【作者】 张莉；

【导师】 施艳秋；

【作者基本信息】 南京中医药大学 ， 中医学（专业学位）， 2014， 硕士

【摘要】 目的：通过对200例卵巢早衰患者发病相关因素的调查,找出卵巢早衰发病的危险因素和保护因素,为卵巢早衰的预防提供科学依据。方法：根据卵巢早衰的诊断标准,并参考相关文献,拟定卵巢早衰发病相关因素调查问卷和《A型行为类型评定量表》,选择2012年3月到2014年2月在江苏省中医院门诊就诊的患者共200例,及同期来门诊就诊的其他患者及正常人群100例为对照组,共300例。由经过培训的调查人员对两组进行详细询问并如实填写问卷,将所得数据录入excel,采用SPSS17.0软件进行统计分析,根据资料类型分别选用X2检验、t检验和秩和检验,并进行单因素及多因素Logistic回归分析,计算各研究因素与POF的关联强度OR值及其95%的置信区间。结果：1、73%的卵巢早衰患者发病年龄在30-40岁之间,19-24岁的患者占6%,卵巢早衰发病有年轻化趋势。2、3.5%的POF患者有家族遗传史,但POF的发生与遗传因素是否相关仍需进一步证实。3、POF的发生与月经初潮年龄、经期、经量、痛经均无关,与妊娠次数相关(P=0.001),月经周期也具有统计学差异(P=0.001)。人工流产是卵巢早衰发生的危险因素之一(OR=1.620,95%C.I.=1.084～2.423)。4、腮腺炎病史是卵巢早衰发生的高危因素(OR=4.116,95%C.I.=1.945～8.714)。5、卵巢手术史如卵巢切除术、卵巢活检术、卵巢囊肿剥除术等与POF发生有关,P<0.05,是卵巢早衰发生的最高危因素(OR=7.744,95%C.I.=1.557～38.510).6、主动吸烟、饮酒与卵巢早衰的发生无关(P>0.05),但是被动吸烟与POF的发生相关(P=0.000),是卵巢早衰发生的中度危险因素(OR=2.306,95%C.I.=1.062～5.007).7、A型性格是卵巢早衰发生的高危因素之一(OR=3.469,95%C.I.=1.696～7.093).8、睡眠质量差是卵巢早衰发生的一个偏高危因素(OR=2.607,95%C.I.=1.309～5.195),而经常进食蔬菜、锻炼身体是卵巢早衰的保护性因素(OR<1),增加豆制品的摄入量对卵巢早衰的发生有预防作用(P<0.05)。结论：1、人工流产、腮腺炎病史、卵巢手术史、被动吸烟、睡眠质量差是卵巢早衰发生的危险因素,其中腮腺炎病史、卵巢手术史、睡眠质量差为高危因素,尤以卵巢手术史为重。2、卵巢早衰患者在人格特征上以A型行为为主,为卵巢早衰发生的高危因素之一。3、经常锻炼身体、进食蔬菜是卵巢早衰的保护因素。更多还原

【Abstract】 Objective:Through the investigation of200premature ovarian failure patients to explore all possible risk factors and protective factors that affect the occurrence of premature ovarian failure, provide scientific basis for the further prevention of premature ovarian failure.Methods:According to the diagnostic criteria premature ovarian failure,and with reference to the relevant literature,develop the questionnaire on possible factors of premature ovarian failure and type A behavior questionnaire.Collected informations from Traditional Chinese Medcine Hospital of Jiang su Province by taking the detail history in200patients with POF(POF group) and in100healthy women (control group),who were evaluated from March2012to February2014.After an investigation by two groups of trained personnel conduct a detailed inquiry and fill out the questionnaire. Survey data entry Excel sorting, and using SPSS17.0on the data for statistical analysis.Dates were analyzed with Chi-square test, t test,nonParametric test or the conditional Logistic regression according to the type of the material, then calculated the Odds Ratios and the95%confidence.Results:1.73%POF patients were between30-40years old,6%POF patients between19-24years old,trends in the incidence of premature ovarian failure of younger.2.3.5%POF patients had family history,but the occurrence of POF whether related to the genetic factors needs further confirmation.3.POF was not associated with age at menarche,menstrual period, menstrual volume and pain,but associated with the times of pregnance (p=0.001),the menstrual cycle a significant difference (P=0.001).And the more artificial abortion, the higher incidence of POF(OR=1.620,95%C.I.=1.084～2.423).4.Having had parotitis was a important risk factor of POF(OR=4.116,95%C.I.=1.945～8.714).5. Having ovarian related operation history,such as ovariectomy, oophorocystectomy, ovarian biopsy, was associated with POF(P<0.05),was the most important risk factor of POF(OR=7.744,95%C.I.=1.557～38.510).6. Initiative smoking and drinking was not associated with POF, but passive smoking was associated with it(p=0.000),was a moderate risk factor of POF(OR=2.30,95%C.I.=1.062～5.007).7.Type A personality was one of the important risk factors of POF(OR=3.469,95%C.I.=1.696～7.093).8. People who had poor sleeping long time were risk factor of POF(OR=2.607,95%C.I=1.309～5.195),while taking more vegetables and exercises were protective factors of POF(OR<1),taking more bean may decrease the occurrence rate of POF (P<0.05)Conclusion:1.Artificial abortion, having had parotitis, having had a history of ovarian operation,passive smoking and having had poor sleeping are risk factors of POF.,while having had parotitis, having had a history of ovarian operation and having had poor sleeping were important risk factors,especially the history of ovarian operation.2. The mainly type of the personality characteristics was A in the group of POF patients,an Type A personality was a important risk factor of POF.3.Taking more vegetables and exercises were protective factors of POF.更多还原