上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (2): 168-.

• 专题报道（妇科疾病研究） • 上一篇    下一篇

炔雌醇环丙孕酮对非肥胖型多囊卵巢综合征患者内分泌代谢的影响

朱洁萍, 滕银成, 陶敏芳   

  1. 上海交通大学 第六人民医院妇产科, 上海 200233
  • 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 陶敏芳, 电子信箱: taomf@126.com。
  • 作者简介:朱洁萍(1971—）, 女, 副主任医师, 博士；电子信箱: pinger_1225@sina.com。

Effects of ethinylestradiol and cyproterone acetate on endocrine metabolism in non-obese women with polycystic ovary syndrome

ZHU Jie-ping, TENG Yin-cheng, TAO Min-fang   

  1. Department of Obstetrics and Gynecology, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2010-02-25 Published:2010-02-25

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摘要：

目的 探讨服用炔雌醇环丙孕酮片（商品名：达英-35）对非肥胖型多囊卵巢综合征（PCOS）患者内分泌代谢的影响。方法 53例非肥胖型PCOS患者接受达英-35治疗，持续6个周期。于治疗前及治疗后第3个和第6个周期末，记录体质量指数、腰臀比、多毛评分和痤疮评分；于早卵泡期及治疗后第3个月和第6个月末，测定血清总睾酮、黄体生成素、卵泡刺激素、空腹血糖、空腹胰岛素，计算黄体生成素/卵泡刺激素比值和胰岛素抵抗指数（HOMA-IR）。结果 治疗前后患者体质量指数和腰臀比无明显变化；与治疗前比较，治疗后两时间点的多毛评分、痤疮评分、血清总睾酮和黄体生成素水平及黄体生成素/卵泡刺激素比值均显著降低（P<0.05）。伴有胰岛素抵抗患者治疗后6个周期末的体质量指数和HOMA-IR 明显高于治疗前（P<0.05）。结论 短期服用达英-35可明显改善非肥胖型PCOS患者的高雄激素血症。对于同时伴有胰岛素抵抗的非肥胖型PCOS患者，达英-35存在加重其胰岛素抵抗程度的可能。

关键词: 多囊卵巢综合征, 炔雌醇环丙孕酮片, 胰岛素敏感性, 高雄激素血症

Abstract:

Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets (Diane-35) on endocrine metabolism in non-obese women with polycystic ovary syndrome（PCOS）. Methods Fifty-three non-obese patients with PCOS were assigned to the 6-month treatment with Diane-35. Body mass index (BMI), waist to hip ratio (WHR), F-G score and acne score were recorded before treatment and at the end of the third and sixth cycle after treatment. Serum total testosterone, follicle stimulating hormone (FSH), luteinizing hormone(LH), LH/FSH, fast plasma glucose, fast insulin and insulin resistance index (HOMA-IR) were obtained at early follicular phase and at the end of the third and sixth month. Results There was no significant change in BMI and WHR after treatment. Compared with those before treatment, F-G score, acne score, serum total testosterone, LH and LH/FSH were significantly decreased at two time points after treatment (P<0.05). BMI and HOMA-IR in patients with insulin resistance were significantly higher at the end of the sixth cycle after treatment than those before treatment (P<0.05). Conclusion Diane-35 can improve hyperandrogenism in non-obese patients with PCOS. However, Diane-35 may aggravate insulin resistance in those with insulin resistance.

Key words: polycystic ovary syndrome, ethinylestradiol and cyproterone acetate tablet, insulin sensitivity, hyperandrogenism