• Title/Summary/Keyword: Pregnancy women

검색결과 1,181건 처리시간 0.146초

Propofol protects against lipopolysaccharide-induced inflammatory response in human amnion-derived WISH cells

  • Kim, Cheul-Hong;Lee, Sang-Hoon;Yoon, Ji-Young;Kim, Eun-Jung;Joo, Jong Hoon;Kim, Yeon Ha;Choi, Eun-Ji
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권5호
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    • pp.369-376
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    • 2022
  • Background: Nonobstetric surgery is sometimes required during pregnancy, and neck abscess or facial bone fracture surgery cannot be postponed in pregnant women. However, dental surgery can be stressful and can cause inflammation, and the inflammatory response is a well-known major cause of preterm labor. Propofol is an intravenous anesthetic commonly used for general anesthesia and sedation. Studies investigating the effect of propofol on human amnion are rare. The current study investigated the effects of propofol on lipopolysaccharide (LPS)-induced inflammatory responses in human amnion-derived WISH cells. Methods: WISH cells were exposed to LPS for 24 h and co-treated with various concentrations of propofol (0.01-1 ㎍/ml). Cell viability was measured using the MTT assay. Nitric oxide (NO) production was analyzed using a microassay based on the Griess reaction. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE 2), p38, and phospho-p38 was analyzed using western blotting. Results: Propofol did not affect the viability and NO production of WISH cells. Co-treatment with LPS and propofol reduced COX-2 and PGE2 protein expression and inhibited p38 phosphorylation in WISH cells. Conclusion: Propofol does not affect the viability of WISH cells and inhibits LPS-induced expression of inflammatory factors. The inhibitory effect of propofol on inflammatory factor expression is likely mediated by the inhibition of p38 activation.

3종 한약 처방 물 추출물과 황금 에탄올 추출물에 의한 자궁내막과 태반세포 기능조절 연구 (A Study on the Regulation of Endometrial and Placental Cell Function by Water Extract of 3 Types of Herbal Medicines and Ethanol Extract on Scutellariae Radix)

  • 박서예;노의정;서창섭;이성기;신현규
    • 대한한방부인과학회지
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    • 제34권3호
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    • pp.1-14
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    • 2021
  • Methods: We investigated the ability to induce decidualization of human endometrial stromal cells and invasive ability of human trophoblast cells by water extract of three types herbal medicines (Dangguijakyak-san, Siryung-tang, Antae-eum) and ethanol extract on Scutellariae Radix. Results: In the process of decidualization of endometrial stromal cells, three herbal medicines including Dangguijakyak-san, Siryung-tang, and Scutellariae Radix increased the production of decidual markers such as prolactin (PRL) and insulin-like growth factor-binding protein 1 (IGFBP1). However, Antae-eum increased mRNA levels of PRL and IGFBP and secretion of IGFBP in decidual stromal cells, but not PRL. Four herbal medicines inhibited the invasion of trophoblast cells. Conclusions: Four herbal medicines may play a role in implantation in women with reproductive failures. However, further studies are warranted to elucidate whether these medications are helpful in the maintenance of pregnancy.

Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries

  • Miftahul, Arsyi;Besral, Besral;Milla, Herdayati;Revati, Phalkey
    • Journal of Preventive Medicine and Public Health
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    • 제55권6호
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    • pp.559-567
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    • 2022
  • Objectives: This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN). Methods: Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017. Results: The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers' demographic/socioeconomic factors, health behaviors, and other factors. Conclusions: In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.

