5%米诺地尔联合口服抗雄药物治疗雄激素性秃发早期脱发现象的初步探讨

Preliminary analysis of hair loss caused by early treatment of androgenetic alopecia with 5%minoxidil and oral antiandrogens

目的:探讨5%米诺地尔联合口服抗雄药物治疗雄激素性秃发(AGA)早期的脱发现象,观察16周内头发脱落数量及特征。方法:收集AGA患者治疗期间(1~16周)脱发量数据,探究脱发量的变化特点。结果:67例AGA患者使用药物后,第2~8周脱发量相对第1周(基线)均明显增加(P<0.05);且分别与第1周和第2周比较,第3周均呈现出脱发量明显增加的情况(P<0.05),由此将脱发量变化百分比>68.22%(第3周脱发量变化百分比的均值)的情况定义为“脱发明显”。据此将患者分为脱发明显组39例(58.21%)和非脱发明显组28例(41.79%)。脱发明显组中,患者脱发量明显增加发生于第3~5周,随后第12周降至基线水平。脱发明显组中脱发量的时间变化、严重程度在男女中差异均无统计学意义(P>0.05),仅20.51%患者每周脱发量变化百分比中的最大数值(简称为最大百分比)较第1周>3倍。结论:“脱发明显”多发生于AGA患者用药后第3~5周,约于第12周降至第1周水平,持续时间短且男女间无明显差别。“脱发明显”是药物作用的一种表现,也预示着毛囊可能由休止期转入生长期的正常过程。

Objective:We analyzed early hair loss in androgenetic alopecia treated with 5%minoxidil and oral antiandrogens,and investigated the characteristics of the"hair loss exacerbation".Methods:An observational study was performed based on the amount and characteristics of hair loss in androgenetic alopecia patients during the treatment period(1-16 weeks).Results:In 67 patients with androgenetic alopecia,the amount of hair loss at week 2-8 was significantly increased compared with that at week 1(baseline)(P<0.05).At the third week,the hair loss showed a significant increase,compared with that at week 1(baseline)(P<0.05),thus a condition when the hair loss in a certain period was greater than the average in the third week was defined"hair loss exacerbation".Then,58.21%(39 individuals)were found to have"hair loss exacerbation".This condition occurred mainly during weeks 3-5,and then,the hair loss dropped to the baseline level at around week 12.There was no significant difference between men and women(P>0.05).In only 20.51%of the total patients,the maximum hair loss was more than 3 times of that at baseline.Conclusions:"Hair loss exacerbation"mainly occurs at the 3 rd-5 th week after the medication and then dropped to the baseline level at about the 12th week.Its duration is short and there is no significant difference between men and women."Hair loss exacerbation"is a manifestation of the effect of drugs,and may indicate the normal process of hair follicles transitioning from telogen to anagen.