不同透析方式对尿毒症育龄期女性患者性激素水平及月经的影响研究  

Study on the effects of different dialysis modalities on sex hormone levels and menstrual patterns in childbearing-age women with uremia

作　　者：吴仪 孙治华 邵宁[2] WU Yi;SUN Zhihua;SHAO Ning(School of Medicine,Wuhan University of Science and Technology,Wuhan,Hubei 430065,China;Department of Nephrology,Tianmen First People’s Hospital,Tianmen,Hubei 431700,China)

机构地区：[1]武汉科技大学医学部,武汉430065 [2]天门市第一人民医院肾内科,湖北天门431700

出　　处：《重庆医学》2025年第4期830-834,共5页Chongqing Medical Journal

基　　金：湖北省自然科学基金面上类项目(2023AFB1105);职业危害识别与控制湖北省重点实验室联合基金项目。

摘　　要：目的研究不同透析方式对尿毒症育龄期女性患者激素和月经的影响。方法选取2020年3月至2024年7月于天门市第一人民医院肾内科就诊的102例育龄期女性尿毒症患者作为研究对象,其中选择血液透析治疗的52例患者纳入血液透析组,选择腹膜透析治疗的50例患者纳入腹膜透析组,另选取同期50例接受体检的健康育龄期女性作为对照组。比较3组研究对象在尿毒症患者透析治疗6个月后的性激素水平及月经情况。结果治疗前、后血液透析组与腹膜透析组的卵泡刺激素(FSH)、泌乳素(PRL)、促黄体生成素(LH)高于对照组,而孕酮(P)低于对照组,差异有统计学意义(P<0.05)。治疗后,血液透析组与腹膜透析组FSH低于治疗前,LH、P、PRL高于治疗前,差异有统计学意义(P<0.05);血液透析组雌二醇(E2)、P略低于腹膜透析组,但差异无统计学意义(P>0.05);血液透析组与腹膜透析组FSH、LH、PRL比较差异也无统计学意义(P>0.05)。治疗后,血液透析组月经正常率、月经紊乱率略低于腹膜透析组,差异无统计学意义(P>0.05),闭经率高于腹膜透析组,差异有统计学意义(P<0.05),闭经后复潮率略高于腹膜透析组,差异无统计学意义(P>0.05)。结论腹膜透析与血液透析均能改善女性尿毒症患者激素失调情况,腹膜透析较血液透析改善月经紊乱情况效果更佳。Objective To investigate the effects of different dialysis modalities on hormonal profiles and menstrual disorders in childbearing-age women with uremia.Methods From March 2020 to July 2024,102 childbearing-age women with uremia treated in the Department of Nephrology of Tianmen First People’s Hospital were enrolled and divided into hemodialysis group(n=52)and peritoneal dialysis group(n=50),and 50 healthy women undergoing physical examinations were selected as the control group.Sex hormone level s and menstrual patterns were compared among three groups at baseline and 6 months post-dialysis.Results Pretreatment levels of follicle-stimulating hormone(FSH),prolactin(PRL),and luteinizing hormone(LH)in both hemodialysis and peritoneal dialysis groups were significantly higher than those in healthy controls,while progesterone(P)levels were lower(P<0.05).Post-treatment,hemodialysis and peritoneal dialysis groups showed decreased FSH and increased LH,PRL,and P compared to baseline(P<0.05).Estradiol(E2)and P levels in hemodialysis group were slightly lower than those in the peritoneal dialysis group without statistical significance(P>0.05).No significant intergroup differences existed in FSH,LH,P,or PRL between hemodialysis and peritoneal dialysis groups post-treatment(P>0.05).Menstrual normalization and disorder rates in hemodialysis group were nonsignificantly lower than peritoneal dialysis group(P>0.05),whereas amenorrhea incidence was significantly higher in hemodialysis group(P<0.05).Menstrual resumption rate after amenorrhea showed no statistical difference between groups(P>0.05).Conclusion Both peritoneal dialysis and hemodialysis effectively ameliorate hormonal dysregulation in female uremia patients,while peritoneal dialysis demonstrates superior efficacy in improving menstrual disorders.

关 键 词：尿毒症 血液透析 腹膜透析 女性激素 月经 

分 类 号：R692[医药卫生—泌尿科学]