育龄期月经过多女性患者中出血性疾病的筛查  

Screening for Bleeding Disorders in Premenopausal Women with Menorrhagia

作　　者：叶絮[1] 冯莹[1] 周旭红[1] 庞缨[1] 李澄宇[1] 赖毅妍[1] 刘凌[1] 谢纬[1] 

机构地区：[1]广州医学院第二附属医院内科,广州510260

出　　处：《血栓与止血学》2011年第5期207-210,共4页Chinese Journal of Thrombosis and Hemostasis

基　　金：广东省医药科技项目(A2010260)

摘　　要：目的对育龄期月经过多女性患者进行出血性疾病的筛查和病因学分析。方法对102例育龄期月经过多女性患者进行出血性疾病的筛查,收集患者的病史、家族史,并分别进行全血细胞计数、血细胞形态学观察、凝血指标的检测、凝血因子水平的测定、血小板黏附和聚集功能测定、von Willebrand因子水平的测定及血小板膜糖蛋白CD 41、CD 42b、CD 61表达水平的测定等。结果 72例(70.5%)患者经检查可找到出血性疾病病因。将患者按照病因分为遗传性出血性疾病组(n=24)和获得性出血性疾病组(n=48)。两组患者的初诊年龄(32.4±9.0∶31.1±10.8岁,P=0.622)和初诊时血红蛋白水平(96.42±19.97∶93.17±30.64,P=0.591)无显著性差异(P>0.05),遗传性出血性疾病组的月经过多病程较获得性出血性疾病组明显延长(217.5±106.2∶15.0±36.5,P=0.007),遗传组中缺铁性贫血发生率较获得组明显升高(18/24∶19/48,P=0.006)。结论育龄期月经过多女性患者中,相当一部分为出血性疾病患者,其中病程较短者以获得性出血性疾病多见,而病程较长者多为遗传性出血性疾病患者,有必要对育龄期月经过多女性患者进行出血性疾病的筛查尤其是遗传性出血性疾病的筛查。Objective To screen for bleeding disorders and do pathogenic study in premenopausal women with menorrhagia.Methods 102 premenopausal women with menorrhagia were screened for bleeding disorders through case history and family history collection,complete blood counting,blood cell morphology analysis,coagulation function and coagulation factor activity detection,platelet adhesion and agglutination function detection,von Willebrand factor determination,platelet membrane glycoprotein CD 41,CD 42b,CD 61 detection.Results Some kind of bleeding disorder can be found in 70.5%（72/102） of the patients.Based on the pathogenesis,the patients were grouped into hereditary group（n=24） and acquired group.There is no significant difference in the age（32.4±9.0∶ 31.1±10.8,P=0.622）and hemoglobin level（96.42±19.97∶ 93.17±30.64,P=0.591）at initial diagnosis between the two groups.But the menorrhagia course was much longer in the hereditary bleeding disorder group than the acquired bleeding disorder group（217.5±106.2∶ 15.0±36.5,P=0.007）.Besides,the prevalence of iron deficiency anemia was much higher in the hereditary group than the acquired group（18/24∶ 19/48,P=0.006）.Conclusion An underlying bleeding disorder can be found in some premenopausal women with menorrhagia.Those with acquired bleeding disorders have much shorter menorrhagis courses than those with hereditary bleeding disorders indicating that hereditary bleeding disorders are more likely to be ignored.Therefore,it is necessary to check for underlying bleeding disorders,especially hereditary bleeding disorders in premenopausal women with menorrhagia.

关 键 词：月经过多 出血性疾病 病因学 遗传性 获得性 

分 类 号：R711.51[医药卫生—妇产科学]