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去氧孕烯与炔雌醇复方制剂对正常及高雄激素血症年轻女孩的影响:关于青春期避孕的思考

The effects of desogestrel and ethinylestradiol combination in normal and hyperandrogenic young girls: speculations on contraception in adolescence.

作者信息

Venturoli S, Porcu E, Gammi L, Fabbri R, Paradisi R, Flamigni C, Patrono D, Capelli M, Paoletti C

机构信息

Institute of Reproductive Physiology and Pathology, University of Bologna, Italy.

出版信息

Acta Eur Fertil. 1988 May-Jun;19(3):129-34.

PMID:2976224
Abstract

Hormone profile and ovarian morphology were studied in two groups of adolescents (group 1:19 girls with slight signs of hyperandrogenism; group 2: 14 normal adolescents) in basal conditions and during a contraceptive combination of 30 micrograms ethinyl estradiol (EE) and 150 micrograms desogestrel (D). Treatment was associated with a low incidence of side effects in both groups. In group 1, acne generally improved within 12 months while hirsutism was only reduced in some subjects (58%) after 12 months of therapy (basal hair score 8.50 +/- 1.60 vs 5.81 +/- 1.53 p less than 0.001). Significant falls in plasma levels of LH, total and free testosterone and an increase in sex-hormone-binding globulin levels were observed during treatment especially in group 1. High percentage of multifollicular ovaries (75%) characterized hyperandrogenic subjects. Ovarian volume and number of follicles, higher in group 1 than 2 in basal conditions, showed a significant reduction in both groups and normal ovarian morphology was restored in hyperandrogenic subjects. Considering the high incidence of hyperandrogenemia in adolescence and its implications, our data suggest that the EE.D combination suits adolescent biological condition and is one of the suitable contraceptive methods in adolescents which also has therapeutic effects.

摘要

在基础状态以及使用含30微克炔雌醇(EE)和150微克去氧孕烯(D)的复方避孕药期间,对两组青少年进行了激素水平和卵巢形态学研究(第1组:19名有轻微高雄激素血症迹象的女孩;第2组:14名正常青少年)。两组治疗的副作用发生率均较低。在第1组中,痤疮通常在12个月内有所改善,而多毛症仅在部分受试者中(58%)在治疗12个月后有所减轻(基础毛发评分8.50±1.60 vs 5.81±1.53,p<0.001)。治疗期间观察到血浆促黄体生成素(LH)、总睾酮和游离睾酮水平显著下降,性激素结合球蛋白水平升高,尤其是在第1组。高雄激素血症受试者的多卵泡卵巢比例较高(75%)。基础状态下第1组的卵巢体积和卵泡数量高于第2组,两组均显示出显著减少,高雄激素血症受试者恢复了正常的卵巢形态。考虑到青少年高雄激素血症的高发生率及其影响,我们的数据表明,EE.D复方避孕药适合青少年的生理状况,是青少年合适的避孕方法之一,且具有治疗作用。

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