Disfonksiyonel uterin kanama ve stres ekseni
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, disfonksiyonel uterin kanama (DUK) tanılı hastalarda elektrokardiyografi ile kalp hızı değişkenliğini ölçerek otonom sinir sistemi aktivitesini belirlemek ve bu hastalığın etyolojisinde stresin rolüne ilişkin temel veriler elde etmektir. Materyal ve Metod: Prospektif vaka kontrol çalışması olarak dizayn edilmiş olan çalışmaya İnönü Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Kliniği'ne 15.09.2018-15.06.2021 tarihleri arasında anormal uterin kanama nedeni ile başvuran ve disfonksiyonel uterin kanama tanısı alan çalışma kriterlerine uygun hastalar dahil edildi. Çalışma periyodu boyunca Uluslararası Jinekoloji ve Obstetrik Federasyonu sınıflandırmasına göre DUK tanısı almış 34 kadın çalışma grubunu oluştururken, yaş ve vücut kitle indeksi açısından eşleştirilmiş, düzenli menstruel siklusu (27-32 günde bir) olan 36 sağlıklı gönüllü ise kontrol grubunu oluşturdu. Çalışmaya dahil edilen tüm gönüllüler, otonom sinir sistemi disfonksiyonunun semptomları yönünden sorgulandı ve gönüllülerin detaylı kardiyak ve nörolojik muayenesi yapıldı. Tüm gönüllülerden bazal elektrokardiyogramlar elde edildi ve anormal elektrokardiyografisi olanlar çalışma dışı tutuldu. Katılımcılara menstrüel döngünün en yoğun döneminde (2-3 gün) kalp hızı değişkenliği analizi için 5 dakikalık elektrokardiyografi çekimi yapıldı. Bulgular: Çalışmaya kontrol grubunda 36 kadın ve çalışma grubunda DUK tanılı 34 kadın olmak üzere toplam 70 kadın dahil edildi. Kontrol grubunun yaş ortalaması 33.28±6.91, DUK grubunun ise 35.32±6.32 olarak bulunmuş olup gruplar arasında yaş açısından anlamlı farklılık görülmedi. Kan hormon düzeylerinden folikül stimule edici hormon, luteinize edici hormon, östriol, testosteron ve tiroid stimule edici hormon düzeyleri açısından gruplar arasında anlamlı farklılık saptanmadı. Her iki grup arasında kilo ve vücut kitle indeksi açısından anlamlı farklılık görülmedi. DUK ve kontrol grubu kalp hızı değişkenliğinin frekans bağımlı parametreleri açısından karşılaştırıldığında gruplar arasında HR, R-R min, R-R max, RRNN, SDNN, RMSSD, pNN50 (%), CV, RM min, RM max, R-R avg min ve R-R avg max parametreleri açısından anlamlı farklılık saptanmadı. Sonuç: Kontrol grubu ile karşılaştırıldığında DUK tanılı hastalarda stres ekseninin elektrokardiyogram parametrelerinde istatistiksel anlamlı bir farklılık saptanmamıştır. Anahtar Kelimeler: Disfonksiyonel uterin kanama; Elektrokardiyogram; Kalp hızı; Menstrüasyon; Otonom sinir sistemi; Parasempatik sinir sistemi; Sempatik sinir sistemi.
Aim: The aim of this study is to determine the autonomic nervous system activity by measuring heart rate variability with electrocardiography in patients diagnosed with dysfunctional uterine bleeding (DUB) and to obtain basic data on the role of stress in the etiology of DUB. Material and Method: This was a prospective case-control study that included patients admitted to the Inonu University School of Medicine Department of Obstetrics and Gynecology between 15.09.2018-15.09.2021 due to abnormal uterine bleeding and was diagnosed with DUB. DUB was classified according to the International Gynecology and Obstetrics Federation classification. During the study period, 34 women diagnosed with DUB formed the study group, while 36 volunteers with age and body mass index-matched healthy and regular menstrual cycles (every 27-32 days) constituted the control group. All volunteers included in the study were questioned symptoms of autonomic nervous system dysfunction, and detailed cardiac and neurological examinations were performed. Baseline electrocardiograms were obtained from all volunteers, and women with abnormal baseline electrocardiography were excluded from the study. Electrocardiography was performed for 5 minutes to analyze heart rate variability during the intensive period of the menstrual cycle (2-3 days). Results: A total of 70 women; 36 healthy women (control group), and 34 women diagnosed with DUB (study group) were included in this study. The mean age of the control group was 33.28 ± 6.91 years, and the DUB group was 35.32 ± 6.32 years, and there was no significant difference in terms of age between the groups. Also, no significant difference was found between the control group and the DUB group in terms of weight and body mass index ( p = 0.311). There was no significant difference in follicle stimulating hormone, luteinizing hormone, estriol, testosterone, and thyroid stimulating hormone between the groupsWhen women with DUB and controls were compared using frequency-dependent heart rate variability parameters, there was no statisyically significant difference in HR, RR min, RR max, RRNN, SDNN, RMSSD, pNN50, CV, RM min, RM max, RR-avg min, and RR-avg max parameters was observed. Conclusion: No significant difference was found between the menstrual cycle and electrocardiogram stress parameters of patients with DUB compared with the control group. Keywords: Dysfunctional uterine bleeding; Electrocardiogram; Heart rate; Menstruation; Autonomic nervous system; Parasympathetic nervous system; Sympathetic nervous system
Aim: The aim of this study is to determine the autonomic nervous system activity by measuring heart rate variability with electrocardiography in patients diagnosed with dysfunctional uterine bleeding (DUB) and to obtain basic data on the role of stress in the etiology of DUB. Material and Method: This was a prospective case-control study that included patients admitted to the Inonu University School of Medicine Department of Obstetrics and Gynecology between 15.09.2018-15.09.2021 due to abnormal uterine bleeding and was diagnosed with DUB. DUB was classified according to the International Gynecology and Obstetrics Federation classification. During the study period, 34 women diagnosed with DUB formed the study group, while 36 volunteers with age and body mass index-matched healthy and regular menstrual cycles (every 27-32 days) constituted the control group. All volunteers included in the study were questioned symptoms of autonomic nervous system dysfunction, and detailed cardiac and neurological examinations were performed. Baseline electrocardiograms were obtained from all volunteers, and women with abnormal baseline electrocardiography were excluded from the study. Electrocardiography was performed for 5 minutes to analyze heart rate variability during the intensive period of the menstrual cycle (2-3 days). Results: A total of 70 women; 36 healthy women (control group), and 34 women diagnosed with DUB (study group) were included in this study. The mean age of the control group was 33.28 ± 6.91 years, and the DUB group was 35.32 ± 6.32 years, and there was no significant difference in terms of age between the groups. Also, no significant difference was found between the control group and the DUB group in terms of weight and body mass index ( p = 0.311). There was no significant difference in follicle stimulating hormone, luteinizing hormone, estriol, testosterone, and thyroid stimulating hormone between the groupsWhen women with DUB and controls were compared using frequency-dependent heart rate variability parameters, there was no statisyically significant difference in HR, RR min, RR max, RRNN, SDNN, RMSSD, pNN50, CV, RM min, RM max, RR-avg min, and RR-avg max parameters was observed. Conclusion: No significant difference was found between the menstrual cycle and electrocardiogram stress parameters of patients with DUB compared with the control group. Keywords: Dysfunctional uterine bleeding; Electrocardiogram; Heart rate; Menstruation; Autonomic nervous system; Parasympathetic nervous system; Sympathetic nervous system
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
