雌二醇片改善绝经女性下生殖道环境对阴道镜下病变检出率的作用研究  

Effects of Estradiol Tablets on the Detection Rate of Colposcopic Lesions in Menopausal Women in Improving the Lower ReproductiveTract Environment

作　　者：朱修香 徐灵 王立锋 杨宝华[1] 夏子茵 李航[1] 程群仙 徐会娣 ZHU Xiuxiang;XU Ling;WANG Lifeng;YANG Baohua;XIA Ziyin;LI Hang;CHENG Qunxian;XU Huidi(Department of Gynaecology and Obstetrics,Shanghai Minhang District Central Hospital,Shanghai 201109,China)

机构地区：[1]复旦大学附属闵行医院/上海市闵行区中心医院妇产科,上海201199

出　　处：《标记免疫分析与临床》2024年第5期799-804,共6页Labeled Immunoassays and Clinical Medicine

基　　金：上海市卫计委临床医学科研支持项目(编号:201840340);上海市闵行区卫健委支持项目(编号:2020MW13)。

摘　　要：目的观察绝经女性使用雌二醇片对阴道镜下病变检出率的影响。方法前瞻性选取2020年12月至2021年10月在复旦大学附属闵行医院妇科宫颈门诊具有转诊阴道镜指征的患者200例作为研究对象,随机数字法分为试验组和对照组,每组100例。试验组在行阴道镜检查前1周开始给予雌二醇片治疗,每次0.5mg,每天1次,连续使用1周;对照组阴道镜检查前未使用任何药物治疗。对比两组患者的临床资料、阴道镜检查结果、患者疼痛、阴道镜满意度、雌激素水平、阴道镜检查总体评价以及用药患者不良反应情况。结果两组患者的年龄、绝经年限以及筛查前合并生殖道症状对比差异无统计学意义(P>0.05)。试验组低度鳞状上皮内病变(LSIL)检出率(75.00%)明显高于对照组(17.00%)(P<0.05),试验组宫颈慢性炎症占比(19%)明显低于对照组(78%),差异有统计学意义(P<0.05)。试验组患者宫颈癌占比、HSIL检出率与对照组相比,差异无统计学意义(P>0.05)。试验组患者的疼痛评分明显低于对照组,阴道镜满意度明显高于对照组,差异均有统计学意义(P<0.05)。阴道镜检后1周,试验组患者血清促黄体生成素(LH)和卵泡刺激素(FSH)水平明显低于用药前,雌二醇(E2)水平显著高于用药前(P<0.05),且试验组患者血清LH和FSH水平明显低于对照组,E2水平明显高于对照组,差异均有统计学意义(P<0.05),而对照组LH、FSH及E2水平在术前和术后1周对比差异无统计学意义(P>0.05);试验组停药1周后血清FSH、LH水平恢复原状,E2下降到原来水平。试验组绝经年限<5年、5~10年及>10年的患者阴道镜检查评估为较充分占比明显均高于对照组,宫颈鳞柱交界区部分可见占比均明显高于对照组(P<0.05)。试验组患者治疗期间有轻微的乳房胀、下腹胀及外阴饱满感,停药1周后上述症状消失。结论绝经女性使用雌二醇片能够明显减轻阴道镜活检的疼痛感,提高Objective To investigate the effect of estradiol tablets on the detection rate of colposcopic lesions in menopausal women.Methods A total of 200 patients with colposcopic indications were prospectively selected from December,2020 to October,2021 in the Gynecological and Cervical Outpatient Department of Minhang Hospital Affiliated to Fudan University,and were divided into the experimental group and control group by random number method,with 100 cases in each group.The experimental group was given estradiol tablets 0.5mg once a day for 1 week before colposcopy,while the control group did not receive any medication before colposcopy.The clinical data,colposcopy results,pain,colposcopy satisfaction,estrogen level,overall evaluation of colposcopy and adverse reactions of patients were compared between the two groups.Results There was no significant difference in age,menopause years and reproductive tract symptoms before screening between the two groups(P>0.05).The detection rate of low-grade squamous intraepithelial lesion(LSIL)in the experimental group(75.00%)was significantly higher than that in the control group(17.00%)(P<0.05),while the proportion of chronic cervical inflammation in the experimental group(19%)was significantly lower than that in the control group(78%)(P<0.05).There was no significant difference in cervical cancer proportion and HSIL detection rate between two groups(P>0.05).The pain score of the experimental group was significantly lower than that of the control group,while the satisfaction with colposcopy was significantly higher than that of the control group(P<0.05).One week after colposcopy,serum luteinizing hormone(LH)and follicle-stimulating hormone(FSH)levels in the experimental group were significantly lower than before treatment,and estradiol(E 2)level was significantly higher than before treatment(P<0.05),while serum LH and FSH levels in the experimental group were significantly lower than those in the control group,and E 2 levels were significantly higher than those in control group(P<

关 键 词：绝经女性 阴道镜检查 雌二醇片 检出率 

分 类 号：R711[医药卫生—妇产科学]