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摘要:
目的 探讨月经状况对社区女性肌肉骨骼疼痛的影响。 方法 采用统一的调查问卷, 对北京市某社区697名35~64岁常住妇女进行面对面调查。问卷内容包括主要的社会人口学特征、月经状况、近2周内的肌肉骨骼疼痛发生情况, 包括颈部、腰背部、膝部和其他部位, 各部位疼痛发生频率用无、偶尔和经常表示。本研究将经常性的肌肉骨骼疼痛视为严重症状, 分析其影响因素。 结果 腰背部疼痛是社区35~64岁妇女最常见的肌肉骨骼症状(33.4%), 其次为膝部疼痛(31.0%)、颈部疼痛(29.7%)、其他部位肌肉骨骼疼痛(25.6%)。绝经后妇女肌肉骨骼疼痛发生率显著高于绝经前妇女(P < 0.01), 绝经后期早期为肌肉骨骼疼痛发生的高峰阶段, 到绝经后期晚期明显下降。颈部疼痛、腰背部疼痛发生率在绝经过渡期开始增加, 与增龄不相关; 膝部疼痛发生率随体重指数(body mass index, BMI)增加、年龄增长而增加(OR=1.085, 1.050)。超重和肥胖是妇女膝部疼痛发生的危险因素。Logistic回归分析显示, 肥胖妇女(BMI ≥ 28 kg/m2)与正常体重妇女(BMI < 24 kg/m2)相比, 膝部疼痛发生的危险度显著增加(OR=2.256)。 结论 绝经是女性肌肉骨骼疼痛发生的重要影响因素, 增龄和超重与肌肉骨骼疼痛的相关性也不能被忽视。 Abstract:Objective To explore the impact of menstrual status on musculoskeletal pain in healthy women. Methods A total of 697 generally healthy women aged 35 to 64 years were recruited from a community in Beijing. Data were collected by face-to-face interview with a questionnaire including social and demographic features, menstrual status, frequency of musculoskeletal pain (rarely, occasionally, or frequently) during the last two weeks at neck, lower back, knee, and other parts of the body. Frequent pain was considered severe and its potential relevant factors were analyzed. Results In all the subjects, 33.4% complained of frequent lower back pain, 31.0% frequent knee pain, 29.7% frequent neck pain, and 25.6% pain at other parts. The prevalence of musculoskeletal pain was higher in postmenopausal women than in premenopausal women(P < 0.01); early postmenopausal women had most frequent musculoskeletal pain, while the frequency declined in late postmenopausal period. The prevalence of neck pain and lower back pain increased during the menopausal transition period and was not associated with age. The prevalence of knee pain increased with body mass index(BMI) and age (OR=1.085, 1.050). Overweight and obesity were risk factors for knee pain in women. Logistic regression analysis showed that the odds ratio of knee pain increased in obese women(BMI ≥ 28 kg/m2) compared with women with normal BMI(< 24 kg/m2)(OR=2.256). Conclusions Menopause may be an important factor for musculoskeletal pain in women, the association of musculoskeletal pain with age and BMI also should be considered. -
Key words:
- menopause /
- climacteric symptom /
- musculoskeletal pain
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表 1 不同月经状况妇女肌肉骨骼疼痛现患率（%）
月经状况 颈部
疼痛腰背部
疼痛膝部
疼痛其他部位肌肉
骨骼疼痛月经正常（n=259） 23.2 25.1 16.6 13.9 绝经过渡期（n=161） 32.3 32.3 28.0 28.6 绝经后期早期(n=156) 33.3 44.0 32.1 36.3 绝经后期晚期(n=121) 34.2 36.8 31.0 30.3 总计(n=697) 29.7 33.4 31.0 25.6 χ2 8.370 17.477 17.609 31.316 P 0.039 0.001 0.001 0.000 
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表 2 社区妇女颈部疼痛的多因素分析结果
影响因素 B SE Wald P OR（95% CI） 月经状况 10.449 0.015 绝经过渡期 0.504 0.226 4.989 0.026 1.665（1.064~2.575） 绝经后期早期 0.631 0.226 7.187 0.005 1.879（1.207~2.923） 绝经后期晚期 0.572 0.226 6.416 0.011 1.733（1.138~2.760）
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表 3 社区妇女腰背疼痛的多因素分析结果
影响因素 B SE Wald P OR（95% CI） 月经状况 13.073 0.004 绝经过渡期 0.388 0.235 2.714 0.099 1.474（0.929~2.338） 绝经后期早期 0.786 0.223 12.466 0.000 2.194（1.418~3.394） 绝经后期晚期 0.529 0.231 5.265 0.022 1.698（1.080~2.669）
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表 4 社区妇女膝部疼痛的多因素分析结果
影响因素 B SE Wald P OR（95% CI） 年龄 0.049 0.013 16.068 0.000 1.050（1.025~1.076） 体重指数（kg/m2） 11.885 0.003 24~27.9 0.543 0.212 6.582 0.010 1.721（1.137~2.606） ≥28 0.813 0.246 10.937 0.001 2.256（1.393~3.653） 月经状况 15.607 0.001 绝经过渡期 0.757 0.262 8.310 0.004 2.131（1.274~3.564） 绝经后期早期 0.919 0.258 12.713 0.000 2.506（1.512~4.153） 绝经后期晚期 0.814 0.259 9.912 0.002 2.257（1.360~3.747）
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表 5 社区妇女其他部位肌肉骨骼疼痛的多因素分析结果
影响因素 B SE Wald P OR（95% CI） 体重指数 0.059 0.026 5.007 0.024 1.061（0.976~4.573） 月经状况 14.232 0.003 绝经过渡期 0.774 0.279 7.697 0.006 2.169（1.255~3.748） 绝经后期早期 0.992 0.273 13.157 0.000 2.697（1.578~4.609） 绝经后期晚期 0.563 0.293 3.678 0.055 1.755（0.988~3.119）
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