Coffee Andrea L, Kuehl Thomas J, Willis Sherilyn, Sulak Patricia J
Department of Obstetrics and Gynecology, Scott & White Memorial Hospital, Texas A&M University System Health Science Center College of Medicine, Temple, TX 76508, USA.
Am J Obstet Gynecol. 2006 Nov;195(5):1311-9. doi: 10.1016/j.ajog.2006.05.012. Epub 2006 Jun 21.
The purpose of this study was to assess the incidence and severity of premenstrual-type symptoms in patients converted from a 21/7 oral contraceptive (OC) regimen to an extended regimen.
This was a single center prospective analysis of the single item Scott and White (S&W) Mood Scale and the Penn State Daily Symptom Report (DSR17) during a 21/7-day followed by a 168-day extended regimen of an OC containing 3 mg of drosperinone and 30 microg of ethinyl estradiol (DRSP/EE).
Of the 114 patients who began the study, 111 completed the preextension 21/7 phase of the study. There were significant differences in severity in the DSR17 and the S&W mood scale among days of the cycle. (P < .0001) The highest values in both scales occurred during the 7-day hormone free interval (HFI) of the 21/7 cycles (P < .001). Of the 111 patients who completed the 21/7 phase of the study, 102 (92%) completed the 168-day extended regimen. During the extended phase of the study, subjects were divided into 2 groups: those with a 100% increase in symptoms from the first half to the second half of the last 21/7 cycle were labeled as high cyclic variability, whereas those with lesser or no cyclic change were labeled as low cyclic variability. There were 55 (54%) with increased cyclic variability in mood scores peaking during the 7-day HFI. Premenstrual-type symptoms measured by both the S&W mood scale and the DSR17 instrument decreased during the extended DRSP/EE OC regimen (P < .0001) compared with the preceding 21/7 cycle, with the greatest improvement detected in the sixth month of continuous OCs (P < .003). The patient group with greatest cyclic variability during the 21/7 regimen demonstrated the most improvement during the 168-day regimen (P < .0001). The single item S&W mood scale was significantly (P < .05) correlated to each of 17 elements of the DSR17 with Spearman R correlation coefficients of 0.25 to 0.57. The greatest correlation coefficient (Spearman's R = 0.66) is with the sum of all 17 items.
A 168-day extended regimen of DRSP/EE led to a decrease in premenstrual-type symptoms compared with the 21/7-day regimen.
本研究旨在评估从21/7口服避孕药（OC）方案转换为延长方案的患者经前型症状的发生率和严重程度。
这是一项单中心前瞻性分析，对单一项目的斯科特与怀特（S&W）情绪量表和宾夕法尼亚州立大学每日症状报告（DSR17）进行评估，研究为期21/7天，随后是含3毫克屈螺酮和30微克炔雌醇（DRSP/EE）的OC的168天延长方案。
在开始研究的114例患者中，111例完成了研究的21/7天预延长阶段。在月经周期各天中，DSR17和S&W情绪量表的严重程度存在显著差异（P <.0001）。两个量表的最高值出现在21/7周期的7天无激素间隔期（HFI）（P <.001）。在完成研究21/7阶段的111例患者中，102例（92%）完成了168天的延长方案。在研究的延长阶段，受试者被分为两组：在最后一个21/7周期中，症状从上半年到下半年增加100%的患者被标记为高周期变异性，而周期变化较小或无变化的患者被标记为低周期变异性。有55例（54%）情绪评分的周期变异性增加，在7天HFI期间达到峰值。与之前的21/7周期相比，在DRSP/EE OC延长方案期间，通过S&W情绪量表和DSR17工具测量的经前型症状有所减轻（P <.0001），在连续服用OC的第六个月改善最为明显（P <.003）。在21/7方案期间周期变异性最大的患者组在168天方案期间改善最为显著（P <.0001）。单一项目的S&W情绪量表与DSR17的17个元素中的每一个均显著相关（P <.05），Spearman相关系数为0.25至0.57。最大相关系数（Spearman's R = 0.66）与所有17个项目的总和相关。
与21/7天方案相比，DRSP/EE的168天延长方案可减轻经前型症状。
