达英-35对多囊卵巢综合征患者代谢与性激素的影响

doi:10.3969/j.issn.1006-7795.2019.04.013

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (4): 560-565.doi: 10.3969/j.issn.1006-7795.2019.04.013

达英-35对多囊卵巢综合征患者代谢与性激素的影响

谷牧青¹, 李扬璐², 程姣姣², 王虎生², 阮祥燕², 贾婵维¹

1. 首都医科大学附属北京妇产医院生殖中心, 北京 100026;
2. 首都医科大学附属北京妇产医院妇科内分泌科, 北京 100026

收稿日期:2019-05-20 出版日期:2019-07-21 发布日期:2019-07-19
通讯作者: 贾婵维 E-mail:ruanxiangyan@163.com
基金资助:
北京市医院管理局"登峰"计划专项经费资助（DFL20181401），首都卫生发展科研专项（2016-2-2113），首都临床特色应用研究与成果推广项目（Z161100000516143），北京市医院管理局临床技术创新项目（XMLX201710），国家外专局引智重点项目（20181100005），医疗健康技术创新与人才培养专项基金（2017041900004，2018042000001），北京市卫生系统高层次卫生技术人才项目（2014-2-016）。

Effect of Diane-35 treatment on metabolism and sex hormone in women with polycystic ovary syndrome

Gu Muqing¹, Li Yanglu², Cheng Jiaojiao², Wang Husheng², Ruan Xiangyan², Jia Chanwei¹

1. Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China

Received:2019-05-20 Online:2019-07-21 Published:2019-07-19
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20181401), Beijing Capital Foundation for Medical Science Development and Research (2016-2-2113), Foundation of Beijing Municipal Science and Technology Commission (Z161100000516143), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (XMLX201710), SAFEA:Project for Key Foreign Experts (20181100005),Medical Health Technology Innovation and Talent Training Special Fund (2017041900004, 2018042000001), Beijing Municipality Health Technology High-level Talent (2014-2-016).

摘要/Abstract

摘要： 目的明确口服避孕药达英-35对多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者的体成分、糖脂代谢及肝肾功能和性激素的影响，分析其在临床运用的有效性和安全性。方法选择多囊卵巢综合征患者59例为研究对象，予达英-35口服治疗3个周期，3个周期后进行自身对照。主要观察指标包括体质量、体质量指数（body mass index，BMI）和腰围（waist circumferences，WC）、臀围（hip circumference，HC）与血压。结果体质量、BMI、WC、HC较达英-35治疗预处理前明显降低，收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）差异无统计学意义；血脂、血糖代谢：总胆固醇（total cholesterol，TC）、三酰甘油（triglyceride，TG）、高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol，LDL-C）、空腹血糖（fasting blood glucose，FBG）、空腹胰岛素（fasting insulin，FINS）和稳态模型胰岛素抵抗指数（homeostasis model insulin resistance index，HOMA-IR），脂肪分布、脂肪百分比比较，差异无统计学意义。性激素相关指标：血清黄体生成素（luteinizing hormone，LH）、游离雄激素指数（free androgen index，FAI）明显降低；性激素结合球蛋白（sex hormone-binding globulin，SHBG）显著增高；而总睾酮（total testosterone，TT）、硫酸脱氢表雄酮（dehydroepiandrosterone sulfate，DHEA-S）、雄烯二酮（androstenedione，AND）、游离睾酮（free testosterone，FT）、血清卵泡刺激素（follicle stimulating hormone，FSH）浓度差异均无统计学意义。肝、肾功能相关指标：血尿素氮（blood urea nitrogen，BUN）有所降低，丙氨酸氨基转移酶（alanine aminotransferase，ALT）、门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、γ-谷氨酰转移酶（gamma-glutamyltransferase，GGT）、血清肌酐（creatinine，Cr）浓度差异无统计学意义。结论 PCOS患者应用达英-35治疗3个月后体质量、BMI、WC、HC明显下降，可能有较好的减体质量效果，对血压无明显影响，达英-35治疗可降低LH浓度，增加SHBG浓度，从而发挥抑制雄激素生物效应。短期应用达英-35对肝肾功能无明显影响，具有较高的安全性。

关键词: 多囊卵巢综合征(PCOS), 达英-35, 代谢

Abstract: Objective To determine the effects of Diane-35 on body composition, glycolipid metabolism and liver and kidney function in patients with polycystic ovary syndrome (PCOS), and to analyze its efficacy and safety.Methods Totally 59 patients with polycystic ovary syndrome were enrolled in this study. Diane-35 was prescribed to them for 3 cycles. After 3 cycles, self-control was conducted, and the monitoring indicators were anthropometric indicators and blood pressure, sugar and lipid metabolism, sex hormone, liver and kidney function.Results Body weight, body mass index (BMI), waist circumference (WC), and hip circumference (HC) were significantly lower than those before pretreatment, while systolic blood pressure (SBP) and diastolic blood pressure (DBP) had no statistical difference. For sugar and lipid metabolism, there was no significant difference in total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting insulin (FINS) and homeostasis model insulin resistance index (HOMA-IR), fat distribution and percentage of fat. For sex hormone related indicators showed as follow:serum luteinizing hormone (LH), and free androgen index (FAI) decreased significantly; sex hormone binding globulin (SHBG) increased significantly; while total testosterone (TT), dehydroepiandrosterone sulfate (DHEA-S), androstenedione (AND), free testosterone (FT), serum follicle stimulating hormone (FSH) levels were not significantly different. For liver and kidney function:blood urea nitrogen (BUN) was decreased, but there was no significant difference in serum creatinine (Cr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). Conclusion Oral contraceptive pretreatment may have a weight-loss effect on PCOS patients, with no significant effect on blood pressure. It can reduce LH level, increase SHBG level and exert the biological effect of inhibiting androgen. Short-term oral contraceptives have no significant effect on liver and kidney function suggesting high safty.

Key words: polycystic ovary syndrome (PCOS), Diane-35, metabolism

中图分类号:

R711.75

谷牧青, 李扬璐, 程姣姣, 王虎生, 阮祥燕, 贾婵维. 达英-35对多囊卵巢综合征患者代谢与性激素的影响[J]. 首都医科大学学报, 2019, 40(4): 560-565.

Gu Muqing, Li Yanglu, Cheng Jiaojiao, Wang Husheng, Ruan Xiangyan, Jia Chanwei. Effect of Diane-35 treatment on metabolism and sex hormone in women with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2019, 40(4): 560-565.

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达英-35对多囊卵巢综合征患者代谢与性激素的影响

Effect of Diane-35 treatment on metabolism and sex hormone in women with polycystic ovary syndrome

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