24(2)：235-238.
1.Clarisa R et al.Defining menopause status.creation of a new definition to identify the early changes of the menopausal transition Menopause:The Journal of the North American Menopause Society,2005,12(2); 128-135.
2.曹泽毅。中华妇产科学。人民卫生出版社,2004,11.
3.Henry M et al. Williams Textbook of endocrinology.2008,11th ed.
4.费安兴,肖新立,游爱平.围绝经期妇女性激素水平的变化.中国妇幼保健,2003,18(7)：406-407.
5. Sowers MR et al. Follicle stimulating hormone and its rate of change in defining menopause transition stage. J Clin Endocrinol Metab,2008 Oct,93(10):3958-3964.
6.Muttukrishna S et al. Serum concentrations of dimeric inhibins, activin A, gonadotrophins and ovarian steroids during the menstrual cycle in older women. Hum Reprod,2000,15(3):549-556.
7.Katz. Comprehensie Gynecologu.2007,5th ed.
8.葛秦生.临床生殖内分泌学女性与男性.科学技术文献出版社,2001,11.
9. Burger HG et al. Cycle and hormone change during perimenopause:the key role of ovarian function. Menopause,2008,15(4 Pt 1):603-612.
lO.Davison SL et al. Androgen levels in adult females:changes with age, menopause, and oophorectomy. J Clin Endocinol Metab,2005,90(7):3847-3853.
11.Longcope C. Adrenal and gonadal androgen secretion in normal females. Clin Endocrinol Metab,1986,15(2):21-228.
12.Stanford JL et al. Factors influencing the age at natural menopause. J Chronic Dis,1987,40(1):995-1002.
13.Gold EB, Bromberger J, Crawford S, et al. Factors associated wit h age at natural menopause in a multiet hnic sample ofmidlife women. Am J Epidermiol, 2001,153(9):865-874.
14.Porter M, Penney G, Russell E, et al.A population based survey of woman's experience of the menopause.Br J Obstet Gynaecol,1996, 103:1025.
15.Kowalcek I et al. Retrospectively experiencing the menopause in Germany and in Papua New Guinea:a comparative report.Zentralbl Gynakol,2003,125(11):467
16.邓小虹,张松文.北京地区围绝经期妇女健康状况的流行病学调查.北京医学,2002,24(4)：235—238
17.陆洪波,杨晓钊,黄永兴等.南宁市妇女围围绝经期综合征流行病学调查研究.广西医科大学学报,2001,18(5)：761—763
18.Pedro AO, Pinto-Neto AM, Costa-Paiva LH, et al.Climacteric syndrome:a population-based study in Brazil.Rev Saude Publica,2003,37(6):735.
19.Yahya S, Rehan N. Age, pattern and symptoms of menopause among rural women of lahore.J Ayub Med Coll Abbottabad,2002,14(3):9.
20.Versi E et al.Urogenital prolapse and atrophy at menopause:a prevalence study.Int Urogynecol J Pelvic Floor Dysfunct,2001,12(2):107.
21.Nadkar MY et al.NE.Relationship between osteoarthritis of knee and menopause. J Assoc Physicians India,1999,47(12):1161.
22.娄友群,江虹.激素替代疗法与药物选择[J].首都医药.1999,8：21—22.
23.乐杰主编.妇产科学[M].人民卫生出版社,1980年(第一版),382—384.
24.林守清,林萍,姜玉新,等.绝经后卵巢和子宫萎缩及血雌二醇降低的观察.中华妇产科杂志,1997,32(9)：524—527.
25.闰琳丽.围绝经期卵巢功能及老化机制的研究.国外医学妇产科学分册,1996,23(5)：262—265.
26.Rannevik G et al.Effects of synthetic luteinizing hormone--releasing hormone on Plasma luteinzing hormone follicle.stimnlating hormone in amenorrheric women.Fertil Steril,1994,25:547-550.
27.梁文郁.中西医结合防治更年期综合征.中国中医基础医学杂志,1999,5(3)：57—59.
28.步世忠,孙梅,张沅,等.更年健上调老年雌性大鼠下丘脑雌激素受体mRNA表达对P物质和β-内啡肽的影响.中国中西医结合杂志,1998,18(1)：28—30.
29.Stefano GB et al.Auto immunomodulation, age-related opioid differences in vertebrate and invertebrate immune systems. Ann.N.Y.Acad.Sci,1992,663:396.
30.Hirikawa K et al. Aging and immunity. Acta Pathol Jpn,1992,42(8):537.
31.王文君,俞瑾,李大金等.雌性大鼠老化过程中脾细胞雌激素受体含量及白细胞介素-2、肿瘤坏死因子活性的变化.中华内分泌代谢杂志,1999,15(4)：225—228.
32.李大金,李超荆,俞瑾,等.中药复方对更年期综合征妇女生殖内分泌-免疫功能的调节.上海免疫学杂志,1995,15(5)：257—259.
33.黄晨,崔致贤.氧自由基在冠心病研究中的现状与展望.心血管病学进展,1994,15(3)：129—131
34.肖炜,邓虹珠,马云,陈育尧,杨俊.益妇宁软胶囊对去势大鼠血清性激素、自由基及NO水平的影响.中药材,2003,26(10)：740—743.
35.方玉荣,王立金,周昕.围绝经期妇女血清性激素水平与自由基、血脂含量的变化.实用妇产科杂志,2004,20(3)：151一152.
36. Mackness MI et al. Alloenzymes os paraoxonase and effectiveness of highdensity lipoproteins in protecting low density lipoprotein against lipid peroxidation.Lancet,1997,349(9055):851.
37.Vallance P et al. Biology and clinical relevance of nitric oxide. BMJ,1994,309: 453.
38.Yang D, Buren GA, Clark KE. Effect of calcitonin gene-related pelide on the uterine vasculafare of the nonpregeant ewe.AmJ Obster Gynecol,1992, 167(1):178-184.
39.Carrasco G A, Van de Kar L D. Neuroendocrine pharmacology of stress.Eur J Pharmacol,2003,463(1-3):235-272
40.Binfa L et al. Influence of paychosocial factors on climacteric symptoms. Maturitas,2004,48(4):425-431.
41.王晓萍.更年期忧郁症的心理治疗.浙江预防医学,1998,(9)：575.
42.赵更力,王临虹,渠川琰,等.妇女个性特征与更年期综合征初探.中国心理卫生杂志,1998,12(3)：136—137.
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