关键词: 月经异常, 肾功能不全, 血液透析, 肾移植, 子宫内膜病变

Abstract:

Objective To evaluate the factors relevant to menstrual disorders in women of childbearing age with chronic renal failure. Methods A cross sectional study was conducted by questionnaire investigation on 222 women with chronic renal failure of childbearing age, who received hemodialysis in Beijing Chaoyang Hospital and Tongzhou Luhe Teaching Hospital of Capital Medical University,between 1st, September to 30th, November 2010, 129 patients were enrolled into the study. Results ①Among 129 women, 69.76% patients suffered from the menstrual disturbances, while 39 patients without any menstrual problem served as controls; there were no significant differences between both groups in respect to age, age of menarche, time of hemodialysis, and body mass index and so on, but suffering from the endometrial hyperplasia, and with history of dysfunctional uterine bleeding were associated with the development menstrual disturbances (P<0.05). ②They were divided into five groups according to their menstrual pattern: amenorrhea (n=23, 25.56%), polymenorrhea (n=33, 36.67%), oligomenorrhea (n=14, 15.56%), eumenorrhea (n=20,22.22%),the normal menstruation (n=39,30.23%). ③Among 90 cases of menstrual disturbances, 48 (53.33%) had normal menstruation after hemodialysis, suffering from the myoma and endometrial hyperplasia, and longer interval between renal insufficiency and hemodialysis were associated with sustained menstrual disturbances.④The association of renal failure and endometrial lesions: 40 patients were D and C indicated the abnormal menstruation, and 13 cases were diagnosed as endometrial lesions (32.5%), 8 cases (20%) simple hyperplasia; 1 case complex hyperplasia; 3 of them (7.5%) had atypical hyperplasia; only one patient (2.5%) had endometrial carcinoma. Longer interval between renal insufficiency and hemodialysis, severe renal insufficiency were associated with the endometrial lesions (P<0.05). Conclusion The women with chronic renal failure often suffer from menstrual disturbances and endometrial lesions.With the uterus myoma and endometrial hyperplasia, and with history of dysfunctional uterine bleeding were associated with the development of menstrual disturbances. Longer interval between renal insufficiency and hemodialysis, severe renal insufficiency were associated with endometrial lesions.

Key words: menstrual disturbances, chronic renal failure, hemodialysis, kidney transplant, endometrial lesion