Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study - Part 1
Can symptomatology help in the diagnosis of endometriosis? Findings from a national case-control study - Part 1
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DOI：
10.1111/j.1471-0528.2008.01878.x
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发表时间：
2008-10-01
影响因子：
5.8
通讯作者：
Wright, J. T.
中科院分区：
文献类型：
--
作者：
Ballard, K. D.;Seaman, H. E.;Wright, J. T.
目的探讨子宫内膜异位症患者自报症状在诊断子宫内膜异位症中的价值。设计一项全国病例对照研究。设置数据来自英国全科医学研究数据库1992- 2001年。样本共5540名年龄15-55岁的妇女，诊断为子宫内膜异位症，每一组与四名无子宫内膜异位症的对照组相匹配。方法分析数据以确定是否有特异性症状高度提示子宫内膜异位症。这些症状的优势比通过条件Logistic回归分析得出。主要结果测量与子宫内膜异位症相关的症状。与对照组（20%）相比，患有子宫内膜异位症的妇女有更大比例的腹盆疼痛、痛经或月经过多（73%）。与对照组相比，子宫内膜异位症妇女发生腹盆疼痛的风险增加（OR 5.2 [95% CI：4.7-5.7]），排尿困难（OR 8.1 [95% CI：7.2-9.3]），月经过多（OR 4.0 [95% CI：3.5-4.5]），生育力低下（OR 8.2 [95% CI：6.9-9.9]）、性交困难和/或性交后出血（OR 6.8 [95% CI：5.7-8.2]），卵巢囊肿（OR 7.3 [95% CI：5.7-9.4]），并被诊断为肠易激综合征（IBS）（OR 1.6 [95% CI：1.3-1.8]）或盆腔炎（OR 3.0 [95% CI：2.5-3.6]）。子宫内膜异位症的妇女也被发现更频繁地咨询医生比对照组和两倍的可能性有时间offwork.Conclusions特定的症状和频繁的医疗咨询与子宫内膜异位症，并出现有用的诊断。子宫内膜异位症可与盆腔炎或IBS并存或误诊。
Objective To determine the value of patient-reported symptoms in diagnosing endometriosis.Design A national case-control study.Setting Data from the UK General Practice Research Database for years 1992-2001.Sample A total of 5540 women aged 15-55 years, diagnosed with endometriosis, each matched to four controls without endometriosis.Methods Data were analysed to determine whether specific symptoms were highly indicative of endometriosis. Odds ratios for these symptoms were derived by conditional logistic regression analysis.Main outcome measures Symptoms associated with endometriosis.Results The prevalence of diagnosed endometriosis was 1.5%. A greater proportion of women with endometriosis had abdominopelvic pain, dysmenorrhoea or menorrhagia (73%) compared with controls (20%). Compared with controls, women with endometriosis had increased risks of abdominopelvic pain (OR 5.2 [95% CI: 4.7-5.7]), dysmenorrhoea (OR 8.1 [95% CI: 7.2-9.3]), menorrhagia (OR 4.0 [95% CI: 3.5-4.5]), subfertility (OR 8.2 [95% CI: 6.9-9.9]), dyspareunia and/or postcoital bleeding (OR 6.8 [95% CI: 5.7-8.2]), and ovarian cysts (OR 7.3 [95% CI: 5.7-9.4]), and of being diagnosed with irritable bowel syndrome (IBS) (OR 1.6 [95% CI: 1.3-1.8]) or pelvic inflammatory disease (OR 3.0 [95% CI: 2.5-3.6]). Women with endometriosis were also found to consult the doctor more frequently than the controls and were twice as likely to have time off work.Conclusions Specific symptoms and frequent medical consultation are associated with endometriosis and appear useful in the diagnosis. Endometriosis may coexist with or be misdiagnosed as pelvic inflammatory disease or IBS.