Wild R A, Demers L M, Applebaum-Bowden D, Lenker R
Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Contraception. 1991 Aug;44(2):113-24. doi: 10.1016/0010-7824(91)90112-s.
Fifty-one hirsute women were randomly treated for nine months with ethinyl estradiol 35 ug plus norethindrone 0.4 mg or 30 ug ethinyl estradiol plus 1.5 mg norethindrone acetate if they needed contraception or spironolactone 200 mg daily if they did not. Metabolic evaluations in response to therapy demonstrated triglyceride elevations with the two oral contraceptives but not with spironolactone. While systolic blood pressure was lower with spironolactone, fasting insulin levels were higher as opposed to either low-dose oral contraceptive preparation. Ethinyl estradiol 30 ug plus 1.5 mg norethindrone acetate lowered 3-alpha-diol glucuronide levels, yet ethinyl estradiol 35 ug plus norethindrone 0.4 mg and spironolactone were more effective in lowering Ferriman-Gallwey Scores. Treatment strategies for hirsute women need to consider metabolic consequences as well as efficacy.
51名多毛症女性被随机分组，若需要避孕，则接受为期9个月的炔雌醇35微克加炔诺酮0.4毫克治疗，或炔雌醇30微克加醋酸炔诺酮1.5毫克治疗；若不需要避孕，则接受每日200毫克螺内酯治疗。对治疗反应的代谢评估表明，两种口服避孕药会导致甘油三酯升高，但螺内酯不会。虽然服用螺内酯时收缩压较低，但与两种低剂量口服避孕药制剂相比，空腹胰岛素水平较高。炔雌醇30微克加醋酸炔诺酮1.5毫克可降低3-α-二醇葡萄糖醛酸水平，但炔雌醇35微克加炔诺酮0.4毫克和螺内酯在降低费里曼-盖尔维毛发评分方面更有效。多毛症女性的治疗策略需要考虑代谢后果以及疗效。
