更年期女性共病糖尿病患者围绝经期症状特征及其对生活质量的影响

Perimenopausal Symptoms and Their Effects on Quality of Life in Menopausal Women with Comorbidity Diabetes

摘要: 目的：探讨分析更年期女性共病糖尿病患者围绝经期症状现状及其生活质量，并分析其围绝经期症状特征。方法：本研究采用方便随机抽样法选取于2023年8月至2024年10月在吴起县人民医院妇产科、内科住院部或门诊部就诊的更年期女性共病糖尿病患者作为调查对象，选用一般资料调查表、改良Kupperman评分量表、围绝经期生存质量量表(MENQOL)进行调查。本研究一般资料中计数资料用频数与构成比((n) %)来描述，计量资料符合正态分布采用($\overline{X}\pm s$ )描述；组间比较采用t检验或方差分析，t检验或方差分析更年期女性共病糖尿病患者围绝经期相关症状在一般资料和疾病相关资料上的差异及影响因素，更年期女性共病糖尿病患者生命质量影响因素采用多元线性回归分析，以P < 0.05有统计学差异。结果：共纳入137例更年期女性共病糖尿病患者，年龄在42~64周岁，平均年龄(52.01 ± 5.50)岁，平均糖尿病病程在1~20年，为(6.01 ± 4.55)年。本研究结果显示，更年期女性共病糖尿病患者围绝经期生存质量量表总得分为(71.24 ± 12.41)分，围绝经期综合征症状最低分为15分，最高分为58分，总得分为(29.24 ± 12.41)分，其中存在轻度围绝经期综合征的患者48例，占比35.0%，占比最高，围绝经期综合征得分在35分以上的患者44例，占到32.1%。本研究单因素分析调查显示，55~64岁、糖尿病病程是更年期共病糖尿病患者其围绝经期综合征症状严重程度的影响因素，糖尿病病程进入多元线性回归方程(P < 0.05)。患者围绝经期综合征症状中，疲乏是最常见的，其次是失眠、易激动、抑郁及疑心、眩晕、骨关节痛并列出现，但在围绝经期综合征症状中泌尿系统感染、失眠、性生活状况症状在重度的患者占比较大，分别占到其症状的33.8%、30.9%、21.2%。结论：本研究更年期女性共病糖尿病患者围绝经期综合征症状较为严重，生存质量较低。围绝经期综合征的频率、严重程度随着年龄的增长而增加，更年期女性共病糖尿病患者随着病程的增加其围绝经期综合征的严重程度也增加。疲乏是该群体最常见的症状，其次是失眠、易激动、抑郁及疑心、眩晕、骨关节痛并列出现，但在围绝经期综合征症状中泌尿系统感染、失眠、性生活状况症状在重度的患者占比较大，可能与糖尿病自主神经功能紊乱有关，二者症状叠加是影响该群体生命质量的主要因素。

Abstract: Objective: To investigate the status quo and quality of life of perimenopausal female patients with comorbidity diabetes, and to analyze the characteristics of perimenopausal symptoms. Method: In this study, convenient random sampling method was used to select menopausal female patients with comorbiditic diabetes who were treated in the obstetrics and gynecology department, internal medicine inpatient department or outpatient department of Wuqi County People’s Hospital from August 2023 to October 2024 as the investigation objects, and general data questionnaire, modified Kupperman score scale and Perimenopausal Quality of Life scale (MENQOL) were used Investigate. In the general data of this study, the counting data were described by frequency and component ratio ((n) %), and the measurement data conforming to normal distribution were described by ($\overline{X}\pm s$ ). T test or analysis of variance were used for comparison between groups. T test or analysis of variance was used to analyze the differences and influencing factors of perimenopausal related symptoms in general data and disease-related data of menopausal female patients with comorbiditic diabetes, and there were statistical differences with P < 0.05. Multiple linear regression analysis was used to analyze the influencing factors of the quality of life of menopausal women with comorbidity diabetes. Results: A total of 137 menopausal female patients with comorbidities were included, ranging in age from 42 to 64 years, with an average age of (52.01 ± 5.50) years, and an average course of diabetes ranging from 1 to 20 years (6.01 ± 4.55) years. The results of this study showed that the total score of perimenopausal female patients with comorbiditic diabetes was (71.24 ± 12.41) points, the lowest score of perimenopausal syndrome was 15 points, the highest score was 58 points, and the total score was (29.24 ± 12.41) points, including 48 patients with mild perimenopausal syndrome. The proportion was 35.0%, accounting for the highest proportion, 44 patients with perimenopausal syndrome score above 35 points, accounting for 32.1%. In this study, univariate analysis showed that 55~64 years old and the duration of diabetes were the factors affecting the severity of symptoms of perimenopausal syndrome in patients with climacteric comorbidities, and the duration of diabetes entered multiple linear regression equation (P < 0.05). Among the symptoms of perimenopausal syndrome, fatigue was the most common, followed by insomnia, irritability, depression and suspicion, vertigo, bone and joint pain, but in the symptoms of perimenopausal syndrome, urinary system infection, insomnia, sexual life symptoms accounted for a relatively large number of patients, accounting for 33.8%, 30.9%, 21.2% of the symptoms. Conclusion: In this study, the symptoms of perimenopausal syndrome were more serious and the quality of life was lower in menopausal women with comorbidities diabetes. The frequency and severity of perimenopausal syndrome increased with the increase of age, and the severity of perimenopausal syndrome also increased with the increase of disease course in female comorbidities. Fatigue is the most common symptom in this group, followed by insomnia, irritability, depression and suspicion, vertigo, osteoarthralgia side by side, but in the symptoms of perimenopausal syndrome, urinary system infection, insomnia, sexual life symptoms in severe patients accounted for a larger proportion, may be related to diabetic autonomic nervous dysfunction, the two symptoms superposition is the main factor affecting the quality of life in this group.