多囊卵巢综合征合并痤疮患者性激素水平的变化及相关性

Sexual hormone levels in polycystic ovarian syndrome patients with acne

目的 探讨多囊卵巢综合征（PCOS）合并痤疮患者性激素水平的变化及相关性.方法 选取PCOS患者55例,其中合并痤疮30例（痤疮组）,无痤疮25例（非痤疮组）,同期另择正常健康女性30例作为对照组.52例PCOS患者采用炔雌醇环丙孕酮片治疗,余3例患者在全麻下行腹腔镜电凝打孔术治疗.采集对照组及PCOS患者治疗前肘静脉血,采用化学发光法测定其黄体生成素（LH）、卵泡刺激素（FSH）、总睾酮.炔雌醇环丙孕酮片治疗3～6个疗程或术后3个月再次复查血性激素,并进行对比.结果 治疗后痤疮组患者痊愈11例,显效7例,有效10例,无效2例.痤疮组血清睾酮的水平显著高于非痤疮组与对照组（P＜0.01）,非痤疮组睾酮水平亦显著高于对照组（P＜0.01）;痤疮组与非痤疮组患者血清LH及LH/FSH均显著高于对照组（P＜0.01）.经炔雌醇环丙孕酮片治疗3～6个疗程或腹腔镜下电凝打孔术后3个月,痤疮组和非痤疮组患者雄激素均显著下降（P＜0.01）.结论 高雄激素血症和PCOS与成年女性痤疮有关,且是其长期不愈的重要原因.炔雌醇环丙孕酮片对此类痤疮有较好疗效.

Objective To investigate the sex hormone levels in polycystic ovarian syndrome （PCOS） patients with acne. Methods Fifty five PCOS patients, including 30 cases with acne and 25 cases with no acne, received ethinylestradiol and cypro- terone acetate tablets （n=52）or laparoscopic ovarian electrocoagulation（ n=3 ）for treatment. The serum levels of follicular stimulating hormone （FSH）, luteinizing hormone （LH） and testosterone （T） were measured by chemiluminescence method in 55 PCOS patients and 30 healthy women （controls） before and 3 months after treatment. Results Serum testosterone in PCOS patients was significant higher than that in controls （P〈0.01）; Serum T level in PCOS patients with acne higher that that without ache （P〈0.01）. Serum LH and LH/FSH levels in PCOS patients were significantly higher than those in healthy controls （P〈0.01）; but there was no significant difference between PCOS patients with acne and without acne. There was no difference in serum FSH levels among these three groups. After treatment the androgen levels were decreased in PCOS patients significantly. Conclusion The development of acne in PCOS patients may be associated with high androgen levels and ethinylestradiol and cyproterone acetate may be effective in treatment for acne in PCOS patients.