月经过多女性缺铁预测、经期生存质量分析及出血倾向测评
发布时间：2019-04-22 19:26
【摘要】：背景及目的： 育龄女性是缺铁的高发人群,月经过多是致育龄女性缺铁的重要原因。本研究以自行开发设计的月经出血评分(MBS),测评女性月经量,探讨其对月经过多女性缺铁的预测作用。 对象及方法： 采用横断面观察研究法.以2012年12月-2013年4月在北京海军总医院妇科门诊就诊的95例月经过多女性为对象,以自行设计的月经出血评分表(MBS)测评经量,并完成血清铁(SI)及血红蛋白(Hb)等相关检查,以探讨MBS预测月经过多女性缺铁的临床效用。 结果： 95例月经过多女性中检出缺铁65例(68.42%),其中铁耗减34例(35.79%)、缺铁性红细胞生成12例(12.63%)、缺铁性贫血19例(20%)。Spearman分析及误差限图分析均表明,MBS评分与女性缺铁程度显著正相关(P0.01)。Logistic回归示,MBS评分是影响月经过多女性缺铁的重要因素(P0.01)。ROC分析示,当女性MBS评分≥41.25时,提示有较高的缺铁风险,有必要作进一步的实验室缺铁筛查,此时预测的灵敏度、特异度分别达50.77%、86.67%,ROC曲线下面积为0.705(P0.01)。 结论： MBS测评法操作简易,能有效预测月经过多女性的缺铁风险,或在门诊、社区基层、女性缺铁普查及日常自我保健中有一定应用前景。 研究背景及目的： 月经过多是育龄女性的常见病症,可致女性缺铁、贫血、疲劳,生理及心理健康状况受损,生存质量下降。本研究以自行开发设计的月经过多特异性生存质量评定表(MS-QOL),评估月经过多女性的经期生存质量,并探讨量表的信效度及临床使用价值。 对象和方法： 采用横断面观察研究法。以2012年12月～2013年4月在北京海军总医院妇科门诊就诊的65例月经过多女性为对象,同期参加健康体检的22例月经正常女性为对照,采集月经史,以MS-QOL量表测评女性经期生存质量,并完成血色素、血清铁等相关检查。 结果： (1) MS-QOL量表信效度分析：以探索性因子分析法提取出量表公因子2个,累积解释变量达71.2%,量表与2个公因子的Cronbachα系数均0.7,量表各条目与其所属因子的相关度均较高,且验证性因子分析结果进一步证实,量表模型拟合效果较优,结构效度较好(x2值=106.94、P值=0.000、RMSEA=0.267、 IFI=0.829、TLI=0.673)。(2)MS-QOL量表临床应用：与月经正常组相比,月经过多组女性的量表评分更高、经期更长、卫生巾用量更多、Hb及Hct更低；且spearman分析结果表明,量表评分与女性经期长度及卫生巾用量相关度较高,与Hb及Hct相关度较低,提示经量增多可能是致月经过多女性经期生存质量降低的更重要原因。 结论： MS-QOL量表信效度较高,实用性较强,或可通过评估及动态监测月经过多女性经期生存质量变化,指导个性化治疗方案的制定,提高治疗效果。 研究背景及目的： 月经过多是育龄女性的常见病症,临床上多伴随子宫肌瘤等妇科器质性病变发生,但约近半数的月经过多女性无明显妇科器质性病变,导致月经过多的原因未明。近年有研究指,无妇科器质性病变的月经过多女性中,有相当比例者止凝血功能低下,出血现象多见。MCMDM-1vWD量表是一种简易、高效的出血倾向测评工具。但检索相关文献数据库后(最后检索时间2013-12-19-11：00),未发现有该量表的中文版本研制使用。本研究拟引入MCMDM-1vWD量表,翻译成中文版本,评估月经过多女性的出血倾向,并分析月经过多女性出血倾向与止凝血功能状态的相关关系。 对象和方法： 将MCMDM-1vWD量表译成中文并回译。以2012年12月～2013年4月在北京海军总医院妇科门诊就诊的39例无妇科器质性病变的月经过多女性为研究对象,同期参加健康体检的22例月经正常女性为对照,采集月经史,以MCMDM-1vWD量表评估出血倾向,并完成止凝血功能等相关检查。 结果： 月经过多女性中,有异常出血现象的人数占比、出血积分(BS)0分的人数占比,均高于月经正常组。将月经过多及月经正常女性,进一步分成不同出血积分(BS)亚组后发现,BS高分组(BS≥3)较BS低分组(BS≤0)经期天数更长、卫生巾用量更多,SI、MPV、Fib、vWF:Act、FVIII:C水平更低,PT更长。二分类logistic回归发现,月经过多女性出血倾向增加(BS≥3)可能与PT延长有关。 结论： 无妇科器质性病变的月经过多女性中,有相当比例者出血事件多见,出血倾向较明显。以MCMDM-1vWD量表为工具进行出血倾向评估,可在一定程度上反映月经过多女性的止凝血功能状态,具有一定临床使用价值。
[Abstract]:Background and purpose: The female of the age of childbearing is a high-risk group of iron deficiency, and too much is an important source of iron deficiency in the female of childbearing age. The results of this study were based on the self-developed design of the menstrual bleeding score (MBS) and the amount of women's menstrual cycle, and the prediction of iron deficiency in excess of the women was discussed. to use. Object and methods: cross-section The study was carried out on the basis of a self-designed menstrual bleeding index (MBS), and the serum iron (SI) and hemoglobin (Hb) were completed. Peer-to-peer review to discuss MBS to predict the excess of iron deficiency in women Clinical Results:65 cases (68.42%) of iron deficiency were detected in 95 cases of excess iron,34 of iron (35.79%),12 (12.63%) of iron-deficiency red blood cells,19 (20%) of iron-deficiency anemia, and Spearman's analysis. The analysis of the error limit shows that the MBS score is positively correlated with the iron deficiency of the female (P0.01). Logistic regression shows that the MBS score is an important factor that affects the iron deficiency of the female (P0.01). The ROC analysis shows that, when the female MBS score is 41.25, it is suggested that there is a high risk of iron deficiency, and it is necessary to make an admission. The sensitivity and specificity of the step were 50.77%, 86.67% and 0.7 respectively under the ROC curve. 