哺乳妇女单次注射迪波盖司通~长效避孕针后血清和乳液中MPA浓度变化

目的:探讨中国妇女哺乳期使用迪波盖司通后血清和乳液醋酸甲羟孕酮(MPA)浓度变化。方法:10名产后哺乳妇女单次注射迪波盖司通(含MPA150mg),在注射后的第1、2、4、6、8、10和12周采集血样和乳液样本,用放射免疫方法测定MPA。结果:血清MPA浓度于注射后第1周最高,到第2、4周时下降明显,第4周后浓度下降趋势逐渐缓慢。乳液MPA浓度在第1周为最高,第2周比第1周降低了约1/2,之后10周平均浓度变化波动在5.09-8.15ng/ml之间。观察期间乳液/血清MPA浓度比值和曲线下浓度面积比值均为0.55。对象之间和同一对象不同时间点乳液/血清MPA浓度存在明显个体差异。结论:哺乳期使用迪波盖司通,将导致血液和乳液中含有一定量的MPA。

Concentration Changes of Medroxyprogesterone Acetate in Serum and Milk in Lactating Woman Who Used Depo Geston~

Objective: To determine the concentration changes of medroxyprogesterone acetate (MPA) in serum and milk in the Chinese lactating women who used Depo Geston. Methods: Ten postpartum and breastfeeding women received an injectable contraceptive of Depo Geston (depo medroxyprogesterone acetate, DMPA, 150 mg/ampoule). Serum and milk samples were collected in the 1st, 2nd, 4th, 6th, 8th 10th and 12th week after contraceptive injection. The concentrations of medroxyprogesterone acetate (MPA) in serum and milk were determined by radioimmunoassay. Results: The highest MPA concentration in serum was observed at the 1st week and then the level of serum MPA decreased obviously at the 2nd and 4th week. After the 4th week, the decline of serum MPA level slowed down. The concentration of milk MPA reached the highest level at 1st week. But at the 2nd week the average level of MPA in milk dropped by half. The MPA concentration in the milk was changed in the range of 5.2-8.3 ng/ml in the following 10 weeks. During observation, the average ratios of concentration and area under curve (AUC) in milk/serum were both 0.55. There was a wide variation in MPA concentrations and ratios of milk/serum between subjects. Conclusion: MPA concentrations maintained a certaim level at the 12th week after DMPA injection. However, whether mather's intake of DMPA during feeding period has effect on children's growth, espcially pubertal growth, deserves further studies.