屈螺酮炔雌醇片和地屈孕酮治疗对超重多囊卵巢综合征患者体成分与脂代谢的影响

doi:10.3969/j.issn.1006-7795.2026.04.005

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (4): 665-672.doi: 10.3969/j.issn.1006-7795.2026.04.005

• 更年期妇科内分泌与生育力保护 • 上一篇下一篇

屈螺酮炔雌醇片和地屈孕酮治疗对超重多囊卵巢综合征患者体成分与脂代谢的影响

李妍秋¹,阮祥燕^1,2*,牧青¹,蒋玲玲¹,张明珍¹,Alfred O. Mueck^1,2

1.首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科, 北京 100026；2. 德国图宾根大学妇产医院妇女健康部与妇女健康研究中心，图宾根 D－72076

收稿日期:2026-04-09 修回日期:2026-05-07 出版日期:2026-08-21 发布日期:2026-07-26
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
北京市医院管理局“登峰”人才计划项目（DFL20181401），高端外国专家引进计划“北京妇科内分泌疑难病研究会诊中心的建立”项目（S20240236）。

Effect of ethinylestradiol /drospirenone and dydrogesterone on body composition and lipid metabolism in overweight polycystic ovary syndrome patients

Li Yanqiu¹ , Ruan Xiangyan^1,2* , Gu Muqing¹, Jiang Lingling¹ , Zhang Mingzhen¹ , Alfred O. Mueck^1,2

1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026; 2.Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen， University Hospitals of Tuebingen, Tuebingen D-72076, Germany

Received:2026-04-09 Revised:2026-05-07 Online:2026-08-21 Published:2026-07-26
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals “Dengfeng” Talent Training Program (DFL20181401), National Foreign Experts Individual Project, Establishment of Fertility Preservation and Consultation Center for Gynecological Endocrine Difficult Diseases (S20240236).

摘要/Abstract

摘要： 目的比较屈螺酮炔雌醇片（ethinyl estradiol/drospirenone，EE/DRSP）和地屈孕酮治疗对超重多囊卵巢综合征患者体成分与脂代谢的影响。方法招募160例于首都医科大学附属北京妇产医院内分泌科就诊，体质量指数（body mass index, BMI）达到超重（24 kg/m2 ≤BMI＜28 kg/m2）且确诊为多囊卵巢综合征的18~40岁育龄期女性作为研究对象。按照2组基线资料具有可比性的原则，采用随机数字表法将患者分为EE/DRSP组和地屈孕酮组，每组各80例。所有患者均进行为期3周期的治疗。对比分析2组患者用药前、用药3周期停药后月经来潮第2~5天的身体测量指标（BMI、腰围、臀围）、血脂指标［三酰甘油（triglycerides, TG）、总胆固醇（total cholesterol, TC）、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）］及体成分指标（下肢肌肉分布系数、脂肪百分比、脂肪分布）。结果治疗3个月后，2组患者的BMI、腰围、臀围、脂肪分布、脂肪百分比均有所降低（下肢肌肉分布系数除外），其中EE/DRSP组患者的BMI、腰围、臀围、脂肪分布、脂肪百分比下降幅度均大于地屈孕酮组，组间差异有统计学意义（P＜0.05）。治疗后两组患者HDL-C、LDL-C均较治疗前明显改善，并且EE/DRSP组患者的HDL-C升高幅度及LDL-C下降幅度均显著高于地屈孕酮组（P<0.05）；而2组的TC及TG治疗前后变化幅度的差异无统计学意义（P＞0.05）。结论 EE/DRSP与地屈孕酮均可在一定程度上改善多囊卵巢综合征患者的代谢状态，但EE/DRSP在体成分及脂代谢改善方面可能具有更明显优势。

关键词: 多囊卵巢综合征, 屈螺酮炔雌醇片, 地屈孕酮, 体成分, 脂代谢, 超重

Abstract: Objective To compare the effects of ethinyl estradiol/drospirenone(EE/DRSP) and dydrogesterone on body composition and lipid metabolism in overweight patients with polycystic ovary syndrome (PCOS). Methods A total of 160 overweight (24≤body mass index (BMI)< 28 kg/m2) women of reproductive age (18－40 years) who were diagnosed with PCOS and treated at the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, were recruited. The patients were randomly divided into two groups, with 80 patients in each group (EE/DRSP group, n=80; dydrogesterone group, n=80). Each group underwent three treatment cycles. The following parameters were observed before treatment and on days 2－5 of menstrual cycle after completing three cycles of treatment: anthropometric measurements (BMI, waist circumference, hip circumference); blood lipid parameters ［triglycerides (TG), total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C)］; and body composition parameters (lower limb muscle distribution coefficient, fat percentage, fat distribution).Results After three treatment cycles, waist circumference, hip circumference, BMI, fat distribution, fat percentage, TC and LDL-C in the EE/DRSP group were significantly reduced compared to baseline (P all<0.05). While HDL-C was significantly increased (P < 0.05). In the dydrogesterone group, BMI, waist circumference, and hip circumference, fat percentage, TC and LDL-C were significantly decreased (P<0.05). When the groups were compared, EE/DRSP led to more significant reductions in waist circumference, hip circumference, BMI, fat distribution, and fat percentage. It also resulted in a more significant increase in HDL-C and a more significant reduction in LDL-C (P all < 0.05). Conclusion While both EE/DRSP and dydrogesterone can improve the metabolic status of patients with polycystic ovary syndrome to some extent, EE/DRSP may offer more pronounced advantages in improving body composition and lipid metabolism.

Key words: polycystic ovary syndrome, ethinyl estradiol/drospirenone, dydrogesterone, body composition, lipid metabolism, overweight

中图分类号:

R711

李妍秋, 阮祥燕, 牧青, 蒋玲玲, 张明珍, Alfred O. Mueck. 屈螺酮炔雌醇片和地屈孕酮治疗对超重多囊卵巢综合征患者体成分与脂代谢的影响[J]. 首都医科大学学报, 2026, 47(4): 665-672.

Li Yanqiu , Ruan Xiangyan, Gu Muqing , Jiang Lingling , Zhang Mingzhen , Alfred O. Mueck. Effect of ethinylestradiol /drospirenone and dydrogesterone on body composition and lipid metabolism in overweight polycystic ovary syndrome patients[J]. Journal of Capital Medical University, 2026, 47(4): 665-672.

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屈螺酮炔雌醇片和地屈孕酮治疗对超重多囊卵巢综合征患者体成分与脂代谢的影响

Effect of ethinylestradiol /drospirenone and dydrogesterone on body composition and lipid metabolism in overweight polycystic ovary syndrome patients

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