联合用药治疗青春期PCOS的激素水平变化研究  

STUDY ON COMBINATION THERAPY OF HORMONE LEVELS IN ADOLESCENT PCOS CHANGE

作　　者：陈雪[1] 刘湘娟 

机构地区：[1]河南省开封市医学科学研究所内分泌科,开封475000 [2]开封市妇幼保健医院妇科

出　　处：《现代预防医学》2010年第18期3460-3461,3466,共3页Modern Preventive Medicine

摘　　要：[目的]观察青春期多囊卵巢综合征(PCOS)患者联合应用二甲双胍、复方醋酸环丙孕酮(达英-35)和安体舒通治疗前后激素水平的变化分析。[方法]将56例青春期PCOS患者随机分为2组,A组(n=28)给予复方达英-35(每片含醋酸环丙孕酮2mg、炔雌醇35μg),B组(n=28)联合给予复方达英-35(每片含醋酸环丙孕酮2mg、炔雌醇35μg)、二甲双胍(1500mg/d)和安体舒通(40mg/d),用药12周后,观察治疗前后临床表现、血性腺激素水平、空腹血糖、空腹胰岛素水平的变化、盆腔B超检查。[结果]治疗12周后,A组患者LH水平、LH/FSH比值较治疗前明显降低,多毛、痤疮症状改善,差异有统计学意义(P﹤0.05或P﹤0.01),雄激素水平无明显变化。B组雄激素水平、空腹胰岛素水平变化降低明显,同A组有显著差异(P﹤0.01)。2组治疗后HOMA-IR变化差异有统计学意义(P﹤0.05)。[结论]复方达英-35联合二甲双胍和安体舒通治疗青春期PCOS可以改善患者的临床症状和异常的激素水平,作为青春期PCOS早期进行干预治疗的选择。[Objecdve] To observe the changes in hormone levels before and after combined treatment of metformin,compound cyproterone acetate（PCA-35）and spironolactone among adolescent polycystic ovary syndrome（PCOS）patients.[Methods] Five-six adolescent girls with PCOS were randomly separated into two groups：group A（n = 28）treated with PCA-35（each slice contained 2 mg Cyproterone Acetate and 35mg /d ethinyloestradiol）,group B（n = 28）received PCA-35（each slice contained 2mg Cyproterone Acetate and 35mg /d ethinyloestradiol）plus 1 500 mg of metformin daily and 40 mg /d spironolactone for 12 weeks.After treating for 12 weeks,we observed the clinical features,sexual hormone level,fasting blood glucose,fasting insulin and Pelvic ultrasonography B [Results] After treating for 12 weeks,the serum follicle LH level and LH /F＇SH ratio significantly decreased,and and hirsutism and acne significantly improved before and after treatment in group A（P﹤0.05 or P﹤0.01）,while the androgen level did not showed significant change.In group B,the androgen level and FINS significantly decreased,and showed significant difference when compared with group A（P﹤0.01）.The change of HOMA-IR before and after treatment showed significant difference（P ﹤ 0.05）.[Conclusion] Joint PCA-35 compound metformin and spironolactone in treatment of adolescent patients with PCOS can improve clinical symptoms and abnormal hormone levels,and could be an early intervention for adolescent PCOS.

关 键 词：多囊卵巢综合征 青春期 二甲双胍 复方醋酸环丙孕酮 安体舒通 

分 类 号：R737.31[医药卫生—肿瘤]