White Terry, Ozel Begüm, Jain John K, Stanczyk Frank Z
Department of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA.
Contraception. 2006 Oct;74(4):293-6. doi: 10.1016/j.contraception.2006.04.005. Epub 2006 Jun 27.
The purpose of this study was to evaluate the effects of the contraceptive patch and an oral contraceptive (OC) on serum concentrations of estrogen-sensitive hepatic proteins, ethinyl estradiol (EE) and levonorgestrel (LNG).
Twenty-four women were randomized to receive three cycles of a contraceptive patch that delivers EE 20 microg/day and norelgestromin 150 microg/day or an OC that contains EE 35 microg and norgestimate 250 microg. Blood samples were taken at baseline and at the end of Cycle 3. Serum levels of sex-hormone-binding globulin (SHBG), thyroxine-binding globulin (TBG), corticosteroid-binding globulin (CBG) and C-reactive protein (CRP) were quantified by immunoassay methods. EE and LNG levels in patch users were measured by radioimmunoassay (RIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay. The paired t test and Student's t test were used for statistical analysis.
Nineteen women completed the study (patch, n=10; OC, n=9). Treatment with both the patch and OC resulted in significant increases from baseline in SHBG, TBG and CBG. The increase in CRP was significant in the patch group and approached significance in the OC group. The increases in SHBG and TBG observed with the patch were significantly greater than those associated with the OC. By way of RIA and LC-MS/MS assay methods, the patch was associated with mean EE levels of 114 and 111 pg/mL, respectively.
The serum concentrations of estrogen-sensitive hepatic proteins and EE associated with the patch suggest that this new contraceptive system may have relatively large net estrogen effects.
本研究旨在评估避孕贴片和口服避孕药（OC）对雌激素敏感的肝脏蛋白、炔雌醇（EE）和左炔诺孕酮（LNG）血清浓度的影响。
24名女性被随机分为两组，分别接受三个周期的避孕贴片（每日释放20微克EE和150微克诺孕酯）或含有35微克EE和250微克诺孕酯的OC。在基线和第3周期结束时采集血样。采用免疫分析方法对血清性激素结合球蛋白（SHBG）、甲状腺素结合球蛋白（TBG）、皮质类固醇结合球蛋白（CBG）和C反应蛋白（CRP）水平进行定量。通过放射免疫分析（RIA）和液相色谱-串联质谱（LC-MS/MS）分析法测量使用贴片者的EE和LNG水平。采用配对t检验和学生t检验进行统计分析。
19名女性完成了研究（贴片组，n = 10；OC组，n = 9）。使用贴片和OC治疗均导致SHBG、TBG和CBG较基线水平显著升高。贴片组CRP升高显著，OC组接近显著升高。贴片组观察到的SHBG和TBG升高显著大于OC组。通过RIA和LC-MS/MS分析法，贴片的平均EE水平分别为114和111 pg/mL。
与贴片相关的雌激素敏感肝脏蛋白和EE的血清浓度表明，这种新型避孕系统可能具有相对较大的净雌激素效应。
