Golland I M, Elstein M E
Department of Obstetrics and Gynaecology, University Hospital of South Manchester, United Kingdom.
Ann N Y Acad Sci. 1993 May 28;687:263-71. doi: 10.1111/j.1749-6632.1993.tb43875.x.
To evaluate the effects of Diane-35 on androgenized oligomenorrheic women with polycystic ovarian syndrome, 32 women with PCOS were recruited to an open study of one-year duration. The effects of Diane-35 on signs of androgenization and on morphological and hormonal parameters were assessed in the pre- and posttreatment cycles and in the 3rd, 6th, 9th, and 12th treatment cycles. Twenty-two women completed the 12-month study period, five withdrew due to adverse events, two were lost to follow-up, and three stopped early because of a lack of efficacy. Ultrasound demonstrated significant reductions in ovarian volume, stromal density, and follicle number and size. Serum concentrations of LH, FSH, testosterone, androstenedione, and dehydroepiandrosterone sulfate decreased, and serum SHBG increased significantly. Mean Ferriman-Gallwey hirsutism scores declined from 14.3 before treatment to 5.7 at completion of therapy. Severe facial hirsutism, present in 23 (71.9%) of 32 women, disappeared in 6 women and improved in 6 women--a healing/improvement rate of 54.6% of 22 women who completed the study. Cycle control was good, amenorrhea occurred in 5 (1.6%) of 322 treatment cycles, while 94.8% of withdrawal bleeds were normal or scanty. Intermenstrual spotting occurred in 7.1% and break-through bleeding in 4.4% of all treatment cycles. The incidence of adverse events was similar to that of other gestagen-estrogen combinations. The results of the study demonstrate that Diane-35 provides an effective therapy for androgenized oligomenorrheic women with PCOS wishing simultaneous contraceptive protection.
为评估达英-35对多囊卵巢综合征雄激素化少经女性的影响,招募了32名多囊卵巢综合征女性参与一项为期一年的开放性研究。在治疗前和治疗后的周期以及第3、6、9和12个治疗周期中,评估了达英-35对雄激素化体征以及形态学和激素参数的影响。22名女性完成了12个月的研究期,5名因不良事件退出,2名失访,3名因缺乏疗效提前停药。超声显示卵巢体积、间质密度以及卵泡数量和大小显著减小。血清促黄体生成素(LH)、促卵泡生成素(FSH)、睾酮、雄烯二酮和硫酸脱氢表雄酮的浓度降低,血清性激素结合球蛋白(SHBG)显著升高。平均费里曼-盖尔韦多毛症评分从治疗前的14.3降至治疗结束时的5.7。32名女性中有23名(71.9%)存在严重面部多毛症,其中6名消失,6名改善——在完成研究的22名女性中,治愈/改善率为54.6%。月经周期控制良好,322个治疗周期中有5个(1.6%)出现闭经,而94.8%的撤退性出血正常或量少。所有治疗周期中,经间期点滴出血发生率为7.1%,突破性出血发生率为4.4%。不良事件发生率与其他孕激素-雌激素组合相似。该研究结果表明,达英-35为希望同时获得避孕保护的雄激素化少经多囊卵巢综合征女性提供了一种有效的治疗方法。