绝经后子宫内膜息肉恶变与代谢综合征的关系初探  

Relation between postmenopausal endometrial polyps canceration and metabolism symptom complex

作　　者：王海波[1] 逯彩虹[1] 李萍[1] 高丽彩[1] 张爱群[1] 赵金荣[1] 

机构地区：[1]解放军第260医院妇产科,河北石家庄050041

出　　处：《中国内镜杂志》2015年第8期819-822,共4页China Journal of Endoscopy

基　　金：河北省2015年度医学科学研究重点课题资助(No:20150369)

摘　　要：目的探讨绝经后子宫内膜息肉恶变与代谢综合征的关系,进而探讨其潜在恶变及恶变的危险因素,为代谢综合征患者的子宫内膜息肉的早期诊治提供理论依据。方法分析2006年1月-2013年1月该院妇产科收治的435例经宫腔镜病理确诊为子宫内膜息肉的患者,依据病理类型分为良性组(415例)和非典型增生(恶变组)(20例),对两组临床资料进行回顾性分析。结果子宫内膜息肉的恶变率4.6%,单因素分析,与子宫内膜息肉发生非典型增生或恶变的相关因素有体质指数(BMI)、绝经年限、绝经后阴道流血、子宫内膜厚度、腰围、空腹血糖、血三酰甘油(TG)、血高密度脂蛋白(HDL)(P<0.05),多元回归分析后得出,BMI、腰围、舒张压、血TG、血HDL、空腹血糖或确诊为糖耐量异常或糖尿病是子宫内膜癌合并代谢综合征的独立危险因素(P<0.05)。结论患有子宫内膜息肉的绝经妇女,子宫内膜息肉恶变与代谢综合征关系密切,建议绝经后有代谢综合征的子宫内膜息肉患者,应严密随访,如合并阴道流血、内膜厚度≥5 mm,息肉≥8 mm或息肉多发等高危因素,应在宫腔镜下切除息肉。[ Objective ] To approach the relation between postmenopausal endometrial polyps canceration and metabolism symptom complex, research risk factors of endometrial polyp （EMP） potential canceration and cancera- tiou, and provide theory base for early diagnosis and therapy of EMP. [Methods] A total of 435 cases of EMP （415 cases of innocence, 20 cases of atypical hyperplasia and canceration） from January 2009 to January 2013 were diag- nosed through pathology with hysteroscope in our hospital. A retrospective analysis was performed on the clinical da- ta of two groups. [Results] EMP canceration rate was 4.6%. The result of single factor analysis showed that correla- tion factors for atypical hyperplasia or canceratiou of EMP were BMI, menopausal years, vaginal bleeding after menopause, endometrial thickness, waistline, fasting blood glucose, TG, HDL （P 〈 0.05）. The result of multiple re- gression analysis showed that independent dangerous factors for endometrial cancer complicating metabolism symp- tom complex were BMI, waistline, diastolic pressure, TG, HDL, fasting blood glucose or sugar tolerance dysfunction, diabetes （P 〈 0.05）. [ Conclusions ] Postmenopausal women with endometrial polyps, endometrial polyps evil change was closely associated with the metabolic syndrome. It is suggested that endometrial polyp patients with post- menopausal metabolic syndrome should be closely followed up, if it is complicated with high risk factors such as vaginal bleeding, endometrium thickness ≥ 5 mm, polyps ≥ 8 mm or multiple polyps, the polyps should be removed under hysteroscope.

关 键 词：代谢综合征 子宫内膜息肉 恶变 危险因素 

分 类 号：R711.52[医药卫生—妇产科学]