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目的:探讨全子宫切除术后卵巢功能减退对绝经前妇女体质指数(BMI)、血脂及血糖水平的影响。方法:选取2010至2013年因子宫良性病变于我院行全子宫切除术的102例患者,分为激素替代治疗组(44例)和无激素替代治疗组(58例)。选取同年龄段健康体检者48例作为对照。随访1年,检测各组患者的BMI、血脂(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白)及血糖水平。结果:与对照组相比,全子宫切除组患者术后1年的BMI、总胆固醇、甘油三酯和低密度脂蛋白均明显上升(P<0.05),高密度脂蛋白较对照组显著降低(P<0.05);空腹血糖值较对照组升高,但差异无统计学意义(P>0.05)。全子宫切除患者中,与无激素替代治疗组比较,激素替代治疗组患者的总胆固醇水平显著降低(P<0.05),甘油三酯、高密度脂蛋白、低密度脂蛋白水平升高,BMI、空腹血糖值降低,但差异均无统计学意义(P>0.05)。结论:全子宫切除术术后引起的卵巢功能减退对糖类、脂类的代谢存在一定影响,小剂量短程雌激素治疗可降低胆固醇等血脂水平。术后应积极监测,合理应用激素替代治疗。
Objective: To investigate the effect of hypofunction after hysterectomy on body mass index (BMI), blood lipid and blood glucose in premenopausal women. Methods: A total of 102 patients undergoing hysterectomy in our hospital from 2010 to 2013 were selected and divided into hormone replacement therapy group (n = 44) and hormone replacement therapy group (n = 58). Select the same age group of 48 healthy subjects as a control. All the patients were followed up for 1 year. BMI, blood lipids (total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein) and blood glucose level were detected in all groups. Results: Compared with the control group, BMI, total cholesterol, triglyceride and low density lipoprotein were significantly increased (P <0.05) and high density lipoprotein P <0.05); fasting blood glucose increased compared with the control group, but the difference was not statistically significant (P> 0.05). In total hysterectomy patients, total cholesterol was significantly lower (P <0.05), triglyceride, high density lipoprotein and low density lipoprotein levels were higher in patients with hormone replacement therapy than in those without hormone replacement therapy. The levels of BMI, Fasting blood glucose decreased, but the difference was not statistically significant (P> 0.05). CONCLUSION: Ovarian hypofunction caused by hysterectomy may have some effect on the metabolism of carbohydrate and lipid. Low-dose short-range estrogen treatment can reduce the level of cholesterol and other blood lipids. After surgery should be actively monitored, rational use of hormone replacement therapy.