05 ( Conclusion: MBS evaluation method is easy to operate, can effectively predict the iron deficiency risk of excessive female, or in the clinic, community base, female iron deficiency general survey and day One of the most common self-care The background and purpose of the study are as follows: too many of the common diseases of the female of childbearing age, which can lead to the deficiency of iron, anemia, fatigue and birth of the female In order to assess the quality of life, the quality of life and the quality of life of the female in the menstrual period were assessed by the self-developed and self-developed mass index of the quality of life (MS-QOL). and explore the scale The validity of the letter and the value of clinical use . Object and method: The cross-sectional observation method was adopted. In the period from December 2012 to April 2013,65 cases of women with more than one female who were treated in the gynaecological clinic of the General Hospital of the Navy General Hospital of Beijing were the subject. In the same period,22 cases of healthy physical examination were taken as control, and the menstrual history was collected and the MS-Q was collected. The Evaluation of Women's Classics by OL Scale period of existence The results were as follows: (1) The reliability and validity of the MS-QOL scale:2, the cumulative interpretation variable was 71.2%, and the Cronbach index of the scale and the 2 male factors was calculated by the exploratory factor analysis method. The coefficient is 0.7, the correlation degree of each entry of the scale and its associated factor is high, and the results of the confirmatory factor analysis further confirm that the fitting effect of the scale model is superior, the structure validity is good (x2 value = 106.94, P value = 0.000, RMSEA = 0 (267, P = 0.829, TLI = 0.673). (2) The clinical application of the MS-QOL scale: Compared with the normal group of the menstrual cycle, the scale score of the female with too many groups is higher, the period is longer, the dosage of the sanitary towel is more, the Hb and Hct are lower, and the spearman analysis results It is shown that the correlation between the scale score and the length of the women's menstrual period and the dosage of the sanitary napkin is high, the correlation with the Hb and Hct is low, and the amount of the indication is increased. multiple possibilities Conclusion: The reliability and validity of MS-QOL scale are high, the practicability is strong, or the excessive female can be monitored by the evaluation and dynamic monitoring. quality of life in the period of menstrual period The development of the individualized treatment plan is guided, and the treatment effect is improved. The background and purpose of the study are as follows: hypermenorrhea is a common condition of the female of the childbearing age, and the clinic is accompanied by the occurrence of gynecological organic diseases such as the hysteromyoma, but About half of the women have no obvious gynaecological organic lesions, which have led to an excessive number of causes. In recent years, there have been researches on the non-gynaecological device In a large number of women with quality lesions, there is a significant proportion of women with low blood coagulation and bleeding. The MCMDM-1vWD scale is a simple and efficient tool for evaluating the bleeding tendency. However, after the relevant literature database is retrieved (the last retrieval time 2 013-12-19-11:00), no Chinese version of the scale was found to be used. The study is to introduce the MCMDM-1 vWD scale to be translated into Chinese version to assess the excess of women sex-based bleeding tendency And to analyze the tendency of excessive female bleeding and the function of stopping blood coagulation. The relationship between state and state. Object and method: The MCMDM-1vWD scale was translated into Chinese and translated into Chinese. In December,2012 to April,2013,39 women with no gynecological organic lesions were enrolled in the Gynecology Clinic of the General Hospital of the Navy General Hospital of Beijing. 