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韓國婦人의 經口避姙藥服用과 肝吸蟲感染間의 相互作用에 關한 疫學的 硏究

An Epidemiological Study on the Interactions of A Hormonal Contraceptive and Liver Fluke Infection in Korean Women

대한보건협회지 1978년 4권 2호 p.31 ~ 38
김응익,
소속 상세정보
김응익 (  ) - 서울대학교 의과대학 인구의학연구소

Abstract


Oral contraceptives are one of the most frequently used methods for fertility regulation throughout the world today. There have been many studies demonstrating often significant effects of these steroid agents on clinical conditions and metabolism. Also studies on the interactions of oral contraceptives with endemic diseases -and drugs have recently done by some investigators.
This study was carried out with the specific purpose of determining the effects of the combined oral contraceptive, Norinyl, on liver functioning in women infected with the liver fluke, Clonorchis sinensis.
The study area was Kimhae County of Kyungsang Nam Do, an area free of liver fluke transmission but an area involved with the Seoul National University Community Health Program.
The study design was done in such a way that a similar number of family planning acceptors were voluntarily recruited into four groups. Women positive and negative for fluke infection who chose to start on the pill or on the IUD comprised the four study groups.
The study subjects were carefully screened according to the information obtained in initial background interviews and initial stool and venous blood collections. All women continuing to use the contraceptive were followed for 12 months after acceptance. Follow-up interview information and blood specimens were obtained at 12 months and all relevant information on the women´s health was ascertained at these times as well as physician referral being always available if needed.
Liver fluke-negative persons were defined as those women who had three consecutive stool examinations (OY concentration method) which showed´ no liver fluke eggs. The blood special means collected were centrifuged locally and the sera were periodically sent to Seoul from the study sites and tested in the Reproduction Laboratory, The Institute of Reproductive Medicine and Population, College of Medicine, Seoul National University, using standardized automated methods.- The sera were tested for SCOT, SGPT, bilirubin,--alkaline phosphates, albumin, total protein and cholesterol.
A total of 166 women had satisfactory follow-up results- through 12 months of contraceptive usage and their results are being carefully scrutinized and following results were obtained:
1. The effect of combined oral contraceptive on liver function in-group infected with liver flukes was not observed, but in the case of serum cholesterol, the effect of oral contraceptive was higher in liver fluke positive group as compared to negative group.
2. The changes of total protein and albumin were not observed in oral contraceptive groups. -
3. In oral contraceptive groups, serum_ GOT was significantly increased,
4. No significant effects of oral contraceptive and IUD on serum GPT, alkaline. phosphates and total bilirubin in all groups.
5. Serum cholesterol was significantly increased in all groups and higher in oral contraceptive group as compared to IUD group.

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