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目的:评价连续服用国产低剂量复方18-甲基炔诺酮(复方18-甲)对妇女脂质代谢的影响。方法:对150例连续服用国产低剂量复方18-甲5～25年健康妇女的血清中TG、TC、HDL-C、LDL-C、ApoA1、ApoB、Lp(a)含量用生化法进行测定,同期使用宫内节育器(IUD)的131例妇女作为对照。两组妇女年龄、使用措施时间、体重指数、经济收入等均无显著差异。结果:与对照组比较,服用国产低剂量复方18-甲5～25年妇女血清各项脂质水平均有不同程度的升高,TG、HDL-C和Lp(a)均值显著升高(P<0.05);ApoA1均值极显著升高(P<0.01)。服药时间<15年时,各项脂质水平高于对照组但未达到显著差异;服药时间≥15年时,TG、ApoA1和Lp(a)显著高于对照组,其它指标也高于对照组但无显著差异。结论:复方18-甲对脂代谢有多重影响。复方18-甲在其连续服用15年内因其对TC和LDL-C作用强于HDL-C,尤其服药时间≥15年时,其对血清Lp(a)的显著增高作用提示长期服用国产低剂量复方18-甲可能对心脑血管系统有不利影响。
OBJECTIVE: To evaluate the effects of continuous administration of domestic low-dose 18-norgestrel (compound 18-A) on lipid metabolism in women. Methods: The levels of TG, TC, HDL-C, LDL-C, ApoA1, ApoB and Lp (a) in serum of 150 healthy women with domestic low dose compound 18- 131 women who underwent intrauterine device (IUD) during the same period served as controls. There was no significant difference between the two groups of women in terms of age, duration of use, body mass index, and economic income. Results: Compared with the control group, all the serum levels of lipids in the 18-A to 25-year-old Chinese women taking the domestic low-dose compound increased to different extents, the mean values of TG, HDL-C and Lp (a) <0.05). The mean ApoA1 level was significantly higher (P <0.01). At the age of 15 years, the lipid levels were higher than those of the control group but did not reach significant differences. TG, ApoA1 and Lp (a) were significantly higher than those of the control group But no significant difference. Conclusion: Compound 18-A has multiple effects on lipid metabolism. Compound 18-A had a stronger effect on serum Lp (a) during its 15-year continuous treatment because of its stronger effect on TC and LDL-C than HDL-C, especially when taken for 15 years or more. Compound 18-A may have adverse effects on the cardiovascular system.