复方避孕阴道环（依伴依）与脂质代谢：一项对比研究。

The combined contraceptive vaginal ring (NuvaRing) and lipid metabolism: a comparative study.

作者信息

Tuppurainen M, Klimscheffskij R, Venhola M, Dieben Th O M

机构信息

Laboratorio Gyne Oy, Kuopio, Finland.

出版信息

Contraception. 2004 May;69(5):389-94. doi: 10.1016/j.contraception.2004.01.004.

DOI:10.1016/j.contraception.2004.01.004

PMID:15105061

Abstract

This study compared the lipid profile after three and six cycles of treatment with NuvaRing delivering 15 microg ethinylestradiol and 120 microg etonogestrel daily with a combined oral contraceptive (COC) containing ethinylestradiol 30 microg and levonorgestrel 150 microg. In the NuvaRing group 40 women were treated and 43 in the COC group. Compared with baseline, total cholesterol did not change in either group. NuvaRing did not affect HDL, but HDL, HDL2 and HDL3 levels decreased with the COC. In contrast, HDL2 increased with NuvaRing at cycle 3. LDL increased after cycles 3 and 6 with COC, and decreased after three cycles of NuvaRing treatment. Apolipoprotein A-1 levels increased with NuvaRing, but decreased with COC; apolipoprotein B and triglycerides increased, and lipoprotein(a) decreased in both groups. Sex hormone-binding globulin increased markedly more with NuvaRing, whereas corticosteroid-binding globulin levels increased less. These changes reflect the lower androgenicity of etonogestrel versus levonorgestrel and show that NuvaRing has a minimal effect on lipid profile.

摘要

本研究比较了每日释放15微克炔雌醇和120微克依托孕烯的阴道环（NuvaRing）治疗三个周期和六个周期后的血脂情况，与含30微克炔雌醇和150微克左炔诺孕酮的复方口服避孕药（COC）进行对比。NuvaRing组有40名女性接受治疗，COC组有43名。与基线相比，两组的总胆固醇均未改变。NuvaRing对高密度脂蛋白（HDL）无影响，但COC使HDL、HDL2和HDL3水平降低。相比之下，NuvaRing在第3周期时使HDL2升高。COC在第3周期和第6周期后使低密度脂蛋白（LDL）升高，而NuvaRing治疗三个周期后LDL降低。载脂蛋白A-1水平在NuvaRing治疗后升高，但在COC治疗后降低；两组的载脂蛋白B和甘油三酯均升高，而脂蛋白(a)降低。性激素结合球蛋白在NuvaRing治疗后升高更为明显，而皮质类固醇结合球蛋白水平升高较少。这些变化反映出依托孕烯相对于左炔诺孕酮的雄激素活性较低，表明NuvaRing对血脂情况的影响极小。