絕經(jīng)綜合征PPT參考課件

1、據(jù)統(tǒng)計，至少半數(shù)以上絕經(jīng)前后婦女有各種各樣的不適癥狀腦腦眼睛眼睛牙齒牙齒血管運動血管運動心臟心臟乳房乳房結腸結腸泌尿生殖道泌尿生殖道骨骨窈窕淑女，君子好逑窈窕淑女，君子好逑女性的一生（卵巢的變化）女性的一生（卵巢的變化）正常女性月經(jīng)相關分期正常女性月經(jīng)相關分期Menopausal transition絕經(jīng)過渡期Perimenopause圍絕經(jīng)期（更年期）Post menopause絕經(jīng)后Adolescence(menarche)初潮初潮Premenopause絕經(jīng)前L.M.P 末次月經(jīng)末次月經(jīng)End of lifeAge of 40+Amenorrhea閉經(jīng)閉經(jīng)1 yearclinical s

2、ituation) 月經(jīng)表現(xiàn)月經(jīng)表現(xiàn)卵泡數(shù)量減少卵泡數(shù)量減少/ /質量下降質量下降雌激素分泌減少雌激素分泌減少子宮內膜增殖不良子宮內膜增殖不良月經(jīng)稀發(fā)或閉經(jīng)月經(jīng)稀發(fā)或閉經(jīng)無排卵，不能形成黃體或黃體功能不足無排卵，不能形成黃體或黃體功能不足孕激素不足或缺乏孕激素不足或缺乏子宮內膜不能轉化為分泌期子宮內膜不能轉化為分泌期月經(jīng)頻發(fā)，不規(guī)則陰道出血月經(jīng)頻發(fā)，不規(guī)則陰道出血 絕絕 經(jīng)經(jīng)圍絕經(jīng)期早期癥狀圍絕經(jīng)期早期癥狀n血管舒縮癥狀血管舒縮癥狀(vasomotor symptom: hot flashes, heat or burning)n情緒障礙等情緒障礙等(mood disorders, insom

3、nia, fatigue, memory loss, depression)Genitourinary atrophyUTI, UI, frequency, urgencydryness of vagina, dyspareunia遠期遠期-骨質疏松癥骨質疏松癥(Osteoporosis)雌激素是女性一生維持骨礦含量的雌激素是女性一生維持骨礦含量的關鍵關鍵激素，絕經(jīng)后骨激素，絕經(jīng)后骨礦含量以每年礦含量以每年3-5%的速率丟失，前五年丟失最快，并將的速率丟失，前五年丟失最快，并將持續(xù)持續(xù)10-15年。人工絕經(jīng)者更為嚴重。致病致殘率極高。年。人工絕經(jīng)者更為嚴重。致病致殘率極高。 脂代謝紊亂脂代謝紊

4、亂血管內皮功能紊亂血管內皮功能紊亂Aekplakorn. J Hypertens 2008;26:191-8.（泰國）National Center for Health Statistics. Vital Statistics of the United States. 1992. Vol. II Mortality, Part A. SEER Cancer Statistics Review 1973-1993. Miller et al, eds. National Cancer Institute, 1997.* Percentage of total deaths in 1999 a

5、mong women aged 65 years and older.Anderson RN. Natl Vital Stat Rep. 2001;49:1-13.心臟疾病糖尿病糖尿病慢性慢性下呼吸道疾病下呼吸道疾病 腦血管疾病乳腺癌乳腺癌34%28%其它癌癥其它癌癥其它其它Early symptomHot flashes, InsomniadepressionGenitourinary atrophy, UTI, UI Long-term consequence OsteoporosisCVDDiagnosis and differential diagnosisclinical situation)hormone determination)：Diagnosis and differential diagnosisorganic disease)*H