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山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (9): 100-104.doi: 10.6040/j.issn.1671-7554.0.2017.123

• 临床医学 • 上一篇    下一篇

流产经历和子宫肌瘤家族史对子宫肌瘤患病风险的影响

龚茁,张敏敏,王志萍   

  1. 山东大学公共卫生学院流行病与卫生统计学系, 山东 济南 250012
  • 收稿日期:2017-02-09 出版日期:2017-09-10 发布日期:2017-09-10
  • 通讯作者: 王志萍. E-mail:zhipingw@sdu.edu.cn E-mail:zhipingw@sdu.edu.cn

Influence of abortion and family heredity history on the risk of uterine leiomyomas

GONG Zhuo, ZHANG Minmin, WANG Zhiping   

  1. Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan 250012, Shandong, China
  • Received:2017-02-09 Online:2017-09-10 Published:2017-09-10

摘要: 目的 探讨流产经历和子宫肌瘤家族史对子宫肌瘤患病风险的影响,为预防子宫肌瘤提出建议。 方法 采用病例-对照研究方法,使用结构式问卷调查的方式收集山东省城市和农村的10个县级单位20~65岁常住已婚已育女性的流产经历和子宫肌瘤家族史,同时收集其年龄、身高等信息。运用Logistic回归模型分析流产经历和子宫肌瘤家族史与子宫肌瘤的关系。应用交互作用的相对超额风险(RERI)、归因于交互作用的比例(AP)和协同指数(S)三个指标评价流产史和子宫肌瘤家族史的相加交互作用。 结果 多因素非条件Logistic回归模型结果显示,流产史(OR=1.39, 95%CI:1.06~1.80)和子宫肌瘤家族史(OR=2.07, 95%CI:1.36~3.15)均为子宫肌瘤的危险因素。流产史和子宫肌瘤家族史对子宫肌瘤患病风险存在相加交互作用(S=5.51, AP=0.59, RERI=2.14)。有子宫肌瘤家族史的研究对象,1次流产和2次以上流产经历其子宫肌瘤患病风险分别增加1.78倍和2.77倍,而无遗传背景的研究对象中,流产经历对子宫肌瘤发病影响较小。 结论 有子宫肌瘤遗传背景的敏感人群应注意计划怀孕,谨慎流产以降低患子宫肌瘤的风险。

关键词: 家族史, 子宫肌瘤, 流产经历, 交互作用, 病例-对照研究, Logistic回归分析

Abstract: Objective To explore the influence of abortion and family heredity history on the risk of uterine leiomyomas, and to provide suggestions for preventing uterine leiomyomas. Methods A case-control study was undertook in this study. A structural questionnaire survey was used collecting the information of abortion experience, family history of uterine leiomyomas, age, height and other information among 20-65 years old married women from 10 urban and rural areas in Shandong province, China. The relations between both abortion experience, family history of uterine leiomyomas and uterine leiomyomas were analyzed by using Logistic regression model. Relative excess risk of interaction, attributable proportion of interaction and synergy index were used evaluating the interaction of abortion and family history of uterine leiomyomas. Results Results from multivariate unconditional Logistic regression model showed that abortion(OR=1.39, 95%CI: 1.06-1.80)and family heredity history of uterine leiomyomas(OR=2.07, 95%CI: 1.36-3.15)were risk factors of uterine leiomyomas. There was an addictive interaction of abortion and family heredity history on the risk of uterine leiomyomas (S=5.51, AP=0.59, RERI=2.14). Patients who had family heredity history and who had one or two more abortion increased the risk of uterine leiomyomas by 1.78 times and 2.77 times respectively. Conclusion Women who have family heredity history of uterine leiomyomas should pay attention to the pregnant plan and prevent abortion in order to reduce the risk of uterine leiomyomas.

Key words: Abortion, Interaction, Case-control study, Uterine Leiomyomas, Family heredity history, Logistic regression analysis

中图分类号: 

