Isojärvi J I, Laatikainen T J, Pakarinen A J, Juntunen K T, Myllylä V V
Department of Neurology, University of Oulu, Finland.
Epilepsia. 1995 Jul;36(7):676-81. doi: 10.1111/j.1528-1157.1995.tb01045.x.
We measured concentrations of serum sex hormones and sex hormone binding globulin (SHBG) in relation to regularity of the menstrual cycles in 8 women before carbamazepine (CBZ) treatment was initiated and after 1 and 5 years of CBZ therapy. In addition, we evaluated menstrual cycle regularity and related endocrine changes in 56 women receiving CBZ treatment for > 5 years. Serum SHBG levels increased, and serum concentrations of 17 beta-estradiol (estradiol) and estradiol/SHBG ratio decreased during CBZ treatment. Two of the 8 patients (25%) in the prospective study group developed menstrual irregularities during the first 5 years of therapy. In the cross-sectional study group of patients treated with CBZ for > 5 years, the frequency of menstrual disturbances was also 25.0% (14 of 56 patients). Concentrations of serum sex hormones and SHBG were measured in 13 women with menstrual disorders and in 11 randomly selected women with regular cycles. In most cases, menstrual disorders were associated with increased serum SHBG and decreased serum estradiol levels and low estradiol/SHBG ratio. Long-term CBZ treatment results in increased serum SHBG levels and decreased estradiol effect, which correlate with the frequency of menstrual disorders in CBZ-treated women with epilepsy.
我们在8名女性开始卡马西平（CBZ）治疗前、治疗1年和5年后，测量了血清性激素和性激素结合球蛋白（SHBG）的浓度与月经周期规律的关系。此外，我们评估了56名接受CBZ治疗超过5年的女性的月经周期规律及相关内分泌变化。在CBZ治疗期间，血清SHBG水平升高，血清17β-雌二醇（雌二醇）浓度和雌二醇/SHBG比值降低。前瞻性研究组的8名患者中有2名（25%）在治疗的前5年出现月经不规律。在接受CBZ治疗超过5年的横断面研究组患者中，月经紊乱的发生率也为25.0%（56名患者中有14名）。我们测量了13名月经紊乱女性和11名随机选择的月经周期规律女性的血清性激素和SHBG浓度。在大多数情况下，月经紊乱与血清SHBG升高、血清雌二醇水平降低和雌二醇/SHBG比值低有关。长期CBZ治疗导致血清SHBG水平升高和雌二醇效应降低，这与癫痫患者接受CBZ治疗时月经紊乱的发生率相关。
