地塞米松对伴有肾上腺雄激素分泌过多的PCOS患者的疗效观察  

Effect of Dexamethason on Women with Polycystic Ovary Syndrome Combined with Adrenal Androgen Excess

作　　者：罗国群[1] 邓伟芬[1] 柳倩茹[1] 马文敏[1] 

机构地区：[1]佛山市妇幼保健院生殖中心,佛山528000

出　　处：《生殖与避孕》2011年第10期707-711,共5页Reproduction and Contraception

摘　　要：目的:探讨地塞米松对伴肾上腺雄激素分泌过多PCOS患者的疗效。方法:采用前瞻、随机、对照的研究方法,将60例经达英-35治疗后高雄激素和临床表现仍然未能明显改善且伴有肾上腺雄激素分泌过多的PCOS不孕患者作为研究对象,将患者随机分成对照组(达英-35+安慰剂)和实验组(达英-35+地塞米松),所有患者治疗3个月,比较2组患者性激素水平、临床表现。随后给予氯米芬(CC)及人绝经期促性腺激素(hMG)促排卵治疗,比较分析临床结局。结果:所有患者治疗后雄烯二酮(A2)均降低,下降率组间无差异(P>0.05),实验组硫酸脱氢表雄酮(DHEAS)降低率、性结合球蛋白(SHBG)提高率明显好于对照组(P<0.05);实验组较对照组的痤疮及多毛症状改善明显(P<0.05),而体质量指数(BMI)及腰臀比(WHR)的改变不明显(P>0.05)。实验组比对照组的成熟卵泡率、排卵率及妊娠率效果更好(P<0.05)。结论:经用达英-35治疗后高雄激素血症和临床表现仍然未能明显改善,并伴肾上腺雄激素分泌过多的PCOS不孕患者,加用地塞米松,较单纯应用达英-35更能有效抑制高雄激素血症,提高SHBG,改善临床表现,提高成熟卵泡率、排卵率及妊娠率。Objective：To investigate the effect of dexamethason on women with polycystic ovary syndrome （PCOS） combined with adrenal androgen excess.Methods：A prospective,randomized,placebo-controlled study was carried out.Sixty infertile women with PCOS combined with adrenal androgen excess whose biochemical and clinical features of hyperandrogenism can not be improved undering Daine-35 were randomly separated into two groups.The control group received Daine-35 plus placebo,while the study group received Daine-35 plus dexamethason daily for 3 months.Then together with the inducing ovulation treatment of clomiphen citrate （CC） and human menopausal gonadotropin （hMG）,mature oocytes rate,ovulation rate and pregrancy rate were evaluated.Results：1） After 3 months of treatment,the decreasing rate of A2 was not significantly different between the two groups （P〈0.05）;The decreasing rate of DHEAS and the increasing rate of SHBG were significantly different;Acne and hirsutism in the experimental group were improved significantly compared with the control （P〈0.05）;While no significant differece was observed in BMI and WHR （P〈0.05）.2） Mature oocyte rate,ovulation rate and pregnancy rate were better improved in study group than those in the control （P〈0.05）.Conclusion：When treating the PCOS patients combined with adrenal androgen excess with Daine-35 plus dexamethason may be more effective in inhibiting hyperandrogen and improving SHBG,clinical features and mature oocyte rate,ovulation rate and pregnancy rate than those with Daine-35 alone.

关 键 词：地塞米松 达英-35 多囊卵巢综合征(PCOS) 临床表现 性激素 妊娠率 

分 类 号：R711.75[医药卫生—妇产科学]