孕激素与短效口服避孕药治疗青春期多囊卵巢综合征的效果及对患者性激素、糖脂代谢和情绪状态的影响  

Effects of progesterone and short-acting oral contraceptives on the treatment of adolescent polycystic ovary syndrome and its influences on sexual hormones,glucose and lipid metabolism,and emotional status of patients

作　　者：张华俊 李蕊 冯玉军 ZHANG Hua-jun;LI Rui;FENG Yu-jun(Department of Pharmacy,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao Hebei 066000,China;Department of Gynecology,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市妇幼保健院药剂科,河北秦皇岛066000 [2]秦皇岛市妇幼保健院妇科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2024年第8期816-819,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划(编号:20221621)。

摘　　要：目的 分析孕激素与短效口服避孕药治疗青春期多囊卵巢综合征(PCOS)的效果及对患者性激素、糖脂代谢和情绪状态的影响。方法 前瞻性选取2022年1月至2023年6月在秦皇岛市妇幼保健院就诊的192例青春期PCOS患者作为研究对象,按照随机数字表法将其分为孕激素组和避孕药组,每组各96例。孕激素组患者给予周期性口服地屈孕酮片,避孕药组患者给予口服屈螺酮炔雌醇片。两组患者均同时给予调整生活方式、控制体重和口服盐酸二甲双胍治疗,均连续治疗3个月经周期。比较两组患者的临床疗效及治疗前和治疗后的血清性激素[卵泡刺激素(FSH)、黄体生成素(LH)、睾酮、雄烯二酮、雌二醇]水平、糖脂代谢指标[空腹血糖、空腹胰岛素(FINS)、HOMA-IR、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、抑郁自评量表(SDS)评分和焦虑自评量表(SAS)评分;并记录两组患者治疗期间的不良反应发生情况。结果 两组患者疗效分布和临床有效率比较差异均无统计学意义(P>0.05)。避孕药组患者治疗后的血清睾酮、雄烯二酮水平分别为(29.15±4.23)、(1.23±0.43) nmol/L,均低于孕激素组[(37.76±4.85)、(1.86±0.56) nmol/L],差异均有统计学意义(P<0.05),而两组患者治疗后FSH、LH、雌二醇水平比较,差异均无统计学意义(P>0.05)。避孕药组患者治疗后的血清HDL-C水平为(1.84±0.28) mmol/L,高于孕激素组[(1.70±0.23) mmol/L],差异有统计学意义(P<0.05),而两组患者治疗后其他糖脂代谢指标比较,差异均无统计学意义(P>0.05)。避孕药组患者治疗后的SDS评分、SAS评分分别为(50.31±5.53)、(50.08±5.25)分,均低于孕激素组[(56.06±6.02)、(57.63±6.00)分],差异均有统计学意义(P<0.05)。在治疗过程中,避孕药组患者的总不良反应发生率为19.79%,高于孕激素组(8.33%),差异有统计学意义(P<0.05)。结论 在青春期PCOS治疗Objective To analyze the effects of progesterone and short-acting oral contraceptives on the treatment of adolescent polycystic ovary syndrome(PCOS) and its influences on sexual hormones,glucose and lipid metabolism,and emotional status of patients.Methods A total of 192 cases adolescent PCOS patients who admitted in Qinhuangdao Maternal and Child Health Hospital from January 2022 to June 2023 were prospectively selected as the study subjects.They were divided into the progesterone group and the contraceptive group according to the random number table method,each group 96 cases.The patients in the progesterone group were treated with periodic oral administration of dydrogesterone tablets.The patients in the contraceptive group were treated with oral drospirenoneand ethinylestradiol tablets.The patients in two groups were simultaneously treated with lifestyle adjustment,weight control,and oral metformin hydrochloride were treated continuously for 3 menstrual cycles.The therapeutic effects and the serum sex hormone[follicle stimulating hormone(FSH),luteinizing hormone(LH),testosterone,androstenedione,estradiol] levels,the glucose and lipid metabolism indicators[fasting blood glucose,fasting insulin(FINS),HOMA-IR,triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],the self-rating depression scale(SDS) scores,and the self-rating anxiety scale(SAS) scores before and after the treatment between the patients in the two groups were compared.The adverse reactions during treatment between the patients in the two groups were compared.Results There were no statistically significant differences in the distribution of therapeutic effects and clinical efficiency between the two groups(P>0.05).The serum testosterone and androstenedione levels in the contraceptive group after treatment were(29.15±4.23) and(1.23±0.43) nmol/L,respectively,which were lower than those in the progesterone group [(37.76±4.85) and(1.86±0.56) nmol/L],and the differences were statisti

关 键 词：多囊卵巢综合征 孕激素类 青春期 短效避孕药 疗效评价 性激素 糖脂代谢 情绪状态 

分 类 号：R711.75[医药卫生—妇产科学]