천계(天癸)에 대한 연구 -내경(內經) 주석가(注釋家)들의 견해(見解)를 중심으로- (Study on Tiangui(天癸)Focusing on the ${\ulcorner}$Neijing${\lrcorner}$(內經) commentators' views)

  • 이용범;허기회
    • 대한한의학원전학회지
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    • 제13권2호
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    • pp.174-188
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    • 2000
  • The meaning of Tiangui(天癸) in $Suwen{\cdot}Shanggutianzhenlun\;素問{\cdot}上古天眞論$ is very important because it has the cause of 'having a child' and it shows the signs to being healthy. But until now there have been many arguments about what the correct meaning of Tiangui is. The most important thing in these arguments is to compare and analyze Neijing(內經) commentators' views, and to understand differences between their views. So I compared and analyzed by focusing on Neijing(內經) text, the other books with explanatory notes, and other commentators' views, and, after that. I got the following results. 1. On the meaning of Tian(天), Wangbing(王氷) and Mashi(馬蒔) considered that it is inborn. Zhangjiecong(張志聽) considered it as the Yang(陽) producing Yin(陰) Zhangjiebin(張介賓) regarded it as the Yang(陽) of Gua symbol. On the meaning of the Gui(癸). Zhangjiebin(張介賓) said that it is Yin qi(陰氣) which is the prior step to Xing(形). Mashi(馬蒔) and Zhangzhicong(張志聽) said that it is spirit or Jingxue(spiritual sanguine) which is the concrete constituents in our body. 2. On the relation bet ween Tian(天) and Gui(癸), Mashi(馬蒔) and Zhangzhicong(張志聽) said that Gui(癸) is made from Tian(天), and Zhangjiebin(張介賓) said that Tian is intrinsic in Gui(癸). 3. On the relation between Tiangui(天癸) and Jingxue(精血), Yangshangshan(楊上善). Wangbing(王氷), and Zhangjiebin(張介賓) regarded Tiangui(天癸) as a concrete matter which is the prior step to becoming Jingxue(精血). Mashi(馬蒔) and Zhangjiecong(張志聽) considered Tiangui(天癸) as a concrete matter. Mashi(馬蒔) considered Tiangui(天癸) as Jing(精)which is directly related to pregnancy. Zhangjiecong(張志聽) regarded Tiangui(天癸) as Jingxue(精血) which controls general physiology of men and women. 4. On the function of Tiangui(天癸), Yangshangshan(楊上善) and Wangbing(王氷) considered that Tiangui (天癸) has relation to menstruation. pregnancy. and, production and extinction of Jing(精). Zhangjiecong(張志聽) argued that Tiangui(天癸) strengthens and warms muscle and derma. and controls differential physiology between men and women, and said that the maintenance of its activity is based on the acquired spirit of food. A book of 『Huangti Neijing Yanjiu Dacheng(黃帝內經硏究大成)』 said that the function of Tiangui(天癸) is to promote generation, to develop the second sexual symbol, and to make growing and aging in body. It also said that Tiangui(天癸) has some relation to kidney and other organs, Chong Meridian, Ren Meridian, Du Meridian, and Dai Meridian. 5. Other commentators of 『Neijing(內經)』 accepted the meaning of Tiangui(天癸) as the prior step of both man's spiritual overflowing and woman's menstruation. 6. On the relation between Tiangui(天癸). and, Cheng and Ren Meridians, Yangshangshan(楊上善) and Zhangjiecong(張志聽) said that Tiangui(天癸) has direct relation with two meridians. Wangbing(王氷) said that Tiangui(天癸) and two meridians have no direct relation. Now I compared commentaors' views of Tiangui(天癸) and studied the differences between their views. I concluded that on the concept of Tiangui(天癸), Zhangjiebin(張介賓)'s explanations express well its connotative meaning. And on the function of Tiangui (天癸), Zhangjiecong(張志聽)'s explanations are excellent because he organized well his seniors' views, and extended its meaning by showing Neijing(內經)'s phrases related to Chong and Ren Meridians. Also, Mashi(馬蒔) suggested that if Tiangui(天癸) comes earlier than normal. people will die soon. But I think that more studies on male and female bodies are needed as to Mashi(馬蒔)'s argument.

