| 摘要: |
| 目的:观察血清睾酮水平正常的青少年男性痤疮患者的性激素水平变化,评价非那雄胺抗雄激素治疗对性激素水平的影响及临床疗效。方法:血清睾酮水平正常的青少年男性痤疮患者共40例,随机均分为治疗组、对照组(n=20),分别采用非那雄胺联合生活方式干预以及单纯生活方式干预两种方法进行对比治疗,比较两组治疗前后临床疗效,观察治疗前后血清总睾酮(testosterone,T)、双氢睾酮(dihydrotestosterone,DHT)、游离睾酮(FT)、性激素结合球蛋白(SHBG)、雌二醇(E2)水平的变化及不良反应,观察治疗组停药3个月后疗效变化。另选健康青少年男性40例为正常组,比较其与痤疮患者基线水平情况及激素水平的差异。结果:血清睾酮水平正常的青少年男性痤疮患者体脂含量、E2水平高于正常组(P<0.05),DHT、FT水平高于正常组(P<0.01),SHBG水平低于正常组(P<0.05)。治疗组总有效率(90%)明显高于对照组(25%),差异有统计学意义(P<0.01)；治疗组停药3个月后有效率为85%。与治疗前相比,治疗组治疗后血清DHT水平明显下降(P<0.01)、FT水平下降(P<0.05),SHBG水平上升(P<0.05)；治疗组及对照组均无严重不良反应发生。结论:血清睾酮水平正常的青少年男性痤疮患者具有体脂含量、DHT、FT、E2水平高,SHBG水平低的特点；应用非那雄胺联合生活方式干预治疗此类患者临床疗效确切,可显著改善性激素水平,且不良反应少,停药后复发率低。 |
| 关键词: 睾酮 寻常痤疮 性腺激素类 雄激素拮抗药 |
| DOI：10.3724/SP.J.1008.2009.01131 |
| 投稿时间：2009-05-05修订日期：2009-07-05 |
| 基金项目: |
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| Changes of sex hormone levels in male acne patients with normal serum testosterone and effect of antiandrogen therapy |
| JIN Xin-ye,DING Wei,HU Xue,WANG Jia,ZOU Da-jin* |
| (Department of Endocrinology,Changhai Hospital,Second Military Medical University,Shanghai 200433,China) |
| Abstract: |
| Objective:To observe the sex hormone levels in adolescent male acne patients with normal serum testosterone,and to evaluate the curative effect of antiandrogen therapy.Methods:Totally 40 adolescent male acne patients with normal serum testosterone were evenly randomized into two groups:the treatment group received finasteride plus life-style intervention,and the control group received life-style intervention only.The curative effects were compared between the two groups,and the levels of serum testosterone,dihydrotestosterone (DHT),free testosterone (FT),sex hormone binding globulin (SHBG) ,and estradiol (E2),and the adverse effects were observed before and after treatment.The curative effects in the treatment group were also observed 3 months after drug withdrawal.Another 40 healthy adolescent males served as normal group for comparison of the baseline hormone levels with ance patients.Results:The patients in our group had significantly higher levels of body fat content,E2 (P<0.05),DHT,and FT (P<0.01),and lower level of SHBG(P<0.05) compared with those in the normal control group.The overall effective rate of the treatment group was 90%,which was significantly higher than that of the control group ( 25%,P<0.01); the effective rate of the treatment group was 85% 3 months after drug withdrawal.The levels of DHT (P<0.01) and FT(P<0.05) in the treatment group were significantly decreased and the levels of SHBG was significantly increased (P<0.05) after treatment.There were no severe adverse effects in both groups.Conclusion:The adolescent male acne patients with normal serum testosterone have higher body fat content,DHT,FT,E2 and lower SHBF levels.The therapy using finasteride plus life-style is effective; it can greatly improve the serum level of SHBF and reduce adverse effects,with low recurrent rate after drug withdrawal. |
| Key words: testosterone acne vulgaris gonadal hormones androgen antagonists |
