血清中邻苯二甲酸酯与子宫内膜异位症的相关性

张励倩; 孙静; 顾磊; 赵栋; 高强; 陈莉莉; 陈波; 厉曙光

血清中邻苯二甲酸酯与子宫内膜异位症的相关性

Correlation between Serum Phthalate Concentration and Endometriosis

摘要

摘要:
目的了解育龄女性邻苯二甲酸酯的暴露水平,分析其与子宫内膜异位症的相关性。

方法 176 名对照和134 名子宫内膜异位症患者的病例对照研究,收集研究对象的调查问卷,气相色谱法检测其血清中邻苯二甲酸酯含量。

结果 310 例女性血清中的邻苯二甲酸二乙酯(DEP)、邻苯二甲酸二丁酯(DBP)和邻苯二甲酸二(2-乙基-己基)酯(DEHP)检出率分别为15.5%、95.2%和93.5%,几何均数分别为0.062、0.219 和0.178 mg/L;病例组血清中DBP 检出率高于对照组,差异有统计学意义(98.5% vs. 92.6%,P< 0.05);病例组血清中DBP、DEHP 水平高于对照组,差异有统计学意义。其中,DBP 为0.304 mg/L vs. 0.171mg/L,P<0.05;DEHP 为0.200 mg/L vs. 0.163 mg/L,P<0.05。多因素logistic 回归分析显示,较高的文化程度、有流产史、避孕药服用史、妇科疾病家族史、较高的血清DBP 含量可能是与子宫内膜异位症发病有关的危险因素(OR>1,P< 0.05)。

结论邻苯二甲酸酯类化合物的暴露可能与子宫内膜异位症的发病相关。

Abstract:
Objective To assess phthalic acid esters (PAEs) exposure in women of childbearing age and to analyze the correlation of PAEs with endometriosis.

Methods A case-control study was conducted among 176 controls and 134 endometriosis patients using the information collected from questionnaires and the serum PAEs concentrations measured by gas chromatography.

Results The positive rates of serum diethyl phthalate (DEP), di-n-butyl phthalate (DBP) and di-2-ethylhexyl phthalate (DEHP) in 310 women were 15.5% (geometric mean, 0.062 mg/L), 95.2% (0.219 mg/L), and 93.5% (0.178 mg/L), respectively. The positive rate of serum DBP in the patients was significantly higher than that in the controls (98.5% vs. 92.6%, P< 0.05). The levels of serum DBP and DEHP in the patients were significantly higher than those in the controls (0.304 mg/L vs. 0.171 mg/L, P< 0.05; 0.200 mg/L vs. 0.163 mg/L, P< 0.05, respectively). The results of multivariate logistic analysis revealed that high education level, abortion history, taking contraceptives, family history of gynecological diseases, and high serum DBP concentration could be potential risk factors of endometriosis (OR>1, P< 0.05).

Conclusion Exposure to PAEs is probably correlated to endometriosis occurrence.

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