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높은 기저 난포 자극 호르몬 수치를 가지는 환자와 고령 환자의 체외수정시술을 위한 과배란 유도에서 GnRH antagonist 다회 투여법과 GnRH agonist 장기요법의 효용성에 대한 연구 (Comparison of IVF-ET Outcomes between GnRH Antagonist Multiple Dose Protocol and GnRH Agonist Long Protocol in Patients with High Basal FSH Level or Advanced Age)

  • 김지연;김낙근;윤태기;차선희;김유신;원형재;조정현;차수경;정미경;최동희
    • Clinical and Experimental Reproductive Medicine
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    • 제32권4호
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    • pp.315-324
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    • 2005
  • Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.

울릉도 여성들의 자궁경부 세포학적 검사소견과 관련요인과의 관계 (The Relationship between Conical Pap. Smear Findings and Related Factors for Uterine Cervical Cancer in Ullungdo Females)

  • 윤인숙;이혜자
    • 대한의생명과학회지
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    • 제4권2호
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    • pp.143-151
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    • 1998
  • 1998년 8월 5일부터 1998년 8월 12일까지 8일간 경상북도 울릉도에서 지역 여성 330명을 대상으로 자궁경부암 발생과 관련된다고 알려진 역학적 요인의 설문과 자궁경부암 집단검진으로 많이 이용되는 자궁경부 Pap. smear를 실시하여 다음과 같은 결과를 얻었다. 검사자의 평균연령은 52.1세였고 50대와 60대의 연령분포가 전체 검사자의 49.0%를 차지하였으며, 교육정도는 중학교 이하가 56.9%로 낮은 교육수준을 나타내었고, 첫 성교연령은 21세 이하가 43.9%를 차지하였고, 첫 임신연령은 21세 이하에서 33.3%로 나타났다. 총 임신횟수는 5회 이상인 대상자는 전체의 52.1%를 차지하였고, 5회 이상의 출산을 한 응답자는 전체의 24.5%였다. 전체의 68.8%에서 유산경험이 있었으며, 대상자의 80.0%에서 남편이 포경수술을 하지 않은 것으로 나타났다. 증상은 전체의 52.1%에서 증상이 있다고 응답하였으며, 증상이 있는 응답자의 증상으로는 대하 48.3%, 소양증 21.5%로 나타났다. 자궁암세포검사 경험과 빈도에서 자궁암세포검사를 받아본적이 있는 응답자는 전체의 63.9%였으며, Pap. smear결과와 검사유무의 관찰에서 정상군보다 비전형세포와 이형성증이 있는 군에서 검사를 받아 본 경험이 유의하게 낮게 관찰되었다(p<0.05).검사를 받아 본 응답자 중 검사경험자의 44.1%에서 단 1회의 검사를 받아보았고, 30.3%는 비정기적으로 검사하였다. 한 번도 검사를 받은 경험이 없는 응답자의 이유로는 특별한 이상이 없었기 때문 51.3%, 부끄러움 때문에 16.8%나타났다. 자궁경부도말의 세포학적 검사결과는 정상 45.8%, 염증 47.3%, 트리코모나스증과 캔디다증이 1.8%, 비정형세포 4.5%, 이형성증이 0.6%였다.인되어, 국내에서도 진드기 교상시 이들 두 가지 열성질환이 동시에 감염될 가능성이 있는 것으로 사료됨으로 진드기 매개성 열성질환에 대한 적절한 진단법 등을 보다 체계적으로 연구하여야 할 것으로 판단된다.A typing 방법은 비교적 빠른 시간 내에 많은 종류의 HLA 대립 유전자형을 정확하게 구분할 수 있으므로 앞으로 tissue typing 실험실에서 유용하게 활용될 수 있을 것으로 생각된다. 또한 DNA typing방법을 이용하여 분석한 한국인의 HLA-class I, II 유전자군의 유전자형 빈도는 골수이식을 비롯한 각종 이식검사, 특수 질환 관련검사나 인류유전학연구 등 HLA 유전자의 임상적 활용을 위한 자료로 사용될 수 있을 것으로 기대된다.있음을 볼 수 있으며 하루 세끼의 식사형태에서 밥을 중심으로 하는 비율은 국내 보다 크게 낮았지만 여전히 다른 식사형태 보다 높은 것을 알 수 있다. 한국 고유의 식문화 특성을 가지면서 거주지역의 식품생산 및 사회 문화적 특성에 영향을 받음으로써 거주국의 식품, 식사 형태, 조리방법을 도입하는 등 부분적으로 변화가 진행되고 있음을 확인 할 수 있었다.가장 시급한 개선점이라고 생각된다. 따라서 효과적인 급식운영을 하기 위해서는 학교식당은 맛, 다양한 메뉴의 식단, 위생, 가격의 저렴 등을 통해서 급식대상자들이 만족한 급식을 할 수 있도록 체계적인 관리 및 운영을 통해 적극적으로 개선해 나가야 할 것으로 사료된다.er (p<0.05), $T_{max}$ might be an insignificant parameter because cyclosporin A generally requires long-term administration. From these results, the two products

