Lobo R A, Shoupe D, Serafini P, Brinton D, Horton R
Fertil Steril. 1985 Feb;43(2):200-5. doi: 10.1016/s0015-0282(16)48373-1.
Spironolactone (S) has been used successfully for the treatment of hirsutism. We evaluated whether the effects of S on serum androgens and hair growth are dose-related and whether S affects secreted androgens to the same degree as peripherally derived androgens. Two groups of 15 hirsute patients, similarly matched, received either 100 or 200 mg S daily for 3 months. Serum total testosterone (T) decreased significantly (P less than 0.05) and to a similar degree with both dosages, whereas unbound T was unaltered. Dehydroepiandrosterone sulfate was unaltered, whereas androstenedione decreased with 200 mg S (P less than 0.05). Peripherally derived serum dihydrotestosterone decreased to a similar degree with 100 and 200 mg S (P less than 0.05), whereas 5 alpha-androstane-3 alpha-17 beta-diol (3 alpha-diol) increased (P less than 0.05) similarly with both dosages. Serum 3 alpha-diol glucuronide (3 alpha-diol-G) increased with both dosages, but not significantly. Anagen hair shaft diameters decreased significantly in both groups by 19% +/- 8% and 30% +/- 4% (P less than 0.05). No correlation was found between hair growth and serum androgens. Because serum unbound T was largely unaltered by S, it is suggested that the antiandrogenic effects of S are primarily related to its peripheral effect. However, there is no good clinical marker for this effect as levels of 3 alpha-diol and 3 alpha-diol-G increase.
螺内酯（S）已成功用于治疗多毛症。我们评估了S对血清雄激素和毛发生长的影响是否与剂量相关，以及S对分泌型雄激素和外周来源雄激素的影响程度是否相同。两组各15例多毛症患者，匹配情况相似，分别每日服用100或200mg S，持续3个月。血清总睾酮（T）显著降低（P<0.05），两种剂量降低程度相似，而游离T未改变。硫酸脱氢表雄酮未改变，而雄烯二酮在服用200mg S时降低（P<0.05）。外周来源的血清双氢睾酮在服用100和200mg S时降低程度相似（P<0.05），而5α-雄烷-3α-17β-二醇（3α-二醇）在两种剂量下均有相似增加（P<0.05）。血清3α-二醇葡糖苷酸（3α-二醇-G）在两种剂量下均增加，但无显著差异。两组生长期毛干直径均显著降低，分别为19%±8%和30%±4%（P<0.05）。未发现毛发生长与血清雄激素之间存在相关性。由于S对血清游离T影响不大，提示S的抗雄激素作用主要与其外周效应有关。然而，随着3α-二醇和3α-二醇-G水平升高，尚无针对此效应的良好临床标志物。
