Ramsay I D, Rushton D H
Department of Endocrinology, North Middlesex Hospital, London, UK.
Clin Exp Dermatol. 1990 Jul;15(4):277-81. doi: 10.1111/j.1365-2230.1990.tb02089.x.
In a group of healthy, non-vegetarian females currently being treated for diffuse androgen-dependent alopecia with 50 or 100 mg of oral cyproterone acetate for 11 days and 30 or 40 micrograms of ethinyl oestradiol for 20 days of the menstrual cycle, significant decreases in mean serum vitamin B12 (P less than 0.0001), haemoglobin (P less than 0.003) and haematocrit (P less than 0.004) values, were observed after 6 months. Serum folic acid, red-cell folate and mean cell volume remained unchanged within the normal range during this time. All patients responded to oral cyanocobalamin, or intramuscular injections of hydroxocobalamin. In patients with baseline serum vitamin B12 levels below 350 ng/l, we would suggest prophylactic cyanocobalamin concurrent with cyproterone-acetate-ethinyl-oestradiol (CPA EE2) therapy. Studies involving other dose regimens of CPA EE2 (Dianette) or cyproterone acetate alone (Androcur, Cyprostat), may require evaluation of the vitamin B12 status if treatment is to be given for periods of longer than 3 months.
在一组健康的非素食女性中，她们目前正接受治疗弥漫性雄激素依赖性脱发，口服醋酸环丙孕酮50或100毫克，为期11天，在月经周期的20天内口服炔雌醇30或40微克。6个月后观察到平均血清维生素B12（P<0.0001）、血红蛋白（P<0.003）和血细胞比容（P<0.004）值显著下降。在此期间，血清叶酸、红细胞叶酸和平均红细胞体积在正常范围内保持不变。所有患者对口服氰钴胺或肌肉注射羟钴胺均有反应。对于基线血清维生素B12水平低于350 ng/l的患者，我们建议在醋酸环丙孕酮 - 炔雌醇（CPA EE2）治疗的同时预防性使用氰钴胺。如果使用其他剂量方案的CPA EE2（达英）或单独使用醋酸环丙孕酮（安君可、环丙司坦）进行治疗且疗程超过3个月，可能需要评估维生素B12状态。
