长效孕激素炔诺酮庚酸酯及复方18甲基炔诺酮对血清性激素结合球蛋白的影响

Effects of Steroid Contraceptive on Serum Levels of Sex Hormone Binding Globulin in Women

24例妇女肌注炔诺酮庚酸酯200 mg,肌注前血清性激素结合球蛋白(SHBG)为53.32±23.23 nmol╱L。注射后5天为41.99±17.06nmol/L(P<0.05),21天降至最低值14.72±10.01 nmol/L,以后逐渐回升,直至注射后84天仍未回复到原来水平(34.46±20.39 nmol/L)。10例妇女单次口服18甲基炔诺酮6 mg+炔雌醚3 mg,服药前血清SHBG水平为42.76±13.89 n mol/L,服药后7天为62.53±10.90 nmol/L(P<0.01),14天达峰值为71.33±5.77 nmol/L,以后持续此高水平,直至服药后56天;8例连续3次口服18甲+炔雌醚,每次间隔23天,服药前血清SHBG水平为44.94±15.36 nmol/L,第1次服药后9天为83.46±10.08 nmol/L(P<0.01),16天达峰值为91.74±2.28nmol/L,以后持续高水平直至第3次服药后30天,第2、3次重复给药对业已升高的SHBG水平无影明显响。第2、3次服药后LNG峰值明显高于首次服药后峰值6倍。

Twenty-four women of reproductive age received one injection of norethisterone enanthate (NET-EN) 200 mg, the mean premedication level of sex hormone binding globulin (SHBG) being 53.23 + 23.23 nmol/L. On the fifth day after injection it was significantly reduced to 41.99+17.06 nmol/L (P<0.05). Meanwhile, NET level was 10.15+3.71ng/L. Twenty-one days after medication the SHBG reached the lowest value (14.72 + 10.39 nmol/L), then it gradually rose, but still did not recover to the basic level during the study period. Ten women received a single oral dose of 6 mg levonorgestrel (LNG) plus 3 mg quinestrol (CEE). The mean level of SHBG was 42.76+13.89 nmol/L at premedication and rose to 62.53+ 10.90 nmol/L on the seventh day after administration.,P<0.01. The SHBG level reached the peak value of 71.33 + 5.77 nmol/L fourteen days after administration. Thereeafter the high level of SHBG Was sustained until fifty-six days after treatment. Eight women took three doses of 6 mg LNG plus 3 mg CEE at twenty-three days intervals. The mean SHBG level was 44.94+15.36 nmol/L at pretreatment, and increased to 83.46 + 10.08 nmol/L nine days after first medication (P<0.01), then reached 91.74 + 2.28 sixteen days after medication. The 2 nd and 3 rd administrations of LNG and CEE did not enhance the SHBG level further. The peak values of LNG after 2 nd and 3 rd medications were much higher than that after 1st medication. A significant correlation between LNG and SHBG levels was found on the first day of 1st, 2 nd and 3 rd administrations.