2 cases of normal women were controlled and collected. history of menstruation To assess the bleeding tendency with the MCMDM-1 vWD scale and to complete the check of the blood-stopping function, etc. Results: too much In the female, the proportion of the number of patients with abnormal bleeding was higher than that of the normal group of the menstrual cycle, and the number of the bleeding points (BS)0 was higher than that of the normal group of the menstrual cycle. It was found that the number of the BS high-group (BS-3) was longer than that of the BS (BS-0), and the number of days in the BS-3 was longer than that of the BS-low group (BS-0). The amount of towel is more, SI, MPV, Fib, vWF: Act, FVIII: C is lower and PT is longer. class lo Logistic regression found that the increase in bleeding tendency in excess of women (BS%3) may be related to the extension of PT Conclusion: There is a significant proportion of bleeding events in women with no gynecological organic disease, and the bleeding tendency is more obvious.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.51
本文编号：2463129
[Abstract]:Background and purpose: The female of the age of childbearing is a high-risk group of iron deficiency, and too much is an important source of iron deficiency in the female of childbearing age. The results of this study were based on the self-developed design of the menstrual bleeding score (MBS) and the amount of women's menstrual cycle, and the prediction of iron deficiency in excess of the women was discussed. to use. Object and methods: cross-section The study was carried out on the basis of a self-designed menstrual bleeding index (MBS), and the serum iron (SI) and hemoglobin (Hb) were completed. Peer-to-peer review to discuss MBS to predict the excess of iron deficiency in women Clinical Results:65 cases (68.42%) of iron deficiency were detected in 95 cases of excess iron,34 of iron (35.79%),12 (12.63%) of iron-deficiency red blood cells,19 (20%) of iron-deficiency anemia, and Spearman's analysis. The analysis of the error limit shows that the MBS score is positively correlated with the iron deficiency of the female (P0.01). Logistic regression shows that the MBS score is an important factor that affects the iron deficiency of the female (P0.01). The ROC analysis shows that, when the female MBS score is 41.25, it is suggested that there is a high risk of iron deficiency, and it is necessary to make an admission. The sensitivity and specificity of the step were 50.77%, 86.67% and 0.7 respectively under the ROC curve. 05 ( Conclusion: MBS evaluation method is easy to operate, can effectively predict the iron deficiency risk of excessive female, or in the clinic, community base, female iron deficiency general survey and day One of the most common self-care The background and purpose of the study are as follows: too many of the common diseases of the female of childbearing age, which can lead to the deficiency of iron, anemia, fatigue and birth of the female In order to assess the quality of life, the quality of life and the quality of life of the female in the menstrual period were assessed by the self-developed and self-developed mass index of the quality of life (MS-QOL). and explore the scale The validity of the letter and the value of clinical use . Object and method: The cross-sectional observation method was adopted. In the period from December 2012 to April 2013,65 cases of women with more than one female who were treated in the gynaecological clinic of the General Hospital of the Navy General Hospital of Beijing were the subject. In the same period,22 cases of healthy physical examination were taken as control, and the menstrual history was collected and the MS-Q was collected. The Evaluation of Women's Classics by OL Scale period of existence The results were as follows: (1) The reliability and validity of the MS-QOL scale:2, the cumulative interpretation variable was 71.2%, and the Cronbach index of the