炔雌醇环丙孕酮片在治疗多囊卵巢综合征女性痤疮中的应用

Application of ethinyl estradiol-cyproterone acetate in the treatment of acne of women with polycystic ovary syndrome

目的探讨达英35在多囊卵巢综合征(PCOS)合并女性痤疮患者中的应用。方法选取PCOS合并痤疮患者65例,同期另择正常健康女性30例作为对照组。65例PCOS患者采用炔雌醇环丙孕酮片治疗。于治疗前及治疗后第3个和第6个周期末,记录多毛评分和痤疮评分;于早卵泡期及治疗后第3个月和第6个月末,测定血清总睾酮、黄体生成素、卵泡刺激素、空腹血糖、空腹胰岛素,计算黄体生成素/卵泡刺激素比值和胰岛素抵抗指数(HOMA-IR)。结果与治疗前比较,治疗后两时间点的多毛评分、痤疮评分、血清总睾酮和黄体生成素水平及黄体生成素/卵泡刺激素比值均显著降低。伴有胰岛素抵抗患者治疗后6个周期末的HOMA-IR水平明显高于治疗前。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 application of ethinyl estradiol-cyproterone acetate（Diane-35） in acne women complicated with polycystic ovary syndrome（PCOS）.Methods Sixty-five PCOS patients complicated with acne were included in the treatment group and another 30 female patients were included in the control group.The treatment group was administered Diane-35.Ferriman-Gallwey（F-G） score and acne score were recorded before treatment and at the end of the third and sixth cycle after treatment.Serum total testosterone,luteinizing hormone（LH）,follicle stimulating hormone（FSH）,fasting plasma glucose,fasting insulin,LH/FSH ratio,insulin resistance index（HOMA-IR） were determined at early follicular phase and at the end of the third and sixth month after treatment.Results F-G score,acne score,serum total testosterone,LH and LH/FSH ratio were significantly decreased at two time points after treatment.HOMA-IR level in patients with insulin resistance was significantly higher at the end of the sixth cycle after treatment.Conclusion The development of acne in PCOS patients may be associated with high androgen levels and ethinyl estradiol-cyproterone acetate may be effective in the treatment of acne.