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연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査) (A Basie Health Survey of the Yonsei Community Health Service Area, Seoul)

  • 양재모;김명호
    • Journal of Preventive Medicine and Public Health
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    • 제1권1호
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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여성의 임금수준이 출산율에 미치는 영향 분석 (The Effects of Female Wage on Fertility in Korea)

  • 김정호
    • KDI Journal of Economic Policy
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    • 제31권1호
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    • pp.105-138
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    • 2009
  • 지난 20여 년간의 지속적인 출산율 감소 현상에 대응한 최근의 정책논의에서 출산율 감소에 대한 이론적 논의는 많이 이루어진데 반해 실증적 연구 결과의 양은 아직 빈약한 수준이다. 본 연구는 출산율 감소의 가장 중요한 원인 중의 하나로 이해되는 여성의 임금수준이 1980년대 이후의 출산율에 미친 영향을 실증적으로 분석한다. 기간모형을 이용하여 출산율의 한 구성요소인 출산 간격을 분석한 결과, 1980년부터 2005년까지의 두 번째 출산확률의 감소 중 여성 임금의 변화가 약 17%를 설명하는 것으로 나타났다. 자료의 한계로 인해 통제되지 못한 변수가 존재하나, 최소한 여성의 임금수준이 출산에 미치는 총체적 효과의 크기를 제시하는 하나의 추정치로서 의미가 있다. 임금으로 표현되는 여성의 노동시장에서의 기회비용 상승이 자녀에 대한 수요를 감소시킨다는 사실은 출산율 저하가 경제발전에 따르는 현상임을 암시한다. 따라서 출산율 제고와 여성의 고용 증진은 동시에 추구해야 할 정책목표로 보이고, 이를 달성하기 위해 정부는 자녀양육에 대한 여성의 노동시장에서의 기회비용을 줄이는 포괄적인 가족친화정책을 고려할 필요가 있다.

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고연령 산모에서 체외 수정 시술로 태어난 쌍생아의 임상 양상 (Perinatal Outcomes of In Vitro Fertilized Twins in Women of Advanced Age)

