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目的:探讨复方口服避孕药(combined oral contraceptive,COC)对健康绝经前妇女大血管和微血管系统功能的影响。方法:选取2012年1月~2014年1月在该院妇科就诊的健康育龄妇女60名为研究对象。随机分为A组(口服妈富隆)、B组(口服优思明)和C组(不接受任何激素治疗采用其他避孕方法),每组各20例。A、B两组在月经周期第1~21天分别服用妈富隆和优思明,共2周期。服药的受试者在月经周期第5~7天、第24~26天回院复查,C组受试者在月经周期第24~26天回院复查,所有受试者均完成2个月经周期的复查。复查内容包括血流介导的血管扩张(FMD)、激光多普勒离子渗透技术(LDI,包括LDI-Ach和LDI-SNP)和数字化容积脉冲(DVP,包括DVP-Si和DVP-Ri),在不同时段对受试者进行FMD、LDI和DVP的监测。结果:A、B两组在服药期间的FMD和LDI-Ach显著高于非服药期间。A、B两组受试者的FMD在非服药期间与服药期间比较差异有统计学意义(P<0.001)。A组受试者LDI-Ach在非服药期间与服药期间比较,差异有统计学意义(P=0.024);B组受试者LDI-Ach在非服药期间与服药期间比较,差异有统计学意义(P=0.018)。A、B两组受试者LDI-SNP在服药期间与非服药期间的变化与LDI-Ach的变化相似。C组受试者的多个指标包括:FMD、LDI-Ach和LDI-SNP在两次随访检查中均差异无统计学意义。在血管僵硬度方面,A、B两组在服药期间与非服药期间、C组在两次随访检查中DVP-Si和DVP-Ri差异均无统计学意义。结论:妈富隆和优思明可以显著增强大血管和微血管的内皮依赖性血管扩张功能。
Objective: To investigate the effect of combined oral contraceptive (COC) on the function of macrovascular and microvascular in healthy premenopausal women. Methods: Sixty healthy women of childbearing age in gynecology from January 2012 to January 2014 were selected as the research object. Patients were randomly divided into group A (oral Marvelon), group B (oral Yasmin) and group C (other contraceptive methods without any hormonal treatment), with 20 in each group. A, B two groups in the menstrual cycle from 1 to 21 days were taken Marvelon and Yousmin, a total of 2 cycles. Subjects taking medication in the menstrual cycle, 5 to 7 days, 24 to 26 days back to the hospital for review, C subjects in the menstrual cycle 24 to 26 days back to the hospital for review, all subjects completed 2 menstrual cycles Review. Retests included flow-mediated vasodilation (FMD), laser Doppler iontophoresis (LDI) including LDI-Ach and LDI-SNP, and digital volume impulses (DVP including DVP-Si and DVP-Ri) Subjects were monitored for FMD, LDI and DVP at different time points. Results: The frequency of FMD and LDI-Ach in group A and group B were significantly higher than those in group A and group B during non-medication. There was significant difference in FMD between A and B subjects during non-medication and during medication (P <0.001). The LDI-Ach in group A was significantly different from that in group A (P = 0.024) during the period of non-medication and that in group B was statistically significant (P = 0.018). The changes of LDI-SNP in group A and group B were similar to those of LDI-Ach during and after taking medicine. Multiple indicators of group C subjects included: FMD, LDI-Ach, and LDI-SNP had no significant difference between the two visits. In the aspect of vascular stiffness, there was no significant difference in DVP-Si and DVP-Ri between two groups in group A and group B during medication and non-medication. Conclusion: Marvelon and Yousmin can significantly enhance the endothelium-dependent vasodilation of macrophages and microvessels.