赖诺普利对多囊卵巢综合征并伴有高血压患者雄激素水平的有益影响

Impact of lisinopril on hyperandrogenism in women with polycystic ovary syndrome

目的:探讨赖诺普利治疗多囊卵巢综合征并伴有高血压患者过程中对血清雄激素和性激素结合球蛋白水平的影响。方法:30例多囊卵巢综合征并伴有高血压患者以赖诺普利10 mg/d治疗8 wk作为前瞻性观察研究。每例对象进入本研究时和治疗12wk结束时,均观察主要指标:1)收缩压和舒张压;2)生殖内分泌激素,包括促性腺激素、硫酸脱氢表雄酮、总睾酮、游离睾酮、17α-羟孕酮血清水平、雄烯二酮、雌二醇、性激素结合球蛋白、促甲状腺激素和催乳素含量;3)胰岛素抵抗。结果:多囊卵巢综合征并伴有高血压患者服用赖诺普利治疗后,获下列效果:1)良好降压效果(收缩压平均下降2.39 kPa,舒张压平均下降1.73 kPa,P皆<0.05)。2)改善胰岛素抵抗(7.2±2.8 vs 6.3±2.0,P<0.05)。3)对性激素有有益影响。血清游离睾酮降低(3.1±1.2 vs 2.0±0.6,P<0.05),但没有影响性激素结合球蛋白水平。结论:赖诺普利除有效降低血压和改善胰岛素抵抗之外,还可使睾酮水平下降。

Objective ：To investigate the effect of lisinopril on serum androgen and sex-hormone-binding globulin （SHBG） levels in hypertensive women with polycystic ovary syndrome （PCOS）. Methods. ： Thirty hypertensive women with PCOS were treated with lisinopril（ 10 mg/day for 8 weeks） in the prospective, observational study. Main outcome measures： serum levels of gonadotropins, DHEAS, total T, free T, 17 α - hydroxyprogesterone （17- OHP）, androstenedione, E2, SHBG, TSH and PRL were determined at screening and end of the treatment. Results： Hypertension treatment with lisinopril decreased significantly in sytolic and diastolic blood presure（P〈0.05 ） ,improved insulin resistance （7.2 ± 2.8 vs 6.3 ±2.0, P〈0.05 ） , and decreased serum free T levels （ 3.1 ± 1.2 vs 2.0 ±0.6, P〈0.05 ） . However, there was no difference in the SHBG levels. Conclusions： Use of lisinopril results in decreased free T levels independently of SHBG. It may affect the free T levels by affecting the ovarian renin-angiotensin system.