scale and the 2 male factors was calculated by the exploratory factor analysis method. The coefficient is 0.7, the correlation degree of each entry of the scale and its associated factor is high, and the results of the confirmatory factor analysis further confirm that the fitting effect of the scale model is superior, the structure validity is good (x2 value = 106.94, P value = 0.000, RMSEA = 0 (267, P = 0.829, TLI = 0.673). (2) The clinical application of the MS-QOL scale: Compared with the normal group of the menstrual cycle, the scale score of the female with too many groups is higher, the period is longer, the dosage of the sanitary towel is more, the Hb and Hct are lower, and the spearman analysis results It is shown that the correlation between the scale score and the length of the women's menstrual period and the dosage of the sanitary napkin is high, the correlation with the Hb and Hct is low, and the amount of the indication is increased. multiple possibilities Conclusion: The reliability and validity of MS-QOL scale are high, the practicability is strong, or the excessive female can be monitored by the evaluation and dynamic monitoring. quality of life in the period of menstrual period The development of the individualized treatment plan is guided, and the treatment effect is improved. The background and purpose of the study are as follows: hypermenorrhea is a common condition of the female of the childbearing age, and the clinic is accompanied by the occurrence of gynecological organic diseases such as the hysteromyoma, but About half of the women have no obvious gynaecological organic lesions, which have led to an excessive number of causes. In recent years, there have been researches on the non-gynaecological device In a large number of women with quality lesions, there is a significant proportion of women with low blood coagulation and bleeding. The MCMDM-1vWD scale is a simple and efficient tool for evaluating the bleeding tendency. However, after the relevant literature database is retrieved (the last retrieval time 2 013-12-19-11:00), no Chinese version of the scale was found to be used. The study is to introduce the MCMDM-1 vWD scale to be translated into Chinese version to assess the excess of women sex-based bleeding tendency And to analyze the tendency of excessive female bleeding and the function of stopping blood coagulation. The relationship between state and state. Object and method: The MCMDM-1vWD scale was translated into Chinese and translated into Chinese. In December,2012 to April,2013,39 women with no gynecological organic lesions were enrolled in the Gynecology Clinic of the General Hospital of the Navy General Hospital of Beijing. 2 cases of normal women were controlled and collected. history of menstruation To assess the bleeding tendency with the MCMDM-1 vWD scale and to complete the check of the blood-stopping function, etc. Results: too much In the female, the proportion of the number of patients with abnormal bleeding was higher than that of the normal group of the menstrual cycle, and the number of the bleeding points (BS)0 was higher than that of the normal group of the menstrual cycle. It was found that the number of the BS high-group (BS-3) was longer than that of the BS (BS-0), and the number of days in the BS-3 was longer than that of the BS-low group (BS-0). The amount of towel is more, SI, MPV, Fib, vWF: Act, FVIII: C is lower and PT is longer. class lo Logistic regression found that the increase in bleeding tendency in excess of women (BS%3) may be related to the extension of PT Conclusion: There is a significant proportion of bleeding events in women with no gynecological organic disease, and the bleeding tendency is more obvious.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.51
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