含不同生物活性的甾体激素避孕药对中国妇女脂代谢的影响

The impact of steroid hormone contraceptives with different bio-activity on lipids profile.

总结7种含有不同生物活性的常用甾体激素避孕药(Marvelon,Microgynon,中国Ⅰ号片,Mercilon,LNG事后药,Mesigyna,Cyclofem)对中国妇女脂代谢的影响。191例需要避孕的健康志愿者分别服用以上不同的避孕药,并依次在用药前、用药期间及停药后采空腹静脉血,观察血清中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A Ⅰ(apo A Ⅰ)、载脂蛋白AⅡ(apo AⅡ)、载脂蛋白B(apo B)水平变化及TC/HDL-C、apo A Ⅰ/apo B比值改变。共观察1665个周期。结果显示,以上7种避孕药均有升高或降低某些脂质水平的作用,但停药后均能恢复,而且无论在用药期间或停药后,以上两项比值无显著改变。结果提示短期服用以上7种避孕药(一年内),对脂代谢无不良影响,并发现由于各种甾体激素类避孕药的配伍各异,因而产生的生物活性不同,对人体脂代谢的影响亦不一致。因此建议如能交替使用不同种类的避孕药,也许可减少长期服药者副作用的发生。

The study evaluated that the effects of seven steroid hormone contraceptives (SHCs)on lipids metabolism in Chinese women during the last decade. A total of 167 healthy volunteers who needs contraception were enrolled in the study and administrated one of seven preparations. Each subject was taken fasting serum samples before, during and after the treatment respectively. The serum paraneters was measured, which included triglycerides (TG) .total cholesterol(TC),High density lipoprotein-cholesterol (HDL-c) , Low density lipoprotein-cholesterol (LDL-c) , apolipoproteins A Ⅰ ,A Ⅱ and B. The changes of ratios TC/HDL-c, apo A I /apo B were also observed. The result shows that the levels of lipids had been either increased or decreased by any one of seven preparations, and would be recovered after the discontinuation of the treatment. There were no significant changes in ratios during the treatment. The result suggests that there is no obvious impact on the lipids profile during the use of any one of seven different kinds of contraceptives within one year. Any minor effects of the metabolism could be reduced by alternatively using two kinds of contraceptives with different biological activity.