  • 정인혁;김성우;조희승;이규형
    • Neonatal Medicine
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    • 제18권2호
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    • pp.197-203
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    • 2011
  • 목적: 35세 이상 산모에서 체외 수정 시술을 통해 출생한 쌍생아와 자연 임신 쌍생아의 임상 양상을 비교하여 35세 이상 산모와 체외 수정 시술로 출생한 신생아 관리에 기초 자료 제공을 위하여 실시하였다. 방법: 2001년 1월 1일부터 2010년 12월 31일 사이 분당차병원에서 출생한 쌍생아 중 산모의 나이가 35세 이상인 신생아 508례를 대상으로 하여, 체외 수정 시술을 시행 받은 288례와 자연 임신군 220례 사이의 주산기 특성과 합병증 및 신생아기 질환발생의 차이를 의무 기록을 통해 후향적으로 조사하였다. 결과: 체외 수정 시술군과 자연 수정군 사이의 산모 연령은 (36.7${\pm}$2.07세 vs. 36.8${\pm}$2.18세, P=0.57)로 통계적 차이는 보이지 않았다. 재태 연령($36^{+0}{\pm}1^{+5}$주 vs. $36^{+0}{\pm}2^{+0}$주, P=0.95), 출생체중(2,420${\pm}$440 g vs. 2,480${\pm}$460 g, P=0.14) 역시 차이는 보이지 않았다. 1분 아프가 점수(7.37${\pm}$1.19 vs. 7.09${\pm}$1.46, P=0.019)와 5분 아프가 점수(8.67${\pm}$0.84 vs. 8.51${\pm}$0.96, P=0.045)는 모두 체외 수정 시술군에서 높았다. 임신성 당뇨, 임신성 고혈압, 전치태반, 조기 양막 파수, 제왕 절개술, 부당 경량아의 빈도는 두 군간의 차이가 없었다. 조발형 패혈증의 빈도는 체외 수정 시술군에서 자연 수정군보다 낮았다(2.4% vs. 6.4%, P=0.02). 그밖에 신생아 호흡 곤란 증후군, 기관지 폐 형성이상, 동맥관 개존증, 신생아 괴사 장염, 뇌실 내 출혈의 발생 빈도는 모두 두 군 간에 차이가 없었다. 결론: 본 기관에서 지난 10년간 고연령 산모에서 체외 수정 시술로 태어난 쌍생아의 임상 양상을 조사하여 자연 수정으로 출생한 쌍생아와 비교하였을 때, 체외 수정 시술로 인하여 주산기 합병증과 신생아기 질환의 발생 빈도가 높아지지는 않았다.

자궁내막증 여성에서 증가된 자궁내막용종의 빈도; 질환의 중증도와의 관련성 (Increased Incidence of Endometrial Polyps in Women with Endometriosis; the Association with Severity)

  • 장혜진;황경주;김미란;안상태;변재광;이은희;박진영
    • Clinical and Experimental Reproductive Medicine
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    • 제33권3호
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    • pp.199-205
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    • 2006
  • 목 적: 자궁내막증에서 발견되는 자궁내막용종의 발생빈도와 자궁내막증 질환의 중증도와의 연관성에 대해 알아보고자 한다. 연구방법: 불임, 심한 월경통, 난소종양 등을 주소로 복강경 수술이 필요했던 여성 631명을 대상으로 하였다. 복강경 수술로 확인된 자궁내막증을 가진 434명과 자궁내막증이 없었던 197명의 여성에서 자궁내시경을 이용한 조직학적인 검사를 통해 자궁내막용종의 발생 빈도를 비교하였다. 또한 자궁내막증 질환의 중증도는 American Fertility Society classification 에 따라 나누었고, 그에 따른 자궁내막용종의 빈도를 비교하였다. 결 과: 자궁내막증을 가진 군 (434명)과 정상 대조군 (197명) 간에 나이, 불임기간, 호르몬 수치 등의 임상적인 차이는 보이지 않았고, 자궁내막용종은 자궁내막증을 가진 여성에서는 274명 (63%)에서 관찰되었고, 자궁내막증이 없는 대조군에서는 58명 (29.8%)에서 관찰되었다(p=0.001). 자궁내막증 1기와 2기에서는 자궁내막용종이 동반된 경우가 각각 54.2%와 64.4% 이었으나, 자궁내막증 3기와 4기에서는 67.6%와 70.2%로 통계적으로 유의하게 정상 대조군에 비해 자궁내막용종의 동반 확률이 높았고, 자궁내막증 중증도에 따라 자궁내막용종의 빈도가 유의하게 증가하는 양상을 보였다(p=0.008). 결 론: 자궁내막증을 가진 여성에서 자궁내막용종을 동반할 확률이 정상인에 비해 높았고, 중증 자궁내막증일수록 동반되는 자궁내막용종의 빈도가 증가하였다.