  • R181.2+3
[1] 刘丽, 许艳瑾, 尹伶. 我国子宫肌瘤的流行病学特征[J]. 现代预防医学, 2014, 41(2): 204-207. LIU Li, XU Yanjin, YIN Ling. The epidemiological characteristics of uterine fibroids in China[J]. Modern Preventive Medicine, 2014, 41(2): 204-207.
[2] 周应芳. 子宫肌瘤药物治疗之评价[J]. 实用妇产科杂志, 2016, 32(3): 180-182.
[3] Zimmermann A, Bernuit D, Gerlinger C, et al. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women[J]. BMC Womens Health, 2012, 12: 6. doi: 10.1186/1472-6874-12-6.
[4] Cardozo ER, Clark AD, Banks NK, et al. The estimated annual cost of uterine leiomyomata in the United States[J]. Am J Obstet Gynecol, 2012, 206(3): 211, e1-e9. doi: 10.1016/j.ajog.2011.12.002.
[5] Stewart EA, Cookson CL, Gandolfo RA, et al. Epidemiology of uterine fibroids: a systematic review[J]. BJOG, 2017. doi: 10.1111/1471-0528.14640.[Epub ahead of print]
[6] Ciebiera M, Wodarczyk M, Sabuszewska-Józwiak A, et al. Influence of vitamin D and transforming growth factor β3 serum concentrations, obesity, and family history on the risk for uterine fibroids[J]. Fertil Steril, 2016, 106(7): 1787-1792.
[7] Song L, Shen L, Mandiwa C, et al. Induced and spontaneous abortion and risk of uterine fibroids[J]. J Womens Health(Larchmt), 2017, 26(1): 76-82.
[8] 陶然. Logistic模型多重共线性问题的诊断及改进[J]. 统计与决策, 2008(15): 22-25.
[9] Wise LA, Laughlin-Tommaso SK. Epidemiology of uterine fibroids: from menarche to menopause[J]. Clinical Obstetrics and Gynecology, 2016, 59(1): 2-24.
[10] Vercellini P, Frattaruolo MP. Uterine fibroids: from observational epidemiology to clinical management[J]. BJOG, 2017. doi: 10.1111/1471-0528.14730. [Epub ahead of print]
[11] Salimi S, Hajizadeh A, Yaghmaei M, et al. The effects of p21 gene C98A polymorphism on development of uterine leiomyoma in southeast Iranian women[J]. Tumour Biol, 2016, 37(9): 12497-12502.
[12] Gallagher CS, Morton CC. Genetic association studies in uterine fibroids: risk alleles presage the path to personalized therapies[J]. Semin Reprod Med, 2016, 34(4): 235-241.
[13] 赵菁, 肖霞. 子宫肌瘤发病的危险因素分析[J]. 山东医药, 2017, 57(14): 94-95.
[14] 邓兰云. 子宫肌瘤发病危险因素分析[J]. 中国公共卫生, 2014, 30(6): 807-808. DENG lanyun. Risk factors of uterine leiomyoma among married women: a case-control study[J]. Chin J Public Health, 2014, 30(6): 807-808.
[15] 唱丽荣, 孙玉倩, 周桂霞. 子宫肌瘤影响因素病例对照研究[J]. 中国公共卫生, 2009, 25(8): 970-971.
[16] 路臻, 高新萍. 子宫肌瘤发病危险因素分析[J]. 中国妇幼保健, 2016, 31(14): 2819-2821.
[17] 林林, 相静, 韩春蕾, 等. SULT1A1基因多态性与子宫肌瘤关系[J]. 中国公共卫生, 2012, 28(3): 315-317. LIN Lin, XIANG Jing, HAN Chunlei, et al. Correlation between SULT1A1 genetic polymorphism and uterine leiomyoma[J]. Chin J Public Health, 2012, 28(3): 315-317.
[18] 封全灵, 张倩, 刘弘扬, 等. 子宫肌瘤发病孕激素相关危险因素病例对照研究[J]. 中国妇幼保健, 2016, 31(2): 241-243. FENG Quanling, ZHANG Qian, LIU Hongyang, et al. A case-control study on related risk factors of progesterone for uterine leiomyoma[J]. Maternal and Child Health Care of China, 2016, 31(2): 241-243.
[19] 何峰. 子宫肌瘤在农村已婚妇女中的发病状况及其相关因素的研究[J]. 中国妇幼保健, 2015, 30(22): 3789-3791.
[20] Sikorski R, Kapec E, Zaleska W. Serum levels of proinflammatory cytokines in women with uterine myomas[J]. Ginekologia Polska, 2001, 72(12A): 1485-1488.
[21] 陈敏玲, 陈慧军, 瞿先花. 人工流产后生殖支原体感染与盆腔炎的相关性分析[J]. 中华医院感染学杂志, 2013, 23(11): 2646-2648. CHEN Minling, CHEN Huijun, QU Xianhua. Correlation between Mycoplasma infections and pelvic inflammatory after temination of pregnancy[J]. Chin J Nosocomiol, 2013, 23(11): 2646-2648.
[22] 杨丽, 黄星, 白符. 人工流产影响因素及与生殖道感染关系[J]. 中国公共卫生, 2014, 30(4): 416-419. YANG Li, HUANG Xing, BAI Fu. Correlation of reproductive tract infections and other influencing factors with induced abortion[J]. Chin J Public Health, 2014, 30(4): 416-419.
[23] 杨晓乐, 时燕萍. 雌激素受体基因α多态性与子宫肌瘤易感关系的研究[J]. 新疆医科大学学报, 2014, 37(2): 248-251.
[24] 王佳茵, 张海珍, 关云谦, 等. 汉族人群雌激素受体β基因多态性与子宫肌瘤的关系[J]. 首都医科大学学报, 2010, 31(5): 660-663. WANG Jiayin, ZHANG Haizhen, GUAN Yunqian, et al. Relationship of estrogen receptor β gene polymorphisms with leiomyoma of the uterus in Han population[J]. Journal of Capital Medical University, 2010, 31(5): 660-663.
[25] 冯丽华, 叶琳, 刘艳广, 等. 雌激素受体β基因多态性与子宫肌瘤相关性研究[J]. 中国妇幼保健, 2009, 24(20): 2848-2850. FENG Lihua, YE Lin, LIU Yanguang, et al. Study on association between estrogen receptor β polymorphisms and uterine leiomyoma[J]. Maternal and Child Health Care of China, 2009, 24(20): 2848-2850.
[26] 陈庆云, 张小燕. 子宫肌瘤发病机制研究进展[J]. 中国实用妇科与产科杂志, 2012, 28(12): 950-952.
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