Chung Jacqueline P W, Yiu Alice K W, Chung Tony K H, Chan Symphorosa S C
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong.
J Pediatr Adolesc Gynecol. 2014 Jun;27(3):166-71. doi: 10.1016/j.jpag.2013.09.011. Epub 2014 Mar 19.
To investigate the effects of 4-month treatment of medroxyprogesterone acetate (MPA) and Diane-35 on the clinical and biochemical features of hyperandrogenism and quality of life of adolescent girls with polycystic ovarian syndrome (PCOS).
A prospective, randomized, cross-over study.
An accredited pediatric and adolescent gynecology clinic of a university-affiliated tertiary hospital.
76 adolescents girls aged 14 to 19 years old with PCOS were recruited from July 2007 to July 2010.
Girls were randomized into 2 groups. Group 1 received oral MPA for 4 months, followed by a washout period of 4 months, and then Diane-35 for another 4 months. Group 2 received the same combination but in the reverse order.
Clinical and biochemical features of hyperandrogenism and quality of life were assessed.
There was no significant difference between the 2 groups at baseline. No significant difference was found in the clinical and biochemical parameters of hyperandrogenism before and after treatment with MPA. Significant reduction of the acne score, LH/FSH ratio, and testosterone level was seen after taking Diane-35. Hirsutism was also improved but it did not reach statistical significant. When comparing post-MPA and post-Diane-35, the post-Diane-35 group had significantly improved acne score and LH/FSH ratio. No significant difference was found on quality of life between both groups after treatment.
Diane-35 may be a more suitable treatment option in adolescent girls diagnosed with PCOS when compared to MPA.
探讨醋酸甲羟孕酮（MPA）和达英-35治疗4个月对多囊卵巢综合征（PCOS）青春期女孩高雄激素血症的临床和生化特征及生活质量的影响。
一项前瞻性、随机、交叉研究。
一所大学附属三级医院的认可儿科及青少年妇科诊所。
2007年7月至2010年7月招募了76名年龄在14至19岁的PCOS青春期女孩。
女孩们被随机分为两组。第1组口服MPA 4个月，随后有4个月的洗脱期，然后再服用达英-35 4个月。第2组接受相同的组合，但顺序相反。
评估高雄激素血症的临床和生化特征及生活质量。
两组在基线时无显著差异。MPA治疗前后高雄激素血症的临床和生化参数无显著差异。服用达英-35后，痤疮评分、LH/FSH比值和睾酮水平显著降低。多毛症也有所改善，但未达到统计学显著水平。比较MPA治疗后和达英-35治疗后，达英-35治疗后组的痤疮评分和LH/FSH比值显著改善。治疗后两组在生活质量方面无显著差异。
与MPA相比，达英-35可能是诊断为PCOS的青春期女孩更合适的治疗选择。
